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Effect of Capacitive Radiofrequency on the Fibrosis of Patients with Cellulite

Authors:
  • Faculdades Estácio Fatern / Uninassau

Abstract and Figures

Background. Cellulite is a type of lipodystrophy that develops primarily from an alteration in blood circulation or of the lymphatic system that causes structural changes in subcutaneous adipose tissue, collagen, and adjacent proteoglycans. The radiofrequency devices used for cutaneous applications have shown different physiological treatment effects, but there is controversy about the suitable parameters for this type of treatment. Objectives. The aim of this study was to evaluate the effects of low-temperature radiofrequency to confirm the thinning of the collagen tissue and interlobular septa and consequent improvement of cellulite. Methods. A sample of eight women was used to collect ultrasonographic data with a 12 MHz probe that measured collagen fiber thickness. The Vip Electromedicina (Argentina) device, frequency of 0.55 MHz and active electrode 3.5 cm in diameter (area = 9.61 cm(2)), was applied to a 10 cm(2) region of the gluteal region for 2 minutes per area of active electrode, during 10 biweekly sessions. Results. The Wilcoxon matched paired test was applied using GraphPad InStat 3.01 for Win95-NT software. Pre- and posttreatment mean collagen fiber thickness showed a 24.66% reduction from 1.01 to 0.67 mm. Statistical analysis using the Wilcoxon matched paired test obtained a significant two-tailed P value of 0.0391. Conclusion. It was concluded that the use of more comfortable temperatures favored a reduction in fibrous septum thickness and consequent cellulite improvement, evidenced by the lower degree of severity and decrease in interlobular septal thickness.
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Hindawi Publishing Corporation
Dermatology Research and Practice
Volume , Article ID , pages
http://dx.doi.org/.//
Clinical Study
Effect of Capacitive Radiofrequency on the Fibrosis of
Patients with Cellulite
Rodrigo Marcel Valentim da Silva, Priscila Arend Barichello, Melyssa Lima Medeiros,
Waléria Cristina Miranda de Mendonça, Jung Siung Camel Dantas, Oscar Ariel Ronzio,
Patricia Meyer Froes, and Hassan Galadari
Potiguar University (UnP), Laureate International Universities, 59054-180 Natal, RN, Brazil
Correspondence should be addressed to Rodrigo Marcel Valentim da Silva; marcelvalentim@hotmail.com
Received  July ; Revised  September ; Accepted  September 
Academic Editor: Masutaka Furue
Copyright ©  Rodrigo Marcel Valentim da Silva et al. is is an open access article distributed under the Creative Commons
Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is
properly cited.
Background. Cellulite is a type of lipodystrophy that develops primarily from an alteration in blood circulation or of the lymphatic
system that causes structural changes in subcutaneous adipose tissue, collagen, and adjacent proteoglycans. e radiofrequency
devices used for cutaneous applications have shown dierent physiological treatment eects, but there is controversy about the
suitable parameters for this type of treatment. Objectives. e aim of this study was to evaluate the eects of low-temperature
radiofrequency to conrm the thinning of the collagen tissue and interlobular septa and consequent improvement of cellulite.
Methods. A sample of eight women was used to collect ultrasonographic data with a  MHz probe that measured collagen ber
thickness. e Vip Electromedicina (Argentina) device, frequency of . MHz and active electrode . cm in diameter (area =
. cm2), was applied to a  cm2region of the gluteal region for  minutes per area of active electrode, during  biweekly sessions.
Results. e Wilcoxon matched paired test was applied using GraphPad InStat . for Win-NT soware. Pre- and posttreatment
mean collagen ber thickness showed a .% reduction from . to .mm. Statistical analysis using the Wilcoxon matched
paired test obtained a signicant two-tailed Pvalue of .. Conclusion. It was concluded that the use of more comfortable
temperatures favored a reduction in brous septum thickness and consequent cellulite improvement, evidenced by the lower degree
of severity and decrease in interlobular septal thickness.
