Radiofrequency-assisted Liposuction Research Articles

A Retrospective Analysis of Upper Arm Rejuvenation Surgery in 50 Patients.

Upper arm aesthetics often suffer from aging effects such as skin laxity and sagging due to collagen and elastin depletion. Fat loss, obesity, and weight fluctuations further exacerbate these issues. Existing classification systems for upper arm excess are complex and have practical limitations. The aim of this study was to develop a more concise and clearer classification of upper arm excess that can guide surgical interventions effectively and assess clinical outcomes. Patients undergoing upper arm rejuvenation surgery from January 2020 to January 2023 were categorized as mild, moderate, or severe. Mild cases underwent suction-assisted liposuction (SAL), moderate cases underwent radiofrequency-assisted liposuction combined with SAL, and severe cases underwent brachioplasty combined with SAL. Arm circumferences and BODY-Q questionnaires were collected pre- and postoperatively. The study included 50 female patients, aged 21 to 49 years. The average follow-up time was 7.5 [2.2] months. Arm circumference reduction rates were 6.8% in mild cases, 15.1% in moderate cases, and 17.3% in severe cases. Regarding the BODY-Q questionnaire for upper arms, the average score increased by 0.9 for mild, 2.1 for moderate, and 2.9 for severe cases. Complications were minimal, including 1 seroma and 2 cases of scar widening. The revised classification system for upper arm excess proved effective in guiding surgical decisions. Selecting the surgical approach based on severity resulted in satisfactory outcomes based on BODY-Q scores. This system offers a concise, objective, and practical tool for plastic surgeons.

Is Bipolar Radiofrequency-Assisted Liposuction Equivalent to Open Anterior Platysmaplasty in Facelift Surgery?

BackgroundDuring facelift surgery, anterior platysmaplasty (AP) has been used for decades, but it limits lateral advancement and can induce contour irregularities. Radiofrequency-assisted-liposuction (RF) in the anterior neck can avoid these disadvantages by tightening skin without open surgery. PurposeThe purpose of the study was to compare the esthetic outcomes in facelift surgery with AP and RF. Study designA five-year retrospective cohort study was performed on facelift patients treated by a single surgeon. Exclusions were single-side surgery, previous facelift, chin/lip augmentation/reduction, and inadequate data. Primary predictor variableThe predictor variable was neck management technique (AP vs RF). Outcome variablesThe primary outcome variable was the change in cervicomental-angle (CMA) following surgery as measured on facial photographs. Secondary outcomes included distance changes from the central CMA point in vertical and horizontal planes to repeatable reference planes. CovariatesCovariates were age, BMI, ASA classification, smoking, and simultaneous procedures. AnalysesThe statistical analysis was performed using Wilcoxon sum-rank, Fisher exact, Kruskal-Wallis tests, Pearson’s correlation, and linear regressions. The level of statistical significance was P<.05. ResultsThere were 132 patients included in the study; 67 received AP and 65 received RF. AP trended toward better performance in CMA change in the unadjusted analysis (-18.7° ± 13.8° versus -22.3° ± 13.7°, respectively, P=.08). AP and RF performed similarly in the adjusted analysis (P=.29). Techniques were similar in horizontal distance change to the CMA (P=.31). RF was associated with less change in the vertical distance to the CMA in the unadjusted analysis (-11.9mm ± 11.0mm versus -6.7mm ± 8.7mm, respectively, P=.01) and adjusted analysis (β=4.3mm, 95% CI .8 to 7.9mm, P=.02). ConclusionUtilization of the RF technique for management of the anterior neck in facelift surgery is associated with similar outcomes to the AP technique in horizontal distance to the CMA but, AP performed better in CMA change and vertical distance to the CMA.

