**2.3 What are the BodyTite and RFAL specifications?**

BodyTite is the RFAL (Radiofrequency assisted Lipo-coagulation or Liposuction) applicator used for lipo-coagulation and Suction Assisted Lipoplasty of moderate to larger sized patients. And is powered by the BodyTite Workstation (**Figure 3**). The BodyTite 2.4 mm diameter applicator has an internal electrode that is silicone coated, silastic capped and 2.4 mm in diameter and 17 cm long. In international (in non-USA markets) there is also a BodyTite 3.9 mm diameter internal electrode, with a 25 cm applicator, which shares the exact same thermal and monitored safety features as the 2.4 mm RFAL applicator. The FaceTite is a 1.2 mm internal electrode that is 12 cm long. The Facetite external electrode is proportionately much larger in diameter than the BodyTite 2.4 mm applicator. The smaller RFAL BodyTite applicator external electrode geometry means the power density and RF skin heating capability is much more efficient than the FaceTite (**Figure 4**).

The BodyTite workshop station can emit up to 70 W of energy and this is more than enough for large volume lipo-contouring patients because of the much higher power density of the smaller 2.4 mm RFAL external electrode. 120 seconds of continuous treatment time is allotted before having to double click the foot pedal. The surgeon does not enter the fluence, rather the machine delivers only the amount of RF energy needed to ensure the rate of rise of tissue temperature is <20 degrees Celsius/cm3/second.

#### **Figure 4.**

*The BodyTite external electrode (top) is much smaller than the FaceTite (bottom), with a larger internal RF emitting electrode (2.4 mm vs. 1.2 mm) and this creates a much stronger power density and coagulation for at the same wattage. Up to 70 W of energy will be emitted automatically, as much as is required (raising and lowering automatically) depending up the rate of rise of adipose tissue.*

*Internal and External Radiofrequency Assisted Lipo-Coagulation (RFAL) in the Control of Soft… DOI: http://dx.doi.org/10.5772/intechopen.97378*

Unlike the FaceTite, where the distance between the internal and external electrode is controlled simply by pinching the proximal hand piece, which brings the two electrodes closer together to achieve the desired inter-electrode distance, with the BodyTite RFAL hand pieces there is electrode dial to set the desired interelectrode distance. With the BodyTite, there is an actual dial on the hand piece that controls and fixes the distance between the electrodes. There is a relative scale for the inter-electrode distance (**Figure 5**).

Practically speaking, each number on the Inter-electrode distance dial, corresponds to the number of centimeters between the external and internal electrode (**Figure 6**).


The high tech, industry leading thermal, high and low impedance, contact sensed, and TSP safety features are the same for the BodyTite as for the FaceTite. The internal electrode is silicone coated with silastic, bullet shaped cap on the end and has thermistor temperature-controlled RF release and adjustable cut off temperatures as high as 70 degrees Celsius. The External electrode houses the contact sensor, external skin thermistor for continuous temperature-controlled skin temperature monitoring, with cut offs ranging from 36 degrees – 42 degrees Celsius, high and low impedance sensor and finally, the Temperature Surge Protection sensor (**Figure 7**).

**Figure 5.**

*On the BodyTite RFAL handpieces, there is an inter-electrode distance control dial, numbered 1–6, which determines the distance between the internal and external electrode.*

#### **Figure 6.**

*The dial has settings numbered 1 through 6. Below is the practical inter-electrode distance for each level on the BodyTite dial.*

#### **Figure 7.**

*BodyTite handpiece. RF flows from the internal electrode, where the temperatures a very strong and coagulative, with FSN contraction and adipose liquefaction, to the external electrode where the temperature is more moderate and the effect is a non-ablative heating, remodeling and tightening of the papillary and reticular dermis.*

Over the past 10 years, through constant RnD and innovation, InMode has delivered to the marketplace and its physician users increasingly smaller and smaller, more elegant RFAL handpieces, culminating the in the AccuTite (and Aviva on the

*Internal and External Radiofrequency Assisted Lipo-Coagulation (RFAL) in the Control of Soft… DOI: http://dx.doi.org/10.5772/intechopen.97378*

#### **Figure 8.**

*The InMode RFAL family of handpieces. All the handpieces, even the tiny AccuTite have the same elegantly engineered thermistors and sensors that make the treatments effective and safe.*

EmPower RF Gynecologic system), which are no bigger than the palm of your hand (**Figure 8**). All the RFAL applicators, even the tiny ones, operate on the same RF principle and with the same array of thermistors and ACE sensed and automated controlled RF delivery for the responsible delivery of soft tissue heat.

#### **2.4 AccuTite: the injectable skin tightening handpiece**

#### *2.4.1 Injectable skin tightening? What does that mean?*

The AccuTite RFAL has become so small and easy to use, it has created a whole new category of anti-aging treatment I call, "*Injectable skin tightening".* What does this mean? The AccuTite RFAL is so small and elegantly engineered, that is now smaller than the microcannula systems I use to inject my soft tissue dermal fillers (**Figure 9**). The microcannula technique facilitates the safe, quick and even injection distribution of Hyaluronic Acid gel fillers into the subcutaneous and supraperiosteal space. With the AccuTite being actually a smaller diameter than my microcannula, I can now use the microcannula port to "inject RF, inject heat, inject subdermal skin remodeling and tightening. What an awesome concept?

In esthetic non-invasive medicine, for too long now, we have *tended to over inject* our patients suffering from skin laxity with soft tissue fillers to provide and lift and tightening effect. And while this Filler, VolumaLift, Liquid Lift (many names) strategy works for modest laxity and in certain facial zones, when laxity increases, we use more fillers and end up with the dreaded **"FILLER FACE",** or **"PILLOW FACE",** an unattractive, over injected, over-filled look. Would it not be nice to tailor our treatments and Inject Skin Tightening where required and volume only where needed and only to replace what was lost….. **AND THAT IS THE CONCEPT OF ACCUTITE, the INJECTABLE SKIN TIGHTENER. NO SUCTION NEEDED! Just simple AccuTite injection of RF thermal skin contraction in the subdermal space** (**Figure 10**).

#### **Figure 9.**

*The AccuTite RFAL handpiece is smaller than the actual microcannula I use to inject my soft tissue dermal fillers (a 22 g, 2 inch, Dermasculpt, blunt tipped, rigid cannula).*

Now, when treating the aging skin envelope of the face or neck, I will add the necessary neuromodulator to shape the face, use the *AccuTite to Inject Skin and Soft Tissue Tightening* where needed and, using the same access port, I will use my #22 g microcannula to add the necessary judicious and artistic soft tissue filler. Add to that Formula, fractional RF skin resurfacing, and you can now achieve truly amazing non-excisional, minimally invasive skin rejuvenation.