1. Introduction
Cellulite is a type of lipodystrophy widely considered as an
esthetic disorder in dermal and hypodermal tissue, whose
alterationisbasedonamorphologicaldisorder.Itdevelops
primarily from an alteration in blood circulation and of the
lymphatic system, causing structural changes in subcuta-
neous adipose tissue, collagen, and adjacent proteoglycans
[,].
In cellulite, fat is stored in fat cells that lie between the skin
and muscle tissue. Fat cells are grouped together into large
conglomerates separated by brous strands (brous septae).
ese brous strands run between the muscle and the skin
andservetoholdthefatinplace(insmallcompartments).
e skin is tethered down by string-like tissues that pull
it inward, toward the interior of the body. As fat cells
expand with weight gain, the gap between the muscle tissue
and skin expands. e brous strands cannot stretch and
cannot support the skin. e tension of these septae pulls
sections of fat in along with them, causing the fat cells in the
subcutaneous layer to increase and stick together within the
connective tissue bers, resulting in dimpling (also described
as “mattress” or “cottage cheese”) [].
In the past decade, cellulite management has inspired
a new generation of innovative medical devices, such as
radiofrequency machines, which promise to correct cellulite
signs and symptoms []. Radiofrequency energy has been
usedformorethanacenturyinavarietyofmedical
applications. It is conducted electrically to the tissue, and
heat is produced when the inherent impedance of the tissue
converts the electrical current to thermal energy. RF devices,
whichhavebeenusedforcutaneousapplications,exhibit
dierent physiological eects: neocollagenesis, the liing
Dermatology Research and Practice
eect, decreased localized adiposity, reduced edema and
broses, and improved cellulite [].
Several experimental in vivo and in vitro studies have
produced evidence about the thermal modication of col-
lagen tissue, but there is no consensus about the optimal
therapeutic algorithm []. At dierent temperaturas, it is
possible to increase or decrease the density of collagen
tissue, mainly of brous septa found in the cellulite process
[]. When heated, collagen, a very organized crystalline
protein structure, transforms into a disorganized gel. Its triple
helix shape is destroyed, since its intermolecular bonds are
sensitive to low heat. When this disorganized gel is subjected
to temperatures above  degrees, its structure is transformed
into a thicker, rigid tissue, with little uid and no elasticity
[,].
Hence, there are a number of controversies about ideal
temperatures for treating cellulite. Some authors propose
high temperatures: Alster and Lupton []treatedcellulite,
obtaining immediate collagen contraction due to heat and
protein denaturation using high temperatures and del Pino et
al. [] observed a thickening and realignment of interlobular
septae using temperatures between  and Cwithradiofre-
quency. ese temperatures are considered high, but there is
another authors that uses low temperature, about  degrees
or  to  degrees above the temperature of the skin [,].
e problem lies in the fact that most cellulite treatments
have proven to be ineective, since the assessment methods
usedaremostlysubjectiveordonotprovideenoughinfor-
mation for the study of subcutaneous tissue. e application
of dierent temperatures to treat cellulite are suggested by
several authors [,], as well as dierences between their
classication. According to Goldman et al. [], the hard
celluliteistypicalofyoungsubjectswithtonedtissues,
typically in Latin American people. Normally, the area is
rigid and presents adherences between supercial and deep
layers and the skin thickness is increased. In these cases,
according to some authors [,], the use of low temperatures
would be more interesting to rene brous septae. On the
other hand, so cellulite is common in older people and
sedentary, with characteristics of weak and white skin. In this
case, radiofrequency high temperature increases the collagen
thickness.
High-resolution ultrasound allows the observation of
subcutaneoustissue,thefatlocatedbetweenskinandmuscle,
and the anatomic vie ws of the layer between the subcutaneous
tissue and the adipose layer, as well as the integrity of the
brous bands (brous septa) that divide them [].
Because of the aforementioned problem, the aim of
this study was to evaluate the eects of low-temperature
radiofrequency ( to  degrees above skin temperature)
in hard cellulite, to conrm the thinning of the collagen
tissue and interlobular septa and consequent improvement of
cellulite.
