1. Please be Seated

2. Radiofrequency Dr. Enas Abu Taleb Lecturer Basic Science Department 2013

4. Contents: What is obesity? What is Radiofreuency? Properties of Radiofrequency. Mechanism of action of radiofrequency. Technical advantage of radiofrequency. Practical application of radiofrequency.

5. Obesity Is fatness in the body, especially caused by too much accumulation of triglyceride and where a person's body mass index (BMI) is 30 or greater. body mass index BMI (Kg /m²)= weight (Kg) Height (m²) N.B: -Normal BMI ranges from 18 to 25. -Overweight people have a BMI from 26 to 30 - BMI of 30 and above = morbidity obese

6. Obesity (cont…) - Usually, aging and obesity = by laxity of the skin ( skin that was once full and firm begins to sag, developing laxity and redundancy). -Traditionally, a surgical procedure was the treatment of this laxity but, technological advances have shifted the treatments toward nonsurgical alternatives in place of plastic surgery because of its efficacy and markedly reduced downtime and complication rate. -Of particular interest has been the development of the nonsurgical techniques for areas of loose skin on the posterior upper arms and around the knees, sites of concern particularly for many women.

7. Obesity (cont…) - Certain devices as radiofrequency (RF) and broadband light sources, have demonstrated utility for tightening and nonsurgical contouring of mild to moderate skin laxity in these regions.

8. Body Contouring - Body contouring is a general term that refers to any surgical procedure that alters different areas of the body, whether it is in a massive weight loss patient or not. -Body contouring after massive weight loss refers to a series of procedures that eliminate and/or reduce excess skin and fat that remains after obese individuals lose a significant amount of weight, in a variety of places including the torso, upper arms, chest, and thighs.

9. Radiofrequency (RF) - is electromagnetic radiation in the range of 3–300 GHz which corresponds to the frequency of radio waves, and the alternating currents which carry radio signals.frequencyradio waves alternating currents -RF is nonablative modality for the treatment of unwanted structural changes i.e. body contouring and the treatment of mild to moderate laxity on the arms and legs. -Rf produces directed delivery of energy to deep dermal tissue, inducing collagen contraction and dermal remodeling eventuating in neocollagenesis.

10. Types of collagen tissue in the subcutaneous space: Dermis: papillary and reticular Fascia: relatively thick layer of connective tissue located between muscles and skin Septal connective tissue: thin layers of connective tissue separating lobules of fat and connecting dermis with fascia Reticular fibers: framework of single collagen fibers encasing fat cells

11. Skin layers and its components

12. Properties of RF 1. RF current doesn’t penetrate deeply into electrical conductors but flows along their surfaces; known as the skin effect so, when the human body is in contact with high power RF currents it can cause superficial but serious burns called RF burns.skin effect 2. RF current can easily ionize air, creating a conductive path through it. This property is exploited by "high frequency" units used in electric arc welding, which use currents at higher frequencies than power distribution uses.arc welding 3. RF has the ability to flow through paths that contain insulating material, like the dielectric insulator of a capacitor. When conducted by an ordinary electric cable, RF current has a tendency to reflect from discontinuities in the cable such as connectors and travel back down the cable toward the source, causing a condition called standing waves, so RF current must be carried by specialized types of cable called transmission line.dielectricstanding waves transmission line

13. Work Theory of Radiofrequency - RF energy is produced by an electrical current. -RF energy produces a thermal effect when its high-frequency electrical current flows through target skin and encounters tissue of high impedance in the deep dermis and subcutaneous fat. -These properties allow RF to circumvent energy scatter and absorption by epidermal pigment and therefore, generate significant thermal energy within deeper tissue layers. This three-dimensional (3D) volumetric heating of the deep dermis leads to collagen denaturation, remodeling, and tissue contraction. -Ultimately, these effects lead to improvement in skin laxity without alteration of the superficial portions of skin

14. Mechanism of Action of RF

15. -RF devices have one of two different electrode configurations – monopolar or bipolar. -Monopolar devices have two electrodes, one that emits the RF energy and a second dispersive electrode that serves as a grounding pad. -Monopolar devices are characterized by high power density and relatively deep penetration. In contrast, bipolar devices have two identical electrodes set at a short, fixed distance. Electrical current flow is restricted to this small distance, resulting in a more controlled current distribution, but significantly less depth of power penetration.

16. (a) monopolar & bipolar, (b) monopolar & tripolar RF electrodes

17. Difference between tripolar, bipolar and monopolar RF is as follows: -Monopolar RF heats tissue in the treated area rather deeply (usually up to 20 mm) and thus affects both the skin and subcutaneous fat. -Bipolar RF heats tissue in the treated area less deeply (usually up to 2-4 mm) and thus primarily affects the skin. The patterns of energy distribution also differ. Combination of monopolar+bipolar devices reduces the required intensity of each and thus minimize side effects and possibly increase effectiveness. -While Multipolar combines the electrodes for the monopolar and bipolar RF application in the same hand piece.

18. Effect of multipolar RF on the abdomen.

19. Technical Advantages of RF 1. Suitable for all kinds of skin. 2. Comfortable and painless. 3. Free operation, non-anaesthetic. 4. No ruggedness. 5. No bleeding, tumidness and bruise. 6. No side effects and rebounding phenomenon. 7. Woundless 8. Easy operation, easy study. 9. Non- exhaustion, low cost investment and quick high returns.

20. Applying radiofrequency to the face

21. Skin contraction during RF energy delivery at different time

23. Before, during and after RF effect on the skin

24. The End See you Next with “Augmentation of Muscle Strength”