Use of Radiofrequency-Assisted Liposuction (BodyTite) for Upper Arms Lifting

BackgroundBody contouring surgery is increasingly requested by patients, both for aesthetic and post-bariatric purposes. There has also been a rapid increase in demand for noninvasive aesthetic treatments. While brachioplasty is burdened by numerous complications and unsatisfactory scars, and conventional liposuction is unsuitable for all patients, nonsurgical arm remodeling performed with radiofrequency-assisted liposuction (RFAL) allows to effectively treat most of patients, regardless of the amount of fat and ptosis of the skin and avoiding surgical excision.MethodsA prospective study was conducted on 120 consecutive patients who presented to the author's private clinic and required upper arm remodeling surgery for aesthetic purposes or after weight loss. Patients were classified according to the modified classification of El Khatib and Teimourian. Pre- and posttreatment upper arm circumferences were taken after 6 months of follow-up to assess the degree of skin retraction obtained by treating the arm with RFAL. A satisfaction questionnaire regarding the appearance of the arms (Body-Q upper arm satisfaction) was administered to all patients before surgery and after 6 months of follow-up.ResultsAll patients were effectively treated with RFAL, and no cases required conversion to brachioplasty. The average reduction in arm circumference was 3.75 cm at 6 months follow-up, and patients’ satisfaction increased from 35 to 87% posttreatment.ConclusionsRadio frequency is a valid tool to treat most patients with upper limbs skin laxity, with significant aesthetic results and a high degree of patient satisfaction, regardless of the degree of skin ptosis and lipodystrophy of the arm.Level of Evidence IVThis journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Nanotechnology and Artificial Intelligence: An Emerging Paradigm for Postoperative Patient Care.

An increasing number of aesthetic surgery procedures are being performed in an ambulatory fashion in office-based settings. Postoperative monitoring of these patients has historically required paid private-duty nurses measuring vital signs, encouraging ambulation, and monitoring overall comfort level. Recently, advancements in nanotechnology have permitted high-acuity data acquisition of multiple clinical parameters that can be transmitted to the surgeon's mobile device in a continuous fashion. The aim of this study was to describe the authors' early experience with this emerging artificial intelligence technology in the postoperative setting. Twenty-three consecutive patients underwent radiofrequency-assisted liposuction and Brazilian butt lift surgery, and were placed in a monitoring garment, SimpleSense (Nanowear Technologies, Brooklyn, NY) postoperatively. The primary outcome was device usability, reflected by compliance with wearing the device and completeness of data collection. During the first 48 hours, 91% of patients wore the device for more than 12 hours per day. Only 39% were compliant with postoperative positioning. No postoperative events were detected. The quality of data collected enables detection of clinical derangements and can alert the surgeon in real time, prompting interventions such as drug administration, position changes, or presentation to the emergency room.

Bipolar Radiofrequency-Assisted Liposuction for Cervical Contouring in Eastern Asians.

East Asian beauty standards uphold a V-shaped face and a long slender neck. Some patients are dissatisfied with the concurrent nonsurgical treatment and prefer limited downtime with minimally invasive procedures to achieve a natural skin-tightening outcome. The authors performed bipolar radiofrequency-assisted liposuction (RFAL) to achieve cervical rejuvenation. To evaluate the efficacy and safety of RFAL for the treatment of cervical skin and soft-tissue laxity in Eastern Asians. In total, 66 patients with neck skin and soft-tissue laxity were treated with bipolar RFAL under tumescent local anesthesia. Further, the surgical outcomes were evaluated based on patient satisfaction score and the Global Aesthetic Improvement Scale (GAIS) score at 6 months postoperatively. Moreover, the incidence of postoperative complications was determined. All patients were followed up for at least 6 months. After RFAL technologies treatment, significant improvement in the neck contour was observed. The average GAIS score was 3.03 (4, very much improved; 3, much improved; 2, improved; 1, no change; and 0, worsened). Approximately 93% of patients were satisfied with the RFAL neck contouring outcome. Notably, no serious complications requiring further intervention were encountered in this series. The described RFAL treatment significantly improved the refinement of neck contouring in Eastern Asian subjects. The simple, minimally invasive cervical procedure under local anesthesia improve the cervical-mental angle definition, tissue-tightening effect, face slimming, and the mandibular line. No serious adverse events except mild complications were reported. This treatment could achieve extraordinary results with a high safety profile.