2. Material and Methods
e study was approved by the Human Research Ethics Com-
mittee of Universidade Potiguar. e sample was composed
of eight women volunteers selected according to the following
inclusion criteria: age between  and  years and complaint
of grade  and  cellulite (according to Curri’s classication)
[], located in the gluteal region, and willingness to submit
to the treatment. Pregnant and diabetic women undergoing
drug or hormone treatment were excluded. e participants
were not submitted to any food restriction and were asked
to maintain their usual daily activities. Aer being informed
aboutthepurposeofthestudyandtheproceduresthatwould
befollowed,thewomengavetheirwritteninformedconsent.
e following data collection instruments were used:
Fibro Edema Geloid Assessment Protocol (PAFEG), pro-
posed by Meyer et al. [] A Sony digital camera, . megapix-
els; GE Vivid  ultrasound machine, with multifrequency
(.– MHz) probe; radiofrequency device and infrared
digital thermometer were also used.
An evaluation was conducted based on PAFEG, which
is composed of three items: identication, anamnesis, phys-
ical examination containing inspection and palpation, topo-
graphic location, severity classication, tactile sensitivity test,
and complementary examinations associated with general
patient information. An ultrasonographic examination was
performed by a medical specialist using a  MHz probe
to measure collagen bers before and aer radiofrequency
treatment. is examination is a simple, nonintrusive, and
reliable method that enables measuring the thickness of
interlobular septae present in more advanced cellulite. ree
dierent septae located at the center of the demarcated area
were measured pre- and posttreatment with a pendulum
probe to avoid inuencing the measures, and the resulting
values of these parameters were used for statistical analysis.
e demarcated area remained during the entire treatment
and adipose layer thickness was also measured both brfore-
and aer treatment. GraphPad InStat . for Win-NT
soware and the Wilcoxon matched paired test were used for
the analyses.
Radiofrequency was applied to the gluteal region with
thevolunteersintheventraldecubituspositionandthe
lower extremities extended and relaxed. Aer delimitating
an area of  cm2and performing asepsis (% alcohol)
of the area to be treated, we applied the Tecartherap-Vip,
Vip Electromedicina (Argentina) radiofrequency capacitive
device, with frequency of . MHz, active electrode . cm
in diameter (area = . cm2), and passive metal electrode
with an area of  cm2, placed in the lower abdominal region
with Carbopol gel for coupling. e application zone was
divided by the measure of the active electrode, obtaining the
measure of  electrodes. Aer the patient’s skin temperature
was measured, the application was initiated, continuing until
the temperature was  degrees above the initial value. Once
this level was reached, linear movements (back and forth)
were performed for  minutes on the area, relative to the size
of two electrodes, during  biweekly sessions.
Statistical analysis of collagen ber thickness before and
aer treatment was based on the PAFEG data and ultrasono-
graphic examination results obtained.
Dermatology Research and Practice
(a) (b)
F : Ultrasonography before and aer  sessions.
(a) (b)
F : Ultrasonography before and aer  sessions.
3. Results
Figures ,,,andcorrespond to the organization and
deposition of brous septae in cellulite areas before and aer
radiofrequency treatment.
e mean thickness values obtained for  brous septae
are shown in Tabl e  .
e mean pre- and posttreatment collagen brous thick-
ness was . mm and . mm, respectively, a reduction
of .%. Statistical analysis using the nonparametric test
for paired data (Wilcoxon matched paired test) showed a
signicant two-tailed 𝑃value of ..
Adipose layer thickness results are shown in Tab l e  .
e mean pre- and posttreatment adipose tissue layer
thickness was . mm and . mm, respectively, an
increase of . mm (.%). Statistical analysis using the
nonparametric test for paired data (Wilcoxon matched paired
test) obtained a nonsignicant two-tailed 𝑃-value of ..
isndingiscorrelatedwiththeincreasedweightofmost
of the patients (mean of . Kg) (Table  ).
ecelluliteshowedalteredconjunctiveandadipose
tissue disposition, with adipose and cell hyperplasia and
hypertrophy, as well as polymerization of the fundamental
amorphous substance, resulting in proliferation of intra-
adipocyte and interlobular collagen bers. ese alterations
provoke reduced circulation in tissues, reduced drainage
and broblast incarceration, and enrichment and rupture of
elastic bers [].
