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Filling a treatment gap

Article-Filling a treatment gap

Using electromagnetic energy with Inmode’s BodyTite radiofrequency-assisted liposuction device offers a needed option for patients who have previously fallen into a body sculpting treatment gap, according to a supplement article published May 2018 in the Aesthetic Surgery Journal.

Two of the paper’s authors, Manhattan, N.Y.-based plastic surgeons Spero Theodorou, M.D., and Christopher T. Chia, M.D., give The Aesthetic Channel the skinny on the FDA-cleared device for lipolysis and contraction of the dermis.

The Aesthetic Channel: Could you elaborate on the treatment gap terminology? How do you identify those patients in the gap in your practice? And why is this a gap?

Dr. Theodorou: There is a large number of ‘in between’ patients in this gap category whose clinical picture presents as ‘not bad enough for an excisional procedure and not good enough for liposuction.’

Currently there is a large number of patients that are not candidates for an excisional procedure, which typically entails long scars…. In terms of skin laxity, they might be too young in age to undergo such a procedure or the quality of their skin is not bad enough for a scar. This group of patients is still however plagued by some degree of soft tissue laxity, adiposity and aging that drives them to seek a solution.

In addition to loose skin, they might have excess fat. The current gold standard for removal of fat is still liposuction. However, this group's skin laxity also precludes them from such a treatment, as they might end up with loose skin.

Solutions [for these patients] have been inadequate until now and present a treatment gap in our current armamentarium. Hence the terminology. Radiofrequency-assisted liposuction addresses this current therapeutic gap.

The Aesthetic Channel: How is radiofrequency-assisted liposuction different than other available options for surgeons?

Dr. Theodorou: Radiofrequency-assisted lipolysis is different because it is a minimally invasive option that offers more skin contraction than any other option on the market, oftentimes up to 40%. 

It is one of the most published technologies, with over 20 peer-reviewed North American clinical papers and similar number of clinical studies.

The Aesthetic Channel: Who are candidates for the radiofrequency-assisted approach? And who are not idea candidates and why?

Dr. Theodorou: The best candidates for radiofrequency-assisted liposuction are not limited to patients that belong to the gap category. [They include] every patient that presents with some degree of skin laxity. Patients with overtly damaged skin with zero elasticity or secondary to massive weight loss may not have as good a response to this technology.

The Aesthetic Channel: What have studies on the technology found regarding its efficacy and safety?

Dr. Chia: BodyTite, FaceTite (Inmode) and radiofrequency-assisted liposuction have been subjects in multiple peer-reviewed clinical publications over the past eight years showing safety and efficacy.  Recent publications include the prestigious Plastic and Reconstructive Surgery (PRS) Journal.

Maintenance of certification (MOC) includes radiofrequency-assisted liposuction as part of every plastic surgeon’s body contouring armamentarium [in an article entitled] Evidence Based Medicine-Liposuction. Just recently, the Aesthetic Surgery Journal highlighted radiofrequency assisted liposuction’s ability to incite soft tissue contraction for the gap patient and provides a good overview of the technology.

The Aesthetic Channel: What can go wrong with radiofrequency assisted liposuction and how can my readers avoid those problems or identify them early? 

Dr. Chia: In the hands a properly trained and skilled surgeon, there are reduced risks as the technology has built-in safeguards, such as thermal temperature monitoring and automatic cutoff of energy. In the past with other technologies, surgeons had to rely on an external heat monitor to determine heat levels, but the BodyTite and FaceTite have temperature sensors embedded into the internal cannula and external electrode, which runs at 1000 cycles per second, giving constant feedback throughout the treatment. However, there is no substitute for a judicious surgeon who is able to carefully monitor and treat a patient. Experience is key in treatment outcomes.

The Aesthetic Channel: Please offer some tips for achieving optimal outcomes with radiofrequency-assisted liposuction.

Dr. Chia: The BodyTite platform has several clinical and practical safeguards that not only maximize safety but also target how effectively the heat is applied. Specifically, it ensures not only limiting the temperature reached to avoid complications but also gives the operator real-time temp readings to ensure the areas being treated are within the therapeutic range for optimal soft tissue contraction to avoid undertreatment….

The unique and elegant design of bipolar directional electrocautery device is the only one in the industry where the external and internal soft tissues are simultaneously heated to elicit increased collagenesis.

A safe, reproducible and effective approach includes identifying a specific area for treatment, heating both the internal and external temps (a BodyTite proprietary hallmark) to their respective therapeutic range for a predetermined amount of time. Coupled with the local anesthesia option, patients can also enjoy the benefits of even greater safety, shorter recovery and financial advantages with equivalent or better results achievable with traditional modes of anesthesia.