- Department of Plastic Surgery
Department of Plastic Surgery » - Radiofrequency liposculpture BODY TITE
The BODY TITE device has made body contouring surgery less invasive and expanded the possibilities of aesthetic procedures by combining radiofrequency burning of excess fat with skin tightening and anti-cellulite techniques. Surgeons use RF liposuction as an independent technique, and also complement classical liposuction and other plastic surgeries with it.
— So the device is bipolar?
- Absolutely right. This is a certain guarantee of its safety. The energy does not go beyond the area between the two electrodes (skin fold). Many people are aware of the controversy surrounding the Thermage procedure, which uses a monopolar principle of energy delivery. In this case, the energy from the nozzle spreads downward and cannot be controlled. Therefore, when performing Thermage, certain contraindications must be taken into account: the risks of fibrosis, the presence of tumor-like processes (for example, fibroids when treating the abdominal area). Although the manufacturers claim that the heating is local, and theoretically I agree with this, in practice my hand does not rise. When using Body Tite
heat does not spread downwards, it is concentrated only in the affected area. This is a fundamentally important point, the know-how of this technique.
Impact zones
Specialists at the RAMI clinic use attachments for radiofrequency liposculpture of the face and body.
The FACE TITE attachment has become an indispensable tool for an aesthetic plastic surgeon to non-surgically achieve a lifting effect in various areas of the face - on the cheeks, forehead, chin, and neck.
With the BODY TITE attachment, the plastic surgeon works on problem areas of the body - knees, inner arms, intimate area, chest, décolleté, buttocks.
An appropriate cannula of the appropriate size is applied to each zone.
— The advantage of liposuction using the Body Tite device is precisely the lifting effect?
- Not only. In my opinion, there are several such advantages.
Firstly, exposure to radio waves has a lipolytic effect. As you know, current always passes along the path of least resistance. In the body, water-containing structures and connective tissues have the least resistance. Fat itself does not allow current to pass through, but being in the temperature zone, it heats up. As a result, the fat cells “melt.” Some of them are removed by suction, and some are eliminated through the excretory organs, including the liver and kidneys. The body itself cannot remove a lot of fat. Therefore, for large volumes, it is recommended to remove part of the adipose tissue directly during surgery. The main thing at this stage is not to get carried away, not to “clean out” fat as much as possible. Adipose tissue is involved in skin regeneration processes, and removing it in large volumes can lead to unevenness, fibrosis and other problems.
Another advantage: radio waves coagulate blood vessels. The radiofrequency technique used for coagulation of blood vessels is essentially an analogue of classical electrocoagulation. This allows not only to reduce the number of hematomas, but also to avoid complications such as seromas.
It is very important, in my opinion, that when using RF energy, microcirculatory restoration of the skin occurs according to the normal type - that is, it is complete. After all, as you know, the health and youth of the skin depend on good blood supply and nutrition.
And finally, RF energy provides an excellent lifting effect. With classic liposuction, fat removal in certain places (chin, knees, etc.) or in older age often leads to sagging skin.
How does the procedure work?
A radiofrequency liposuction session is performed under local anesthesia and therefore does not cause pain or discomfort to the patient. The intervention usually lasts no more than one and a half hours.
The nozzle of the device, which works on the face and body, is equipped with two electrodes: the first directs the flow of high-frequency radiation to break down subcutaneous fat from the inside, the second transmits energy through the skin, leveling the microrelief of the skin. Thus, the BODY TITE liposculpture technology provides a triple effect from the procedure: fat burning, skin lifting and cellulite elimination.
— Let's start with the Body Tite procedure...What problems can we solve with its help?
— It helps to remove fat deposits on the inner and outer thighs, inner arms, fat on the front and inner surfaces of the knees, folds on the abdomen, subgluteal folds, flanks around the waist, folds on the back, etc. The procedure is very relevant for men with pseudogynecomastia – excess adipose tissue in the area of the mammary glands. True gynecomastia is an increase in the amount of glandular tissue due to hormonal reasons. The procedure gives excellent results when removing a fatty lump (“widow's hump”) on the back of the neck. Often this problem occurs in thin men and women due to certain constitutional features. In this case, liposuction is also therapeutic in nature. The accumulation of fat in this area, causing compression of the vertebrae, often leads to chronic headaches, local pain in the upper extremities, etc.