Figures to show the ultrasonographic results of
collagen ber thickness aer radiofrequency treatment at
comfortable temperatures ( to  degrees above skin temper-
ature), demonstrating a decrease in interstitial brosis. Two
temperatureobservationparameterscanbeusedtoapply
radiofrequency: the rst is based on infrared thermometer
values and the second based on the subjective scale of heat
applied to each patient. It is suggested that G, a moderate
and pleasant heat level, be reached to achieve an increase in
the distensibility of collagen tissue [].
Figure  shows the presence of an adipose tissue gra
performed  years before following lipoaspiration. e tissue
is surrounded by interstitial brosis in Figure (a),butaer
treatment (Figure (b)) there is no visible brosis in this
area. e reorganization of brous tissue, as well as the
reduction in ber thickness observed aer ultrasonographic
examination, may be associated with the eects of radiofre-
quency. According to Verrico et al. [], radiofrequency
thermotherapy favors the absorption of type I collagen by
activating protein metabolism activators. is corroborates
the results and biological eects obtained for brous septum
thickness as well as the improvement in cellulite.
Dermatology Research and Practice
(a) (b)
F : Ultrasonography before and aer  sessions.
(a) (b)
F : Ultrasonography before and aer  sessions. ese gures shows the presence of an adipose tissue gra performed  years before
following lipoaspiration. e tissue is surrounded by interstitial brosis in (a), but aer treatment (b) there is no visible brosis in this area.
4. Discussion
e radiofrequency eects on the conjunctive tissue evalu-
ated by ultrasonography have been documented in a number
of studies [,]. In research using high temperatures, the
changes observed reect the increased echodensity of con-
junctivetissuestructures,evidencedbyanincreaseinthe
amount of bers and compactness of existing bers. is
allows us to assume that high-temperature RF worsens the
clinical picture of cellulite.
According to the literature, radiofrequency also favors
a decrease in lipolysis and thickness and fat accumulation
in adipocytes, consequently reducing venous and lymphatic
uid retention caused by hypodermal tissue compressing
vessels and nerve endings []. Ta b l e shows that the temper-
ature conditions of this study did not satisfactorily alter adi-
pose tissue measures, evidenced by oscillating increases and
decreases in these values. According to PAFEG assessment,
the anthropometric data of the patients changed considerably
during the study, inuencing the reduction of adipose tissue.
It should be pointed out that no changes in patient diet were
indicated.
It was demonstrated that ultrasonography can be used as
a diagnostic method to evaluate the characteristics of subcu-
taneous tissue and to observe the eects of radiofrequency
in cellulite treatment. is methodology could be applied to
evaluate other treatments related to cellulitis and localized fat.
A diculty of this study was a small sample because of the
cost of the ultrasonography exam, so we suggest the repetition
of this research with a greater number of patients.
e use of more comfortable temperatures favored both a
reductioninbrousseptumthicknessandanimprovement
in the clinical appearance of cellulite, demonstrated by the
reduced degree of severity and decreased interlobular septal
thickening. Radiofrequency has been little studied in the
area of esthetic medicine; therefore, more studies are needed
to ascertain its real eects, since temperature variations
signicantly aect collagen tissue.
Authors’ Contribution
e authors declare that they participated in the design,
analysis of results and contributed eectively in carrying out
Dermatology Research and Practice
T : Average thickness of collagen bers.
Patient Grade of cellulitis Average thickness of collagen bers (measures/)
Before treatment (mm) Aer treatment (mm) Dierence (mm) Dierence Porcentual (%)
Grau  . . . .
Grau  . . . .
Grau  . . . .
Grau  . . . .
Grau  . . . .
Grau  . . . .
Grau  . . . .
Grau  . . . .
Media 1.01 0.67 0.34 24.66
T : Average of adipose tissue layer.
Patient Grade of cellulitis Average of adipose tissue layer
Before treatment (mm) Aer treatment (mm) Dierence (mm) Dierence Porcentual (%)
Grau  . . . .
