Accent: Radiofrequency to treat flaccidness
Cellulitis has been defined as a vasculopathic skin condition that affects 90% of women and that is usually accompanied by excess body fat and flaccidness.
The physiopathology of cellulitis is composed of several instauration phases: a phase of oedema, in which liquids and aggressive substances leak through the walls of the vessels around adipocytes (or fatty cells). Adipocytes cannot perform their metabolic exchanges properly in this toxic environment an increase in size and become surrounded by conjunctive fibres in the last stages that strangle them. Adipocytes also become surrounded by lymphatic cells incapable of catching toxins. This cascade of reactions closes a vicious circle that retrofeeds itself and in which radiofrequency has found several levels of application.
Flaccidness is defined as a skin dysfunction proper of the natural or accelerated aging process. Initially, there is a decrease in cell metabolism and flaccidness appears as a result of the biosynthesis of collagen and elastine. The number of fibroblasts decreases and the skin looses its tropism loosing its capacity to undergo its natural exchange processes, which in turn leads to a poorer skin quality. The network of collagen and elastine that is attached to the dermal papillas and underlying tissues gives the skin its support structure. Failure of this complex organic structure (collagen, elastine and fundamental substance) mechanically detaches the skin from the epidermis and dermis.
Radiofrequency produces a deep heating effect that affects the skin and the subcutaneous fat tissue. Such heating favours lymphatic drainage, decreasing the amount of liquids and toxins in which the adipocytes of cellulitis-affected tissue are embedded. At the same time, there will be increased circulation in the area thereby improving the metabolism of subcutaneous fat tissue and the appearance of the accompanying skin. Lastly, and most importantly, radiofrequency prompts the formation of new collagen, both in the skin as well as in the subcutaneous tissue, allowing the tissues to become firmer thanks to the rearrangement of fibrous septa and the thickening of the overlying dermis. This decrease in volume is caused by a reduction of oedema and by the compaction that takes place through the connective tissue. A hypothesis involving the role of a third mechanism in which the rupture or lysis of the membrane that surrounds fat cells would occur contributing to this reduction of volume, is yet to be demonstrated.
Treatment duration can vary depending on the area to be treated. Small areas such as arms or abdomen are usually treated in 25 to 30 minutes; larger areas such as trochanters (saddlebags) can extend to 45-50 minutes per session. The procedure is simple. Prior to the session, the area is marked using a template and a surgical marker pen. Subsequently, aromatic oil is rub onto clean skin and the energy is delivered. The delivery of energy is carried out by means of a treatment head that is constantly moved over the skin’s surface. About three passes are usually necessary per template until a sufficient temperature is reached, capable of causing the previously mentioned changes. Once the session is completed, aloe vera gel is applied in the treated areas and the patient can return to his or her normal activity immediately after the procedure. Sun exposure and UVA should be avoided for the next 24 to 48 hours.
The number of session can vary, although a minimum of 8 to 12 are considered to be necessary at a one week interval. Results can be observed after the second or third month. It is normal, though, for patients to notice a slight improvement during the first days after the session, due in part to the contraction of initial collagen and in part due to a small inflammatory reaction caused by the aggressiveness of the procedure that will disappear in 3 to 4 days. The procedure is well tolerated and anaesthesia is not required.
There is a sensation of heat and people with painful cellulitis may experience some pain due to friction with the treatment head in certain areas. Side effects are: reddening and oedema after the session (these side effects are rare and transitory) and some small ecchymosis in areas of capillary fragility (not frequent). Treatment is contraindicated in pregnancy, breastfeeding, pacemaker carriers, metallic prosthesis carriers, as well as those patients suffering from severe cardiac conditions and diseases of the connective tissue and neuromuscular diseases. Overweight patients are not good candidates either.
In synthesis, RADIOFREQUENCY can be considered a new therapeutic alternative for the treatment of cellulitis and body flaccidness. The method consists in a deep and controlled heating that affects the skin and subcutaneous cell tissue provoking a cascade of reactions that involve collagenesis (firming up the skin and fibrous septa), draining fat from the lymphatic ecstasy, improving skin circulation and subcutaneous tissue, with the consequent decrease of the unflattering orange skin peel. The technique improves flaccidness and achieves a volumetric reduction of the treated area. We should not forget that these two diseases are rather complex and that the association of other techniques usually afford the best results.