The Application of Subcutaneous Radiofrequency After Liposuction for the Lower Face and Neck Contouring Under Local Anesthesia.

Radiofrequency-assisted liposuction (RFAL) is a new choice in energy-assisted body-contouring techniques. The purpose of this study is to observe the clinical effect and safety of RFAL on lower face and neck contouring under local anesthesia, and different outcome compared with traditional liposuction. From November 2016 to November 2020, a total of 72 patients with fat accumulation and skin laxity in lower face and neck, including 42 patients underwent subcutaneous radiofrequency after liposuction (group A) and 30 patients underwent traditional liposuction only (group B). The patient's parameters recorded involved age, sex, body mass index, the volume of fat aspirated, energy delivered, operative time, and complications. They were photographed for comparison before and after treatment. At 3 and 6 months after the operation, improvement in skin tightening and patient satisfaction was surveyed postoperatively and assessed by third-party surgeons. At 6 months after the operation, evaluations scores of the contouring outcome had significant difference between 2 groups (3.0±0.9 versus 2.5±1.0, P =0.045). There was no significant difference at 3 months (2.8±1.0 versus 2.6±1.0, P =0.265). Although the satisfaction rate of group A was higher than that of group B both at 3 months (76.2% versus 66.7%) and 6 months (80.9% versus 60.0%), there were no significant differences in average score ( P >0.05). No significant complications or adverse events requiring further medical or surgical intervention after treatment. Subcutaneous radiofrequency after Liposuction is a safe and effective treatment that can achieve significant improvement of the fat accumulation and skin laxity of the lower face and neck under local anesthesia.

Two-stage Radiofrequency-assisted Lipoabdominoplasty.

Summary:Decades of lipoabdominoplasty safety, reliability, and efficacy have permitted more aggressive contouring of the abdominoplasty flap without increased risk for wound healing complications. However, the recent introduction of unrestricted liposuction of all vascular zones and high-definition liposculpting continue to challenge the vascularity of the abdominoplasty flap, particularly in high-risk patients. The present study reviews the authors' approach to abdominal lipodystrophy, and introduces a technique which maximizes fat extraction and skin excision while reducing risk of complication (two-stage radiofrequency-assisted liposuction and abdominoplasty).

Aesthetic Nonexcisional Arm Contouring.

Surgical excision remains the gold-standard therapy for arm skin laxity. However, many patients refuse surgical treatment for fear of the prominent long scars associated with brachioplasty. The objective of the study was to compare the aesthetic outcome of 2 energy-assisted liposuction arm-contouring techniques, radiofrequency-assisted liposuction (RFAL; Group A) and Renuvion helium subdermal coagulation (Group B), with a control group treated with VASER-assisted liposuction (VAL) alone (Group C). This is a randomized controlled study of 176 patients seeking arm contouring, who were treated between February 2017 and December 2020. All of the patients underwent VAL, followed by either RFAL (53 patients, Group A) with the BodyTite RF platform or subdermal coagulation (66 patients, Group B) with the Renuvion platform; 57 patients in the control group (Group C) received VAL alone. Patient data, marking techniques, operative details, complications (and tips and tricks to avoid them), and aesthetic outcomes were recorded and tabulated. Surgical team, third-party, and patient satisfaction surveys were conducted 6 months postoperatively. The study included 176 patients (153 female and 23 male) with a mean age of 32 years (range, 20-59 years). All patients were followed up for a minimum of 6 months. In total, 96 (80.6%) patients reported their satisfaction with the overall technique. An independent plastic surgeon considered the result good to excellent in 97 of 119 cases of the studied group. The umbrella of nonexcisional arm contouring can be extended to include treatment of difficult cases of arm laxity with energy-producing machines. The procedure can achieve a reduction in fat deposits and significant improvements in skin laxity.