Grau  . . . .
Grau  . . . .
Grau  . . . .
Grau  . . . .
Grau  . . . .
Grau  . . . .
Grau  . . . .
Media 29.7 30.3 0.5 5.5
T : Mean body weight alterations aer radiofrequency treat-
ment.
Patient Alterations in weight (Kg)
.
.
.
 .
 .
.
.
 .
Media 0.51
this paper and make public responsibility for its contents,
in which any aliations or nancial agreements between
authors and companies that may be interested in publishing
this paper were not omitted.
Conflict of Interests
e authors state that they do not have any conict of
interests with the subject discussed in the paper or to the
products/items mentioned. We declare that the paper quoted
is unique and that the work, in part or in full, or any
other work with substantially similar content has not been
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... Os objetivos da pesquisa foram verificar as evidências científicas sobre a aplicação da radiofrequência no FEG com vistas à temperatura aplicada e avaliar o rigor metodológico das pesquisas. Quanto às amostras e caracterização dos grupos, há variação de mínimo de 8 [16,17] e máximo de 50 [14] participantes, porém nenhum dos estudos aqui investigados relata aplicação de cálculo amostral, ou se a amostra foi de conveniência. A diferença entre amostras maiores ou menores e diferentes grupos eleitos dificultam a padronização dos resultados, a exemplo, dois estudos [15,10] [13] e um não descreveu [11]. ...
... Levaram em consideração a classificação de Nurnberger-Muller [21] as pesquisas [10,12,13,16,18,20], já a classificação proposta por Rossi e Verganini [22] foram dois estudos [14,15], enquanto que a classificação de Curri [23] e Fibro Edema Geloid Assessment Protocol (PAFEG) foi aplicado em um [17], e a classificação proposta por Guirro e Guirro [1] também em único estudo [19]. Dois estudos não relatam a classificação aplicada [9,11]. ...
... sessões [18], entremeando duas [11], quatro [16], seis [9,12], oito [10,13,20] e 10 [17,19] e 12 sessões [14]. Os intervalos foram semanais [10,13,14,20], quinzenais [9,11,12,16,17], e por duas vezes na mesma semana [18,19]. ...
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O Fibroedema Geloide (FEG) é uma afecção vascular e estética, com maior incidência em mulheres, que pode ocasionar a redução da qualidade de vida e autoestima. Sendo a radiofrequência um recurso para seu tratamento, esta revisão buscou por evidências científicas sobre sua aplicação, temperatura ideal para melhores resultados e o nível de evidência dos estudos. Por meio de pesquisa nas bases eletrônicas Pubmed, Lilacs, Web of Science e Cochrane foram limitadas pesquisas entre 2006 e 2019, com os descritores radiofrequency, cellulite, celulite, celulites e a palavra-chave: gynoid lipodystrophy, nos idiomas português e inglês. Foram incluídos estudos que descreveram o objetivo de investigar a radiofrequência de forma isolada no FEG. Foram encontrados 206 estudos e 12 foram incluídos. Foram verificadas limitações quanto a metodologia aplicada no âmbito amostra, metodologia empregada, e/ou a análise de dados e ausência de parâmetros de aplicação. Quanto a temperatura observou-se maior representação entre 40 e 42oC, com níveis de evidência moderados quanto aos estudos. São necessários trabalhos futuros com maior padronização de parâmetros, além de um maior rigor metodológico para melhor investigação da temperatura ideal para o tratamento do FEG.
... Indeed, several companies suggest RF systems as valid and safe alternative technologies capable of achieving the same clinical results in improving cellulite [20]. Despite this evidence for RF devices in treating cellulite, no procedure has been successful in the long-term period [21]. Microwaves are part of the RF spectrum (frequency range between 1 and 300 GHz) [22], and this technology has become very popular in modern society and is not even a newcomer to medical applications. ...
