Fracional bipolar radiofrequency skin tightening and wrinkle reduction (Sublative Rejuvenation using eMatrix)

Generic name: Fracional bipolar radiofrequency

Brand(s): eMatrix via Sublative Rejuvenation® technology

Maker / Website: Syneron, Inc (www.syneron.com)

Cost: Depending on the area treated, a single treatment usually costs from $300 to $1500. However, more than one treatment is usually needed. Some providers reduce the cost per treatment, depending on the total number administered.

Function / Purpose:
Bipolar radiofrequency is used primarily for skin tightening / reduction of sag (most commonly of the face and neck but sometimes elsewhere) and possibly wrinkle reduction. Similar to certain laser treatments, radiofrequency can be applied in a fractional pattern in which many small discontinuous areas of the skin are treated in a grid-like fashion. This allows applying greater energy density without necessarily increasing the rate of side effects, or reducing the rate of side effects while using standard energy density.

Details:
Bipolar radiofrequency is one of the modes in which radiofrequency (RF) can be used in medicine and cosmetics. (See our overview of radiofrequency treatments). Bipolar delivery of radiofrequency for cosmetic rejuvenation is based on applying two closely positioned electrodes to the treated area. The electric current that goes between the electrodes is relatively small and shallow. As a result, the tissue in the treated area is heated less deeply (usually up to 2-4 mm) and less intensely (compared to monopolar RF devices). Thus bipolar RF procedures tend to be safer and gentler than the monopolar ones. In particular, since bipolar RF effects are relatively shallow, there is less risk of the overheating and subsequent loss of facial fat, a side-effect sometimes seen after monopolar treatments. Conversely, bipolar RF is less useful for indications when relatively deep tissue heating may be desirable, such as cellulite treatment and body sculpting.

Typically, a single bipolar RF treatment would produce less noticeable results than a monopolar one. In fact, bipolar RF procedures are often done in a series of several treatments whose benefits are believed to be cumulative.

A more recent step to improve the risk/benefit profile of bipolar radiofrequency is to combine it with the fractional approach that has been used in other directed energy treatments (e.g. lasers) for some years. Most directed energy treatments for skin rejuvenation, including radiofrequency, work by producing controlled skin damage, which results in a healing response and tissue remodeling, eventually leading to a more youthful texture and appearance.

The idea of the fractional approach to directly energy treatments is to treat many very small discontinuous areas of the skin in a grid-like fashion (as opposed to treating large contiguous areas). Presumably it is easier for the body to repair many small lesions than a single large one. This provides a way to apply greater energy density without necessarily increasing the rate of side effects, or, conversely, to reduce the rate of side effects while applying standard energy density.

Commercial treatment systems that combine bipolar radiofrequency with the fractional approach are available. In particular, eMatrix system by Syneron corporation used a proprietary variant of fractional bipolar radiofrequency trademarked Sublative Rejuvenation^TM. Others are likely to follow.

From a theoretical standpoint, the idea behind fractional bipolar radiofrequency is makes sense. There is a good reason to believe that fractional approach may increase the benefits and/or decrease the risks of bipolar radiofrequency treatments. Unfortunately, as of the time of this writing, there are no published independent studies that compare fractional bipolar radiofrequency to regular bipolar radiofrequency treatment or its other variants. Therefore, it is premature to say that fractional bipolar radiofrequency has definite advantages over its regular cousin. Furthermore, since fractional bipolar radiofrequency is relatively new, the best practices for its application remain to be fully established. Nonetheless, this is a promising treatment that may turn out to be considerable improvement over standard bipolar radiofrequency as a tool for skin tightening, retexturing and wrinkle reduction.