Before and after
I would like to pay special attention to working with the area around the knees. Conventional liposuction in this area was often complicated by the fact that the skin did not contract and an unsightly “pocket” of skin hung over the knee. Using RF energy avoids this problem.
Radiofrequency breast lift: awkward questions for the surgeon
Is radiofrequency breast lift safe? And why the same effect cannot be achieved with other surgical methods - answers surgeon and oncologist Vardan Arshakyan.
After reporting about breast lift using the Body Tite device, you have many questions. For some, the result seemed insufficiently noticeable. Others were concerned about how safe the technique was. We collected the most pressing questions and asked them to plastic surgeon, candidate of medical sciences, oncologist-mammologist Vardan Arshakyan.
About the method and its safety
— The Body Tite device is certified. Is the technique for eliminating breast ptosis using it approved?
- Certainly. Only it is not the methods that are certified, but the surgical devices. The areas in which they can be used are determined by the manufacturer. The Body Tite device and its attachments, including Beast Tite, are certified in Russia, which means their safety for use in the mammary glands has been confirmed. In addition, there are 16 FDA approvals (you know, this is the most stringent control and supervision body), 12 from the European Patent Office.
-That is, no method of surgical intervention is certified, be it implantation or abdominoplasty, right?
- Yes. But there are patents. If the technique is unique, that is, no one has used it before, the doctor can assign it to himself. I filed documents for a patent for a technology for correcting breast ptosis. But the Breast Tite lift itself is not unique; it has been practiced in the USA, Latin America and Europe since 2015. My idea is to combine certain operating modes of the device.
— Does RF exposure affect the rate of cell division? Could such exposure in the long term lead to such undesirable consequences as cancer?
— On the one hand, any operation is an injury. And any injury creates conditions for active cell division. Simply because the injury healing process occurs due to the increased formation of connective tissue cells.
But reduction mammoplasty (breast size reduction - Ed.) or breast lift using the classical surgical method are more traumatic techniques than RF. The area of intervention there is much larger. And another question is what effect causes a major concussion on the cells - a scalpel and an electrocoagulator or radiofrequency energy.
However, just because any injury leads to cell division does not mean that this process will fail. The appearance of neoplasms is determined by human DNA. If during conception an error occurs in the genome of the cell, there is such a possibility. Therefore, before any mammoplasty, the patient undergoes many tests. Including the presence of a genetic mutation, which indicates the hereditary nature of the disease.
Six months after the operation, an examination is required. This period is considered a control period in plastic surgery. The result is formed, tissue restoration processes are completed, and if negative consequences arise as a result of the intervention, at this stage they appear. After five, ten or fifteen years, a direct connection between the operation and any disease can no longer be established.
— Why is a device that was originally created for liposuction used in the mammary glands?
— It is wrong to perceive Body Tite as a liposuction device. This is a device for bipolar radio wave exposure. RF energy reduces subcutaneous fat and skin area. This mechanism can be used for different purposes and areas: face, body, chest.
How it works: let's say a girl has suddenly lost weight. The skin cannot contract immediately. The same thing happens in the subcutaneous fat layer of the mammary glands. The fat cell capsules are stretched. There is no adipose tissue inside. There is a pacifier. To shrink it back to normal size, we hit it with RF energy. There are also fibrous bridges (fibrous septa) between the fat cells. They are also being reduced. And significantly – up to 50 percent.
— What area does RF energy spread over? Could she accidentally touch the nipple-areolar complex or the glandular lobules of the mammary gland?
- It can’t, because the energy arises strictly between the two electrodes. And their position is controlled by the surgeon.
Let me draw. The inner cannula with the electrode is inserted – only and exclusively – into the subcutaneous fat layer (SFA). The outer cannula receives energy at the surface of the skin. The radiation goes in a strict direction - from bottom to top. From the inner cannula (IVC) to the upper one (skin surface). It does not walk left and right and does not “fall” down - this would contradict the laws of physics. As a result, targeted heating of soft tissue occurs.