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Background: Cellulite represents a common cosmetic problem that affects nearly all women. This study aimed to evaluate microwave therapy's effectiveness for cellulite treatment. Methods: In this study, 26 women showing severe or moderate cellulite underwent four sessions of microwave therapy on the buttocks and posterior thighs. The following assessments were performed at baseline and the three-month follow-up after the last treatment: the Cellulite Severity Scale (CSS), Nürnberger-Müller classification scale, photographic evaluation, and buttocks/posterior thighs circumference measurements. A Likert scale questionnaire was used to assess patient satisfaction at the 3-month follow-up. Results: The treatment positively affected the cellulite severity as confirmed by the Cellulite Severity Scale (CSS) and Nürnberger-Müller classification scale results. CSS showed a significant amelioration in cellulite severity between the initial assessment and the 3-month follow-up for the buttocks and posterior thighs, with total average scores that ranged from 10.7 ± 3.1 to 4.5 ± 1.8 (p < 0.01). The treatment also resulted in a remarkable improvement in comfort/satisfaction and a buttocks and posterior thighs circumference reduction. No serious adverse events were observed. Conclusions: Microwave therapy has proven to be a safe treatment for improving cellulite appearance and reducing body circumferences.
... Furthermore, mEHT treatment in malignant fibrosarcoma also showed a great benefit to the patient [340]. Note that RF current is widely used for cellulite fibrosis [341], and skin laxity [342], but only for areas near the surface. MEHT is active in deeply located tissues of the body [247], so therefore the usual activity against fibrotic structures is expected anyway. ...
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The COVID-19 pandemic has experienced unprecedented limitations and extraordinary scientific efforts to address this exceptional situation. Despite blanket closures that have resulted in significant financial constraints and losses around the world, research has an “unlimited” budget, with an exceptional concentration of medical and scientific care on a single topic: understanding the mechanisms for overcoming the disease. A large number of clinical trials have been launched with different drugs that have been behind different concepts and solutions. I would like to focus on the complexity aspect of COVID-19. Living systems are organized in a complex way, which implies dynamic stochastic phenomena, and deterministic reductionism can mislead research. When research focuses on individual molecules or pathways as products, it is distracted from the processes in which these products operate, thus neglecting the complex interactions between regulations and feedback controls. Common problems in product-oriented research are articulated as “double-edged swords”, “Janus behavior”, “two-sided action”, with a simple question: “friend or foe?” I focus on the missing complexity. I propose a bioelectromagnetic process that can maintain a complex approach, affecting processes rather than products. This hypothetical proposal is not a comprehensive solution. Complexity itself limits the overall effects of causing “miracles”. Well-designed electromagnetic effects can support current efforts and, in combination with intensively developed pharmaceuticals, bring us closer to a pharmaceutical solution against COVID-19.
... At the beginning and end of the study, an ultrasound examination was performed in the gluteal region, delimited by a mold in a 10 cm 2 area, which allowed to evaluate the transformation of the fibrous septa and fat layer in the area with cellulite before and after the proposed treatment. Ultrasonography is considered an efficient diagnostic method to assess fibrous septa integrity and to identify treatment effects on cellulite and on localized fat [18]. ...
... The physiological effects associated with RF are the induction of collagen denaturation, resulting in neocolagenogenesis, and the reduction of edema and fibrosis (15)(16)(17)(18) . However, its implications for the treatment of muscle injuries still have little evidence reported in the scientific literature. ...
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Background: Radiofrequency (RF) is recommended to treat pathologies with the presence of inflammation, as it induces diathermyand, consequently, promotes better oxygenation, nutrition and local vasodilation. Objective: Evaluate the effect of RF on muscleregeneration in Wistar rats. Methods: It is a controlled and randomized experiment, with a sample composed of 40 Wistar rats,divided equally into four groups: G1 (control group), G2 (lesion, without RF), G3 (RF after 72 hours of lesion) and G4 (RF after 7 daysof lesion), all sacrificed 21 days after the injury. The RF parameters used were: Sine wave; frequency of 0.5MHz; 5 cm² treatmentarea on the region around the lesion; power of 45%; two-minute application; intensity of 15 seconds to heat the head, 1 minute at20% and another minute at 10%. An optical microscope was used for histological analysis and, for the biomechanical properties(maximum elongation and maximum load), the mechanical traction test of the gastrocnemius muscles. For statistical analysis, thetwo-way ANOVA test and the Benferroni test were used, considering 5% of significance. Results: It was observed in G3 that theinflammatory process was optimized by the RF when compared to the other groups, presenting intact muscle fibers with a discreetregeneration process. G4, on the other hand, revealed intense inflammation with significant granulation tissue, as well as fibrosis andhealing. As for the biomechanical characteristics, there were no statistically significant differences in the intergroup comparison.Conclusion: RF was more effective when applied after 72 hours after the injury, in addition to not interfering with musclebiomechanical characteristics.