Not all Radiofrequency Devices Are Created Equal: A Thermal Assessment.

Not all Radiofrequency Devices Are Created Equal: A Thermal Assessment.

Current status and prospects of clinical application of liposuction

To review the characteristics and deficiencies of various liposuction methods to provide reference for choosing more suitable liposuction in clinic and ideas for the improvement and development of liposuction equipment. The literature related to liposuction in recent years was consulted, and the principle, indications as well as existing problems were reviewed. Liposuction can be divided into two categories according to the principles of fat separation. The first type relies on physical cutting to separate fat, including suction-assisted liposuction (SAL), power-assisted liposuction (PAL), and water-assisted liposuction (WAL). SAL and PAL are simple to operate and low in price, but the effect of liposuction mainly depends on the experience of the surgeon, and complications such as uneven appearance, hematoma, and ecchymosis may occur. WAL saves time and effort, but has lower cost performance. The second type relies on energy destruction to separate fat, including ultrasound-assisted liposuction, laser-assisted liposuction, and radiofrequency-assisted liposuction. This type of surgery has the advantages of less trauma, fast postoperative recovery, and skin tightening. However, the equipment is more expensive, and has a risk of skin burns. Liposuction can effectively reduce local fat accumulation, but it still has limitations. Equipment improvement and fat transplantation are important directions for liposuction's future development.

Upper Airway Obstruction Following Radiofrequency-Assisted Liposuction of the Neck and Lower Face: A Case Report

Upper Airway Obstruction Following Radiofrequency-Assisted Liposuction of the Neck and Lower Face: A Case Report

Second Generation Radiofrequency Body Contouring Device: Safety and Efficacy in 300 Local Anesthesia Liposuction Cases.

Background:Suction-assisted lipectomy has undergone significant improvements in technique, outcomes, and safety. The local anesthetic option has an excellent safety profile, and energy-based modalities such as radiofrequency-assisted liposuction (RFAL) devices were developed to enhance soft-tissue contraction. The purpose of this study was to report a single center’s experience with two surgeons using the second-generation RFAL device compared with the first-generation device in terms of safety and efficacy.Methods:In total, 300 consecutive operations were performed under local anesthesia. Following tumescent injection, the RFAL device was used to heat the skin and underlying collagen network. Subsequently, areas to be contoured were followed with suction-assisted lipectomy to remove excess fat and fluid.Results:An estimated 300 operations were performed on 240 patients in 421 anatomic areas. Treated areas included the face, trunk, and extremities. The average maximum temperatures were 38.6°C externally and 65.6°C internally. The average total and fat aspirate volumes were 1264 and 648 mL. There were no major complications or mortalities, and 3 minor complications treated locally.Conclusions:The data indicated statistically significant lower proportions of major, minor, or cumulative complications compared with the patients who received first-generation RFAL treatment. Major complications were exhibited for 6.25% of the first-generation group and 0% for the second-generation group. The first-generation group exhibited 8.3% minor complications, with 0.7% in the second-generation group. In sum, the data from the second-generation series of RFAL device operations indicate a statistically, as well as clinically, significant reduction in the overall complication rates compared with the first-generation device.

The Efficacy and Safety of Subcutaneous Radiofrequency After Liposuction: A New Application for Face and Neck Skin Tightening.

Minimally invasive or noninvasive skin-tightening procedures have become trends in facial and neck rejuvenation. Radiofrequency-assisted liposuction (RFAL) is a new choice for the treatment of skin relaxation that is more effective than noninvasive surgery without surgical incision. The authors recommend a 2-step method in which radiofrequency is applied after appropriate liposuction is performed. This approach is safer and more effective than traditional RFAL, and the authors detail the safety guidelines, operative techniques, postoperative satisfaction results, and complications. A total of 227 patients with lower face and neck skin laxity underwent RFAL between April 2012 and June 2019. The following data were collected: age, body mass index, operative duration, volume of fat aspirated, amount of energy delivered, and number and type of complications. Patient satisfaction was surveyed postoperatively and assessed by third-party surgeons at 3 and 6 months. At 6 months after operation, 78.8% of patients considered the results moderate to excellent, whereas 21.2% of the patients considered the results to be poor or thought there was no change. The photograph evaluation performed by independent plastic surgeons showed moderate to excellent results in 89.1% of patients. There were no major complications that required further medical or surgical intervention. This 2-step method is a safe and effective improvement in the application of radiofrequency for face and neck skin tightening. Patients can achieve significant contour correction via minimally invasive surgery with a lower risk of side effects.