On the left is Body Tite bipolar technology (energy is absorbed by the upper cannula). On the right is another, monopolar (the energy is not received by anything and is dissipated in the tissues).
About the effectiveness of radiofrequency tightening
— Some readers suggested that the effect of breast lift in Olya’s case was achieved through surgical reduction of the areola. At some point, I myself doubted it - what if this was the trick?
- Let's imagine that you are right. We excised a small area inside the areola. Without affecting the surrounding skin. This means that the distance from the upper border of the areola to the collarbone should have remained the same, right? And it decreased: by 3 cm on each side. This is the result of contraction of the upper pole of the mammary glands, and we also worked with the lower one.
-Agree. But have you tried radiofrequency lifting without reducing the areola area?
-Twice. Usually, ptosis is still accompanied by deformation in the size of the areolas. They stretch due to a lack of surrounding tissue, for example, during lactation and weight gain.
In one case, areola reduction was not required. We combined the technique with implantation.
In the other, no additional manipulations were done. I can show the photo only to you. The patient does not give permission for publication on the Internet. (We confirm that the tightening effect is visible. - Ed.) For this reason, I and many other surgeons cannot post a full gallery of works on the site. Not all patients agree to this.
My task as a surgeon is to bring the linear distances that make up the geometry of the mammary glands to the physiological and aesthetic canon. If I see that there are indications for reducing the areola area, I tell the patient about it. But she makes the decision. If she thinks this is unnecessary, the Breast Tite attachment is inserted through small punctures with a diameter of 1.5-2 mm, after which no scars are left at all.
— At the initial consultation, can we assess how much the breasts will rise after surgery?
– The position of the nipple-areolar complex will change by an average of 1.5-2 cm. This is the result of lifting the upper pole of the mammary glands, but the area in the lower quadrants will also decrease (the linear size from the inframammary fold to the nipple). I recommend the technique to those for whom this degree of correction will be sufficient to raise the nipple to the physiologically correct level - the middle of the shoulder.
Radiofrequency lift vs. other methods
— Periareolar mastopexy is also considered a non-traumatic method of lifting. The scar is the same (If compared with RF + reduction in the area of the areola.) And the effect is the same? Better? Why not prefer this method?
— I don’t do this type of lift at all, because I consider it a half-measure. What is a half-measure in surgery: they did something, but it is impossible to say that it became more aesthetically pleasing. I'll explain. In periareolar mastopexy, the nipple-areolar complex is lifted by detachment and excision of the skin flap around it. There is a large circle, and there is a small one. We sew them together.
As a result, the areola may become deformed. Stretch vertically to an oval shape. At the same time, deep tissue mastoptosis does not disappear anywhere. The nipple moves one to one and a half centimeters higher, and the lower pole of the breast still tends downward.
This method is not considered a full facelift and is not popular among surgeons. But sometimes it is combined with breast implantation.
— So, an alternative to RF is a vertical lift?
— There is another problem with vertical lifting. It leads to a lengthening of the distance from the nipple to the inframammary fold plus enlargement and ptosis of the lower pole of the breast. I'm drawing.
Let's say there is grade II ptosis. The distance from the nipple to the fold is 10 centimeters. The surgeon, observing such a picture, suggests implantation and vertical mastopexy.
This is how the cut is made.
To eliminate ptosis, you need to raise the lower edge of the areola to the level of the fold. We raise. Now simple math. The diameter of the areola is added to the distance from the nipple to the fold - 3.5-4 cm. Since we reduced the skin flap only in width. Before the operation, the distance from the nipple to the fold was 10 cm, but now it is 13.5-14 cm. The proportions of the mammary glands have changed.
Now let’s imagine that implantation is carried out simultaneously with the lift. The most protruding part of the implant is removed from its base along the lower curve by an average of 5.5-8 cm, as this corresponds to the natural architecture of the mammary glands. The nipple should be located at the level of this most protruding point. But as a result of vertical mastopexy, it appears higher. (Patients often complain that it peeks out of the bra.) And the implant pulls the already elongated lower pole of the breast down. The shape of the mammary glands is distorted, and in addition, a vertical scar remains for life.
