3. Clinical approach and basic parameters

The basic RFAL approach of the author has been to deploy BodyTite® applicators just before aspiration to ensure optimal soft tissue contraction, liquefy the adipose tissue for more gentle aspiration forces and coagulate the small venules and arterioles to lessen post aspiration extravasation and ecchymosis. Some physicians choose to aspirate first and perform the RFAL after debulking and they have reported good results with this technique, but theoretically aspirating first may compromise and traumatize some of the FSN, perhaps limiting the amount of contraction that could occur and would injure the small vessels before thermal coagulation increasing the risk of bruising.

The BodyTite® applicators come with a dial on the hand piece that can control the distance between the internal and external electrodes, facilitating delivering thermal coagulation and different depths and levels. In general, Level 6, 5, 4, 3, 2 and 1 correspond to 6, 5, 4, 3, 2 and 1 cm inter-electrode distance and, remember, the effective coagulation is within 1–2 cm of the tip of the internal electrode (Figure 6).