Soft Tissue Contraction in Body Contouring With Radiofrequency-Assisted Liposuction: A Treatment Gap Solution.

Radiofrequency-assisted liposuction is a relatively new concept in energy-assisted body contouring techniques and has received instrument approval. This supplemental article reviews the clinical application of electromagnetic energy via the BodyTite (InMode Corporation, Toronto, Canada) device on soft tissues during suction lipectomy, its effect on soft tissue contraction, and its use in aesthetic body contouring in various clinical scenarios.

Radiofrequency-assisted Liposuction for Neck and Lower Face Adipodermal Remodeling and Contouring.

Background:The purpose of this study is to report our experience using radiofrequency-assisted liposuction (RFAL) for neck and face contouring. This article details the operative technique, selection, complications, third-party surgeon appraisal, and patient satisfaction survey.Methods:From November 2009 to November 2013, 55 patients who underwent RFAL treatment were enrolled in the study. Postoperative patient satisfaction surveys were conducted, and 2 independent plastic surgeons evaluated contour and skin quality with randomized preoperative and postoperative photographs at 6 months postoperatively. The different parameters recorded involved age, sex, weight, body mass index, operative time, amount of fat aspirated and energy delivered, complications, and aesthetic outcome in 1 and 4 weeks and 3 and 6 months. Our longest follow-up was 4 years. Patients were asked 6 months postoperatively to grade their satisfaction as poor, no change, moderate, good, and excellent.Results:The mean age was 51 years (range, 35–61 years), and the mean amount of fat aspirated was 30 mL (range, 10–200 mL). Five out of 55 patients (9.1%) developed tissue hardness that resolved with massage. All patients were followed up for a minimum of 6 months. Eighty-five percent of patients were satisfied with their contouring result and degree of skin tightening (48/55 patients). Two independent plastic surgeons considered the improvement in contouring and degree of skin tightening good to excellent in 52 of 55 cases.Conclusions:In appropriately selected patients, RFAL neck and face contouring represent a safe procedure to achieve significant improvement of the skin laxity and fat deposits of the cervicomental zone and jowls.

Radiofrequency-Assisted Liposuction Compared with Aggressive Superficial, Subdermal Liposuction of the Arms: A Bilateral Quantitative Comparison.

Background:Liposuction of the arms alone may be inadequate for aesthetic improvement because of skin laxity. Radiofrequency-assisted liposuction (RFAL) and aggressive superficial liposuction (SupL) have been described to stimulate soft tissue retraction to improve results. We compare the techniques and describe a classification scheme that factors skin laxity, skin quality, and Fitzpatrick type to provide treatment recommendations.Methods:Ten consecutive female patients underwent RFAL of 1 arm and SupL on the contralateral arm. All patients had Fitzpatrick skin types of III, IV, or V with an average body mass index of 26.0. Using fluorescent tattooing, key points on the arm skin were measured preoperatively and postoperatively to indicate changes in surface area.Results:There were no complications in the group, and all patients reported satisfaction with the aesthetic results. All patients showed reduction of measured skin surface areas and skin distances postoperatively. At 1 year, the measured surface area reductions on the anterior arms averaged 15.0% for RFAL and 10.9% for SupL on the anterior arm skin. Posteriorly, RFAL showed 13.1% reduction and SupL 8.1% reduction in the surface areas at 1 year. Linear reduction for RFAL averaged 22.6% and 17.8% for SupL 1 year postoperatively anteriorly.Conclusion:Both RFAL and SupL of the arms showed quantifiable and sustained reductions in skin surface. Good contour and soft tissue contraction were achieved with both techniques but RFAL with its safety features presents an alternative to SupL, which has a higher complication rate, risk for contour deformities, and steeper learning curve.