The advantage of a radio frequency device is that it reduces all linear distances - both horizontally and vertically. We have a three-dimensional reduction in all vector directions.
- Now you will say that the anchor lift is also somehow bad, and I, as the owner of problematic breasts, will go hang myself :))
— No, the anchor technique is just effective and works for any initial data, including III degree ptosis and hypermasted breast volume. But, yes, this is an extensive intervention with a long rehabilitation period. Three weeks without showering before the stitches are removed. Sleep in a controlled position. Every three to four days - dressings. And, of course, two scars: vertical from the nipple and horizontal at the level of the fold.
However, keep in mind that they can expand (I have seen cases where the scar tissue was about 2 cm wide). For example, if the lift was accompanied by implantation of large-volume mammoendoprostheses. Or if the patient has gained a lot of weight.
The risk also increases that in the future the lactation process will be difficult or impossible at all. This happens when the ductal system of the mammary glands is injured during surgery. Most often, when a lift is combined with reduction plastic surgery.
Who is suitable for radiofrequency breast lift?
— Let’s summarize, who is RF lifting suitable for?
— Firstly, for girls with a slight degree of ptosis. When lifting the nipple-areolar complex by two (on average) centimeters is enough for it to rise above the inframammary fold.
Secondly, for girls who want to fill their breast volume. They have stretched and flabby skin - but do not want to fill it with overly large implants. Then we work in stages: we reduce the skin and subcutaneous fat. Then we fill this “shirt” with lipofilling or small implants.
I am convinced that every surgical method has its patient. If a person is sure that technology will not help him, there is no need to convince him otherwise. During the consultation, the doctor offers several options for solving the problem. Explains the advantages, disadvantages (each method has them) and shows the results of the work. But it’s up to you to decide what result you want and what you’re willing to sacrifice for it.
Website of surgeon Vardan Arshakyan.
Institute of Plastic Surgery and Cosmetology: Olkhovskaya, 27, tel..
— How much fat can be removed?
— I would like to remind you: liposuction is intended to correct your figure, and not to combat excess weight. The task of our specialists is to remove fat optimally, not maximally. With this technique, we do not get carried away with megaliposuction (three liters of fat or more). Indeed, for the body, such removal of fat is a serious loss, leading to disruption of metabolic processes and the removal of a large number of immunocompetent cells located in soft tissues. As a result, the body's resistance to various, even minor complications is significantly reduced. They can be either immediate or delayed. For example, thromboembolism can be a reaction of the blood coagulation system to severe postoperative trauma or infectious complications. Here is such a cascade of unpleasant reactions.
How Fractora technology works
The Fractora handpiece uses fractional radiofrequency, which is applied to the skin through multiple needle electrodes. The doctor's assortment includes several attachments with different numbers of needle electrodes, with different percentages of coverage, and with different depths of exposure. The doctor’s choice of attachment depends on the problem that needs to be solved and on the anatomical features of the skin. Processing parameters are also selected individually. Radiofrequency exposure to the skin gives the effect of ablation and heating and allows you to obtain a comprehensive result of skin rejuvenation from remodeling, stimulation of collagen and elastin production, ablation of epidermal and dermal tissue:
- smoothing skin texture;
- contour formation;
- strong lifting effect;
- thickening, volumization of the skin;
- elimination of pigmentation, blood vessels;
- smoothing out wrinkles.
— Does radiofrequency-assisted liposuction require rehabilitation?
- Certainly. Any liposuction, no matter how carefully it is done, is accompanied by tissue trauma - swelling, hematomas, damage to nerve endings. We inject the solution - the face swells. We apply heat - this additionally increases swelling.
Then comes the postoperative period. Wearing compression garments is very important here. It is necessary for the formation of a uniform distribution of adipose tissue and tissue fusion. Depending on the location and volume, it is worn from a week to two. The only exception is the Face Tite procedure. But still, the rehabilitation period is shorter than with conventional liposuction.
Recovery
During the first two weeks, wearing compression garments is usually recommended to maintain skin tone and enhance the regeneration process of the upper thin layer of the dermis. To consolidate the effect, hardware cosmetology techniques, massage and other rehabilitation measures can be prescribed - at the doctor’s choice.
