PEER-REVIEW | DERMAL REJUVENATION | Figure 1 Radiofrequency technology comparison
A Monopolar configuration Energy is dispersed through the skin to the whole body, requiring intensive cooling to prevent epidermal damage (blue electrode).
B Bipolar configuration Energy flows superficially between the electrodes, cooling is needed to prevent overheating of the epidermis in the contact areas.
C Non-ablative 3DEEP configuration with phase-controlled electrodes (Green/red electrodes denote electrical polarity) Energy is mostly focused into the dermis and hypodermis, hence no cooling is needed.
systems that use one RF electrode require a higher
level of user expertise owing to the higher energy density on the electrode4, 5
. The use of this type of system is
frequently associated with pain and requires intense active cooling to protect the epidermis. Furthermore, much of the energy is being wasted, as the energy flows uncontrolled throughout the body6, 7
. The use of bipolar
(second generation RF) or multipolar RF (third generation RF) has been limited because of the superficial nature of energy flow between the two or more bipolar electrodes connected to a single RF generator8
. Despite high expectations, the
improvements offered by first, second, and third generation RF systems are usually limited, owing to the small volume of dermal heat produced9
. A new generation of RF technology (fourth generation)
uses multiple RF generators for optimal control of the thermal effect. A multisource RF therapy system
A new generation of RF technology (fourth
generation) uses multiple RF generators for optimal control of the thermal effect.
(EndyMed Pro, EndyMed Medical, Caesarea, Israel) allows a volumetric, homogeneous, targeted, and controlled dermal heating for non-ablative RF treatments. The Food and Drug Administration (FDA)-cleared EndyMed Pro, powered by 3DEEP technology, has six RF generators that enable full control of the phase of the current flowing between each pair of electrodes. The multiple electrical fields created repel/attract each other, providing the ideal combination of energy directed to a deeper skin layer with minimal surface heating. The repelling forces between adjacent electromagnetic fields drive energy vertically into the target tissue, reducing the amount of energy flowing through the skin surface. In addition, the multiple generators enable better distribution of the energy on the
electrodes, reducing the energy density on each electrode, which in turn makes the treatment more comfortable and safe for the patient. The comparison between the different RF modalities is schematically represented in Figure 1. In the current study, the author tested a new treatment
protocol for full-face non-ablative skin tightening. The treatment was performed using the EndyMed Pro multisource RF system. The system forces the energy to penetrate into the deep dermis, causing a non-ablative deep dermal heating effect that results in painless skin tightening.
Figure 2 Thermal imaging (ThermaCAM SC 640, FLIR Systems) of bipolar radiofrequency pulse (A) and 3DEEP radiofrequency pulse (B). In both cases, the same energy and pulse duration were used. The comparison shows superficial flow of energy with the bipolar technology, while with the 3DEEP technology a much deeper penetration can be seen. This advantage enables the 3DEEP technology to reduce risks for epidermis and increase efficacy in the deep dermis
80 ❚ March 2013 |
prime-journal.com
Materials and methods A total of 30 patients (all female, aged 38–76 years, average age 55.96 years) were treated using the EndyMed Pro 3DEEP system. The patients were randomly recruited to the study after
they had been given a thorough
evaluation and had expressed an interest in joining the study ® only after fulfilling the inclusion criteria. The
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