Monopolar Radiofrequency

Abstract

Radiofrequency (RF) was first applied to aesthetic uses as monopolar RF. In its monopolar form, RF is applied to the target area by means of a dedicated handpiece, while a grounding pad is applied to the body at a distance. This differs from the mode of unipolar RF, in which a single electrode with no return is applied to the skin; the distinction between these two modalities is discussed in detail in the chapter 'Unipolar Radiofrequency'. The entry of RF into the body at the site of contact with the active electrode leads to bulk tissue heating, which can be provided at a depth. This ability to heat a volume of tissue noninvasively is applied to skin tightening on the face and body, as the heat induces both immediate collagen contraction and delayed collagen synthesis, by thermal induction of fibroblasts. Cumulative experience with monopolar RF has led to better, more reproducible, and better-tolerated results as treatment protocols and devices have evolved. Monopolar RF has a firm place as a safe and popular technology in the aesthetic armamentarium.Nonablative radiofrequency (NARF) devices find their place in dermatology for the purpose of skin tightening as they readily target the deeper tissues of the dermis and induce collagen remodeling. They have gained particular popularity because of their ability to offer improvement of lax and/or photodamaged skin without the postoperative morbidity and financial burden of surgical procedures. Compared to more invasive alternatives, the results of NARF are modest; however, it remains in demand secondary to its lower side effect profile and remarkably short postprocedural downtime. This continuing shift away from ablative and invasive aesthetic procedures continues to be driven largely by patient and clinician preferences [1].Monopolar radiofrequency (RF) is a nonsurgical approach to skin tightening and photorejuvenation. The FDA first cleared its use for treatment of periorbital rhytids in 2002. Additional clearances were given for tightening of the lower face in 2004 and for skin tightening on the body in 2005. The first device, Thermage ThermaCool (Sol-

Cosmetic dermatology in menopause

“…Unlike fractional lasers, in which photons are absorbed and heat is generated in microthermal zones, radiofrequency devices cause heating of larger volumes of tissue. Monopolar radiofrequency devices use a single electrode placed at the surface of the skin and a grounding pad placed elsewhere on the body 29 . Bipolar radiofrequency devices use two electrodes placed at the skin surface, and current flow is limited to a path between the two electrodes 30 .…”

“…Monopolar radiofrequency devices use a single electrode placed at the surface of the skin and a grounding pad placed elsewhere on the body. 29 Bipolar radiofrequency devices use two electrodes placed at the skin surface, and current flow is limited to a path between the two electrodes. 30 The depth of heating with bipolar radiofrequency is dependent on the distance between the electrodes, whereas monopolar radiofrequency devices enable deeper but less precisely controlled heating.…”