Non-surgical body contouring
Today’s patient wants to avoid the downtime and potential complications associated with surgery. Non-invasive devices provide alternative solutions for body contouring procedures. Practitioners give their reports
FACETITE & NECKTITE: The clinical results of the FaceTite/NeckTite handpieces of the BodyTite device are comparable with results of surgical procedures such as a mini-facelift, writes Dr Diane Irvine Duncan
The FaceTite applicator is a bipolar, solid probe, radiofrequency device. The silicone coated internal electrode is passed directly under the skin in the superficial hypodermal-subcutaneous fat space. The internal and the external electrodes are connected at the hand-grip. The RF energy is emitted from the tip of the internal electrode from the small, uncoated region, behind a bullet-shaped, isolated blunt tip.
The internal electrode of the NeckTite, unlike the FaceTite, is a cannula that can connect into a pump, enabling simultaneous aspiration. The RF energy from the internal electrode causes a coagulative necrosis of the sub-dermal fat. It coagulates blood vessels and tightens the fibrous components of the adipose layer, leading to tissue lifting and reduction of the skin surface.
The RF energy is delivered directionally to the external electrode, which delivers gentle, sub-necrotic RF energy across the epidermal surface into the papillary dermis. The internal electrode moves slowly, in tandem, through the superficial sub-dermal fat.
The FaceTite and NeckTite are attached directly to the BodyTite platform. The RF energy and cut-off values are set to the desired epidermal temperature. This helps prevent thermal damage.
The skin surface to be treated is divided into zones. In FaceTite treatment, which is superficial, there are two clinical end points. The first pass is done with a stamping technique, in which the handpiece is held in one spot for about 1–2 seconds, depending on the fat and skin thickness, until there is an audible popping. This sound represents the RF coagulative necrosis of the adipose tissue immediately under the dermis.
Once all the skin in the treatment zone has been treated, the applicator is passed slowly through the same tissue again until reaching an epidermal temperature of 38–40oC. The FaceTite applicator is then moved to the next zone until all the lax skin has been treated.
Reaching these two end points is critical to achieving the desired tightening effect. Usually no suction is needed, and so the FaceTite handpiece is equipped with a solid rod and not with a cannula. However, if needed, a little suction may be done with a syringe following the procedure.
The NeckTite handpiece may be used slightly deeper in the neck hypodermis, and even deeper in areas such as the arms. It has a cannula for simultaneous suction and a control to adjust depth of the treatment.
The NeckTite is passed slowly through the fat layer until an epidermal temperature of 38-40oC is achieved, like the second stage of FaceTite treatment. The NeckTite handpiece may be used on small lax body areas such as the arms, inner thighs, knees and umbilical area in a similar manner.
Patients with brow, cheek, lower lid and/or jaw line and neck laxity, as well as lax arms presented for treatment. Age range was 45–66 years and skin type included I–V.
For pain control, all procedures were performed under mini-tumescent local anaesthesia. The local anaesthetic solution was a mixture of one bottle of 1% lidocaine mixed in one litre of Ringers lactate and 2ml of epinephrine 1:1000. About 150cc of infiltrate was used for the brow, cheek, lower face and another 100cc was used for neck treatments. Prior to the tumescent anesthesia, supra-orbital, infra-orbital, zygomatico-facial, temporal and mental nerve blocks were performed with 1% lidocaine.
After waiting 8–10 minutes for the vasoconstrictive epinephrine effect, the FaceTite procedure was performed. The access ports (a #11 blade, 1mm dermatologic punch, or a 22G syringe needle) were the hairline for the brow, crow’s feet for the lower lids, commissural for the nasolabial fold, the cheek-upper lip-nasolabial, and marionette lines. The jaw line was treated from a sub-lobular port and neck from sub-mental and sub-lobular ports.
The incisions for NeckTite may need a stitch for closure; the FaceTite incisions often are small enough to remain unstitched.
All patients were followed up for a minimum of two months. All before and after photos were analysed. Significant tightening of the lower lid, malar pads, cheeks, nasolabial and marionette folds was observed in all patients, along with substantial skin texture improvement. Jaw line, chin enhancement and tightening were apparent in all patients.
The NeckTite applied to lax arms has shown a mean surface area reduction of 33.5% and vertical shortening of 50%. Patients experienced only mild discomfort post-operatively, but oedema and swelling were present for five to seven days. There were no burns or major complications and ecchymosis was minimal. All patients were satisfied with the degree of tightening achieved and the short downtime.
FaceTite may be used for neck tightening, however, when there is additional problem of excessive fat, the NeckTite that provides simultaneous liposuction may be more suitable.