Nonexcisional Tissue Tightening

Background: Recent publications show that heat-mediated tissue tightening is a promising treatment for the lax abdomen and may provide better long-term outcomes than traditional suction-assisted liposuction (SAL). Objectives: The author evaluates the degree and duration of skin surface area contraction, as well as the influence of anatomic location of the treatment region on the degree of tissue tightening, in a study comparing SAL alone vs SAL plus radiofrequency-assisted liposuction (RFAL). Methods: In this prospective, randomized, split abdominal study, 12 consecutive patients were treated with SAL alone on 1 side and with SAL plus RFAL on the other side. Each patient had 4 (3 × 3-cm) squares—2 per treatment type—tattooed in the lower abdominal region (2 on the right and 2 on the left). The surface area of these squares was measured with the Vectra computerized measurement system (Canfield, Inc, Fairfield, New Jersey) at pretreatment, at 6 weeks posttreatment, and at 1 year posttreatment. All measurements were subjected to statistical analysis using predictive analytic software and were evaluated for statistical significance. Results: In regions treated with SAL alone, there was a 10.4% mean skin surface area contraction at 6 weeks and 8.3% at 1 year posttreatment. The mean skin surface area reduction was 25.8% in regions treated with radiofrequency plus SAL at 6 weeks and at 1 year. The anatomic location of each square (medial vs lateral) did not statistically correlate with more or less tissue tightening. Conclusions: Radiofrequency-assisted tissue tightening, when applied in conjunction with SAL, is effective in achieving greater skin surface area reduction. Level of Evidence: 2

Radiofrequency-assisted Liposuction for Arm Contouring: Technique under Local Anesthesia.

Background:Contouring of the arms that does not involve skin excision remains a difficult challenge due to the dependent nature and quality of the skin. Although brachioplasty remains effective, it requires a lengthy incision. Radiofrequency-assisted liposuction (RFAL) may improve skin retraction with a satisfactory aesthetic result without skin resection and the resultant scar. The purpose of this study is to present our experience of RFAL arm contouring under local anesthesia, detailing safety guidelines, the marking technique, operative technique, complications, third-party surgeon appraisal, and patient satisfaction survey.Methods:Forty patients underwent RFAL under local tumescent anesthesia for aesthetic arm contouring. Postoperative patient satisfaction surveys were conducted and independent third-party surgeons were surveyed to assess improvements in contour and skin quality with preoperative and postoperative photographs.Results:Complications included 1 burn near the elbow treated successfully with local wound care and 1 seroma that resolved with aspiration. The patient survey indicated that most patients had minimal or no discomfort with the injection of local anesthesia, application of radiofrequency energy, or aspiration of fat. The majority of patients were satisfied with their contouring result and degree of skin tightening. Third-party plastic surgeons found the improvement in contouring and degree of skin tightening good to excellent.Conclusions:In appropriately selected patients, RFAL arm contouring under local anesthesia represents an alternative procedure with acceptably low morbidity and high patient satisfaction. To achieve consistent results while minimizing complications, consideration to anatomic details, infiltration of the local anesthetic, and application of the radiofrequency energy must be given.

Treatment of Overweight Patients by Radiofrequency-Assisted Liposuction (RFAL) for Aesthetic Reshaping and Skin Tightening

Treatment of Overweight Patients by Radiofrequency-Assisted Liposuction (RFAL) for Aesthetic Reshaping and Skin Tightening

Improving Outcomes in Upper Arm Liposuction: Adding Radiofrequency-Assisted Liposuction to Induce Skin Contraction

Improving Outcomes in Upper Arm Liposuction: Adding Radiofrequency-Assisted Liposuction to Induce Skin Contraction