**3.2 How does the morpheus RF flow and induce soft tissue contraction?**

The Morpheus handpiece delivers 24, "monopolar-like", silicone coded positively charge, RF emitting electrode pins beneath the skin into the superficial fat. A specific and proprietary pulse of radio frequency electrical energy is then delivered to the fat, which coagulates (tightens) the sub- dermal adipose and, importantly, shortens the horizontal, oblique and vertical connections to the skin called the FSN and, or the fibrous septal network. This action of FSN contraction provides a significant tightening of the soft and reducing overlying wrinkles, scars, irregular texture, pores and even stretch marks and acne scars. The silicone coated needles protect the skin from any thermal injury (**Figures 5** and **6**).

The RF energy then flows up toward the skin surface, along the silicone coated needle and along the FSN to the negatively charged triangular-shaped electrodes on

#### **Figure 4.**

*The Morpheus hand piece and tip is a reciprocating motorized device that propels silicon coated pin-electrodes through the skin and into the superficial fat just under the skin. The uncoated, positively charged tips of the pins-electrodes release strong radiofrequency (RF) energy that causes a localized adipose coagulation and RFAL tightening of the fat and contraction of the FSN connections to the skin. The fat and FSN contraction tightens the overlying soft tissue. The RF energy then flows from the tip of the positively charged electrode-pin up to the surface of the negatively charged, triangular shaped electrodes, which sit statically on the skinthrough which the pin-electrodes are protrude. (lower left and right) the RF also flows to other negatively charged external return electrodes on the sides and this is gentle, non-nectrotic in nature, and tightens the dermis non-ablatively.*

*Internal and External Radiofrequency Assisted Lipo-Coagulation (RFAL) in the Control of Soft… DOI: http://dx.doi.org/10.5772/intechopen.97031*

#### **Figure 5.**

*The Morpheus delivers positively charged, silicone coated needle electrode through the skin into the superficial fat. The skin and epidermal-dermal junction is protected by the silicone coating. The tip of the electrodes are not coated and are embedded in the fat. The tip of each probe-needle is positively charged, and strong RF energy is emitted that heats, coagulates and tightens the fat, FSN and overlying skin. The RF flow distantly to negatively charged, larger surfacing area negative return electrodes that sit statically on the surface of the skin (and NOT ADJACENT the needle tip, hence NOT micro-RF micro needling).*

#### **Figure 6.**

*The uncoated tip of the Morpheus pin-electrode is positively charged and results in a strong coagulative and ablative lesion in the fat and surrounding FSN. The RF then flows up the pin-electrode, along the FSN to the negatively charged triangular return electrodes that the pin-electrode protrude through and return electrode on the sides of the tip. This superficial RF is non-ablative in nature and results in a non-necrotic heating and tightening of the papillary and reticular dermis.*

the surface of the skin, that surround the pins-electrodes and this delivers a nonablative, non-necrotic and significant direct heating of the papillary and reticular dermis and skin which stimulates new collagen, elastin and ground substances,

further tightening the soft tissue envelope and smoothening overlying wrinkles, folds irregular texture, scars and even in large pores, stretch marks and acne scars (**Figure 6**).

The protrusion of the needle-electrode through the dermis into the fat is a mechanical, fractional dermal injury, which will lead to some remodeling and dermal enhancement from the mechanical nature of the injury, however, this fractional dermal injury is non-thermal, due to the silicone coating. The epidermaldermal thermal sparing nature of the Morpheus, focusing more on the FSN and adipose contraction, makes this device more effective at tightening lax skin and can avoid many of the epidermal-dermal junctional complications of thermal fractional dermal technologies (**Figure 7**).

During the nonsurgical face and neck lift, the Morpheus can be applied to the neck, face, upper and lower lids and brow, as well as lax body areas, to achieve a state-of-the-art, industry-leading nonsurgical facelift and skin contraction. At my clinic, SpaMedica, the Morpheus has replaced other, formally new and innovative technologies such as the 5-year-old Profound and 8-year-old Ulthera and other external radiofrequency devices, all of which offer a good non-surgical lift, Morpheus provides a **GREAT** improvement [2–8].
