Improving Upper Arm Skin Laxity Using a Tripollar Radiofrequency Device

December 2015 | Volume 14 | Issue 12 | Original Article | 1463 | Copyright © December 2015


Braden McKnight BS,a Rachel Tobin BS,b Yasmeen Kabir MD,c and Ronald Moy MDa

aKeck School of Medicine of USC, Los Angeles, CA
bYale University, New Haven, CT
cCedars Sinai Medical Center, Los Angeles, CA

Abstract
BACKGROUND: Non-ablative treatments for excess subcutaneous fat have been increasingly integrated into dermatologic practice. Objective: The objective of this study was to determine the safety and efficacy of a tripolar radiofrequency device on tightening skin and reducing the circumference of the upper arms.
METHODS & MATERIALS: Twelve females received eight weekly non-ablative treatments using a tripolar radiofrequency device on the anterior and posterior upper arms. Evaluations included body weight, photographs, and circumference measurements at baseline and each subsequent week throughout the 8-week time period. The subjects and the investigator completed evaluations of clinical improvement using a 5-point assessment scale.
RESULTS: A significant circumference reduction was achieved in each arm of all twelve patients. A mean reduction of 1.99 ± 0.94 cm (P=0.001) was observed between the initial and final measurements after the 8-week treatment period.  At the 4-week follow up, the average circumferential reductions of the posterior and anterior upper arms were sustained. Patient evaluations indicated moderate to good improvement of size, tightness, and overall appearance. The procedure was well tolerated without pain.
CONCLUSION: Tripolar radiofrequency devices offer a safe and effective non-invasive technology with beneficial effects on the circumferential reduction and overall appearance of the posterior and anterior upper arms.

J Drugs Dermatol. 2015;14(12):1463-1466.

Introduction

Radiofrequency technology is frequently used in dermatology for skin tightening and the reduction of fine lines, wrinkles, and cellulite. Radiofrequency energy is a form of electromagnetic energy that heats the skin and restores skin elasticity and firmness. This treatment is becoming significantly more popular, due to its efficiency, versatility, safety and efficacy in treating a broad range of body and facial regions.1 Radiofrequency technology tightens skin through heat-induced shrinkage of collagen and augmentation of lipolytic activity.2
In contrast to lasers, which heat the skin through a pulse of light targeting chromophores, radiofrequency devices heat the skin by firing charged particles within the tissue as an electric current.3 Radiofrequency treatment induces a deeper tissue thermal effect than ablative lasers, thereby heating and denaturing a deeper layer of underlying collagen and stimulating fat metabolism.4 It is this depth of penetration that leads to a greater volume of tissue heating and significant circumference reductions in the thighs and abdomen, not previously seen with ablative laser treatments.5
In a monopolar system, energy is applied to tissue through one electrode and a grounding plate, which results in volumetric deep heating of tissue.6 In a bipolar system, the superficial tissue is heated when the electric current flows between the two electrodes, both located on the site being treated.6 The electrical circuit needs to be closed to heat the tissue. Greater volume of tissue is treated with the monopolar system, thus this system requires a greater current and a higher level of energy as compared to the bipolar system.7
A tripolar device combines the deep tissue heating effects of the mono-polar radiofrequency system with the superficial heating effects of the bipolar radiofrequency system in one applicator, thereby minimizing power consumption while also maximizing the single treatment efficacy and duration of results.5 In the tripolar device, the radiofrequency current flows between three electrodes, one positive and two negative. This arrangement of electrodes causes each to act as a common pole, eliminating the need for cooling of the electrodes and skin, optimizing safety.8
Previous studies have demonstrated success in reducing the circumference of the abdomen and thighs using a tripolar device. 2,5,9 The objective of the current study is to determine the safety and efficacy of a tripolar radiofrequency system in tightening skin and reducing the circumference of the posterior and anterior upper arms. We evaluated the treatment outcomes