... Estes resultados não aconteceram no grupo controle, apenas no grupo tratado por radiofrequência. Segundo outros estudos 8,12,13 que também utilizaram esta metodologia para avaliar o envelhecimento facial, o aumento do ângulo do sulco nasogeniano pode ser um indicador de melhoria na flacidez facial devido a sua abertura através da redução da ptose da pele 14,15 . Provavelmente, apesar da ausência de um resultado estatístico importante, esta Na análise qualitativa das fotos por especialistas pode-se observar que os avaliadores consideraram que o grupo que recebeu a aplicação da radiofrequência apresentou uma melhora clínica importante. ...
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Introdução: A radiofrequência é um recurso que têm sido frequentemente utilizados na prática clínica para o tratamento da flacidez facial e aparecimento de rugas. Objetivo: Investigar os efeitos da radiofrequência no rejuvenescimento facial. Métodos: Trata-se de um ensaio clínico controlado. A amostra foi composta por 40 voluntárias do sexo feminino, com a faixa etária entre 35 a 55 anos, dispostos em 02 grupos, sendo grupo controle e grupo tratado com radiofrequência. Resultados: Nos valores individuais das medidas do ângulo do sulco nasogeniano é possível verificar um aumento e consequente melhora da qualitativa da flacidez facial. Conclusão: A radiofrequência promoveu uma melhora clínica ao nível do ângulo do sulco nasogeniano.
... Вставка 8. Изменения в структуре кожи после применения RF-тока для лечения целлюлита Сонографическое исследование с участием 8 пациентов (25-40 лет) с целлюлитом в ягодичной области показало, что при одних и тех же параметрах воздействия RF-токами у двоих пациентов произошло уменьшение толщины жирового слоя (примерно на 51%), еще у двоих -ее увеличение (примерно на 59%), а у остальных состояние кожи осталось без каких-либо изменений [28]. При этом шесть пациентов ответили на лечение уменьшением фиброза, у одного волонтера наблюдали значительное усиление развития фиброза в подкожной клетчатке и еще один не показал никакой реакции этих структур на проведение RF-процедуры. ...
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Радиочастотные (RF) токи в эстетической медицине прошли за последнее десятилетие классическую «дорогу» от «неизвестно» до «хорошо известно» и теперь прочно обосновались в становящемся все более пестрым спектре эстетических услуг. Для оценки эффективности этого вида лечения было выполнено большое количество клинических исследований и опубликованы многочисленные работы с результатами применения RF-токов, большинство из которых оценивали этот метод как «эффективный». Уровень доказательности этих исследований, к сожалению, как правило, довольно низок
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(Background). Oxygen is essential for life, and investigation of the skin's oxygen environment and identification of its effects on the skin may lead to the discovery of new antiaging targets. To understand individual skin differences and age-related changes, we developed a noninvasive method using near infrared spectroscopy (NIRS) to measure the regional saturation of oxygen (rSO2) of human skin. (Materials and methods). To construct an NIRS sensor probe specialized for skin measurement, the distance between the sensor transmitter and receiver was optimized based on data for the thickness of the facial skin to the subcutaneous fat layer. To analyze the relationship between skin oxygen saturation and body oxygen saturation, rSO2 was measured by NIRS, oxygen saturation of peripheral artery (SpO2) was measured by pulse oximeter, and physical conditions were considered, such as body mass index (BMI) and muscle mass, in Japanese women (age 20s–60s). (Results). Both skin rSO2 and SpO2 varied among individuals and decreased with age. Only SpO2 showed a relationship with BMI and muscle mass, whereas rSO2 showed no relationship with these physical conditions. No relationship between rSO2 and SpO2 was observed. (Conclusion). Individual and age-related differences in skin by rSO2 values were found by NIRS optimized for local skin; however, the factors affecting rSO2 differed from those affecting SpO2, and further study is needed.
