Effects of Capacitive Radiofrequency at the Dermis and Adipose Tissue in the Abdominal Region

In Brazil, the search for satisfaction with self-image has been increasing, since the profile of the population has been altered by cultural factors such as industrialized foods with high caloric content and sedentary lifestyle. These factors result in the accumulation of adipose tissue in typical and atypical places, caused by the imbalance of the energy balance, that is, a higher caloric intake when compared to the energy consumption.

Noninvasive fat reduction is a rapidly expanding field of cosmetic rejuvenation, as many patients are unwilling to suffer the downtime and healing associated with traditional invasive liposuction. The radiofrequency (RF) device has been shown to be safe and effective for non-invasive fat reduction, as well as cutaneous enhancement and improvement of skin flaccidity (BOISNIC, et al., 2014).

Radiofrequency emits focused electromagnetic waves that find resistance in the tissue, generating heat (KRUEGUER, LEVY and SADICK, 2012). This thermal energy affects the triple helix structure of the collagen, subsequently breaking the intramolecular hydrogen bonds, resulting in immediate contraction of the collagen and neocollagenesis in the dermis, without interfering in the epidermis.

This neocollagenesis and remodeling of collagen results in a visibly compacted and organized dermis. Skin enhancement is an important effect, since patients that search for non-invasive fat reduction usually also seek improvement in skin flaccidity. This represents a substantial improvement over currently available technology (BOISNIC, et al, 2014).

There is controversy regarding the mechanism of fat mobilization. Some authors, after observing human skin cultures at the end of the series of RF treatments found a profound effect on subcutaneous adipocytes. The analysis resulted in altered morphology and increased expression of the pyroptosis marker, APAF-1, suggesting that pyroptosis induced by irreversible electroporation is the mechanism of action. Adipocyte pyroptosis results in the release of triglycerides from disintegrated cell membranes, but in a delayed and gradual manner, allowing a slow and safe removal through the interstitial space and liquid transport systems, lymphatic vessels and other metabolic functions. There was no evidence of necrosis or inflammatory changes observed in adipocytes after treatments with BodyFX, a type of radiofrequency (BOISNIC, et al, 2014).