In our clinic Porta Med s.r.o. in Kosice /Viliam Jurasek M.D./ we have been using radiofrequency liposuction since January of this year. Since 1997 we have been using standard tumescent liposuction.
Based on our experience, tumescent method has brought good to very good results. Although there occurred from time to time pain, bruises and also swellings caused by mechanical disruption of fat tissue, vessels, nerves with relatively longer duration for complete recovery. Sometimes there occurred odds and loss of tonus and skin elasticity. On the other hand we have never noticed any inflammation or serum creation. We use Sattler’s, Klein’s or Hunstadt’s technique for tumescent solution.
Another, power assisted liposuction shortens the duration of the treatment and is more comfortable for the surgeon, however, it is more traumatic. In spite gentle technique and suction by ultrasound assisted liposuction the results of skin contracture after the suction are not too visible. Laser liposuction has the disadvantage of small coagulate zones near the fiber endings and especially insufficient control of temperature, which can cause a risk of local burns, insufficient thermal uniformity and quite large untreated areas.
Described problems are in great extent solved by new radiofrequency liposuction. Radiofrequency energy is brought into the subcutaneous fat that is treated by tumescent fluid through handle with two electrodes, /almost the same as by bipolar coagulation./ One is external and one is internal, radiofrequency current runs in between them. The temperature that is created coagulates the fat as desired. At the same time the collagen is modified by final lifting effect of the skin.
Radiofrequency generator is connected to a computer that checks the temperature of the skin, coagulated fat and impedance limits of the tissue. There is set constant maximal temperature of the skin and if it overcomes the limit, the device stops the dosage of radiofrequency current. This function prevents skin overheat and enables to safely keep maximum temperature. The treated areas depend on the length of the internal electrode, which measures 18 cm. The treated area is usually of size 10x15 cm. The effect of thermal lipolysis can be manifested by loss of mechanical resistance of the tissue and completely free movement of the handle. After the treatment there follows standard liposuction. Compared to previous liposuctions it requires smaller under pressure, approximately 0,65 to 0,80 kPa. It is also very fast. The dissolved fat is almost totally liquid.
It is naturally still very early to evaluate results of our first patients. Real results that I gained from two clinics /Germany and Canada/ were overwhelming. At present after liposuction of for example abdominal wall, we would have to do lipectomy because of the abdominal fold. It is not necessary after the new liposuction because of its lifting effect. It is valid also for navel transport into a new position. There might be also the possibility to use smaller handles on face, where the lifting skin effect could replace facelift in indicated patients.
Advantages of radiofrequency liposuction for the surgeon and patient are fast and equal coagulation and therefore fat dissolution on large areas; minimal bleeding and therefore elimination of creation of bruises caused by vessel coagulation and decrease in the aspiration value. Compared to the past I found the biggest advantage in safe skin collagen heating on the preset temperature, which causes better contracture and tightening of the skin. /body tightening effect./