**The BodyTite, FaceTite, AccuTite and Morpheus Contraction Formula = Total Tissue Contraction = the summative effect of**

RFAL FSN 30–40% + Morpheus Subdermal 15–20% + = 60–70% Total Tissue contraction

## **2.2 What is RF?**

RF, or Radiofrequency energy is part of the electromagnetic spectrum, with a frequency range that is dependent upon the industry and device. In medicine, in general, radiofrequency energy is high frequency alternating electrical current that operates in a frequency in the range of 100 kilohertz to 6 megahertz (**Figure 2**). The most common frequency of medical equipment alternating electrical current is one million cycles per second. The RF deployed in esthetic medicine is generally a pure thermal effect (the InMode BodyFX and Evovle TRIM being the exception, where its effects are both thermal and electroporation). The action potentials of nerves are not sensitive to RF current at the frequencies deployed in esthetic medicine (*one million cycles/second*) [16].

The FaceTite, AccuTite, BodyTite and CelluTite RFAL technology uses an alternating electrical current operating in the frequency of one million cycles per second. When one looks at the electromagnetic spectrum in medicine, very low frequency energies such as iontophoresis are deployed in medical devices. This is followed by radiofrequency energy, microwave, infrared laser and light devices, visible laser and light devices and x-ray systems. In the cosmetic space, radiofrequency energy has been deployed internally for surgery with necrotic and ablative devices, such as monopolar and bipolar electrocautery, or the classic Bovie, as well as non-ablative external devices, such as Thermage or the moving non ablative, temperature-controlled RF system from InMode the Forma.

At a cellular level, the alternating current of radiofrequency flows between positive and negatively charged electrodes of the device. The alternating nature

#### **Figure 2.**

*The electromagnetic spectrum and commercial devices and where RF energy and the esthetic space resides.*

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

of the radiofrequency current causes micro-oscillations in molecules throughout the tissue the RF is flowing through. The micro-molecular motion and microoscillation results in heat and heat is a final end pathway to the desired therapeutic effect of radiofrequency energy. There are three main types of radiofrequency thermal effects and InMode through and its various Esthetic workstations, deliver all types of RF injury to tissue and biological systems: (i) RF Ablation of Tissue

#### **Figure 3.**

*The 40 watt BodyTite RFAL workstation. RFAL heats in an automated fashion the soft tissue at the optimal "rate of rise of temperature per volume of tissue", an automated BodyTite feature called temperature Surg protection or TSP. optimal thermal volumetric velocity, as determined by in-vivo studies, is <20 degrees Celsius/ cm3/second. BodyTite RFAL will deliver just the amount of energy needed to heat a volume of adipose at this rate (rarely the whole 40 Watts are required). TSP is the automated control of this rate of rise. If the rate of rise of temperature rises to between 20 and 35 degrees Celsius, then the BodyTite workstation will automatically drop the power to the system, lower the RFAL energy on tissue until the adipose temperature quickly returns to less than 20 degrees celsius/cm3/second. Importantly, if the rate of rise of adipose tissue is >35 degrees/cm3/ second then the energy to the BodyTite workstation is cut-off and the user hears dull, flat "TSP audible". By the time the BodyTite user repositions the RFAL hand piece and takes the foot of the pedal for a second, the adipose tissue temperature will drop, allowing the physician to begin treatment again.*

(ii) RF coagulation of tissue and (iii) RF subnecrotic, non-ablative heating of tissue. The BodyTite workstation provides the physician the versatility of combinations of these 3 tissue effects [1]. (For more on details on the Basic Science of Radiofrequency energy, see Dr. Kriendel chapter on the same in this book.)