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Introduction: Right now, we are facing a global pandemic caused by the coronavirus SARS-CoV-2 that causes the highly contagious human disease COVID-19. The number of COVID-19 cases is increasing at an alarming rate, more and more people suffer from it, and the death toll is on the rise since December 2019, when COVID-19 has presumably appeared. We need an urgent solution for the prevention, treatment, and recovery of the involved patients. Methods: Modulated electro-hyperthermia (mEHT) is known as an immuno-supportive therapy in oncology. Our proposal is to apply this method to prevent the progression of the disease after its identification, to provide treatment when necessary, and deliver rehabilitation to diminish the fibrotic—often fatal—consequences of the infection. Hypothesis: The effects of mEHT, which are proven for oncological applications, could be utilized for the inactivation of the virus or for treating the fibrotic consequences. The hypothesized mEHT effects, which could have a role in the antiviral treatment, it could be applied for viral-specific immune-activation and for anti-fibrotic treatments.
Article
Objetivo: revisar a literatura sobre a eficácia da radiofrequência no tratamento do fibroedema gelóide. Metodologia: trata-se de uma revisão bibliográfica mediante a busca de artigos científicos nas plataformas Scielo e PubMed, publicados entre os anos de 2008 a 2018. Como descritores utilizou-se em inglês: "treatment" and "esthetic" or “treatmentradiofrequency” and “radiofrequencyand celulite”e o marcador boleano and.E em português: fisioterapia, celulite e radiação eletromagnética. Após aplicar filtros de pesquisa e os critérios de inclusão foram selecionados os artigos que serviram de base para a realização deste estudo. Resultados: Foram encontrados seis artigos nos meses de abril e maio, os quais foram organizados em um quadro. A literatura evidenciou eficácia da utilização da radiofrequência e melhora significativa do aspecto do fibro edema gelóide. Considerações Finais: A utilização de radiofrequência mostra-se eficaz e uma técnica promissora na terapêutica do fibro edema gelóide.
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AimsCapacitive Electric Transference (CET) is a new therapeutic modality used by physical therapists in orthopedic and esthetics that causes deep warning using a radiofrequency of 0.55MHz.The purpose of this study is to analyze the effects of CET in dermis and hypodermis adipocytes and the changes in the conjunctive tissue.
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The aim of this study was to assess the use of magnetic resonance as a new method for evaluating the manual lymphatic drainage technique in treating cellulitis. Cellulitis is one of the main esthetic problems that lead women toward seeking guidance and specific treatments. There are various therapeutic approaches, owing to the multifactorial nature of its pathogen, although the effectiveness of most of these has not been definitively proven, given that the assessment methods used are mostly subjective or do not provide enough information on subcutaneous tissue. The introduction of magnetic resonance as a means of assessing a lymphatic drainage technique in cellulitis treatment makes the evaluation more accurate, since it enables a detailed study of subcutaneous architecture.
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Cellulite affects 85-98% of post-pubertal females of all races. While not a pathologic condition, it remains an issue of cosmetic concern to a great number of individuals. Despite its high prevalence, there have been few scientific investigations into the physiology of cellulite. There have only been a few dozen peer-reviewed articles devoted to cellulite in the medical literature in the past 30 years. There is no definitive explanation for its presentation. This greatly complicates the ability to treat or improve it. The four leading hypotheses that purport to explain the physiology of cellulite include: sexually dimorphic skin architecture, altered connective tissue septae, vascular changes and inflammatory factors. Treatment modalities can be divided into four main categories: attenuation of aggravating factors, physical and mechanical methods, pharmacological agents and laser. There are no truly effective treatments for cellulite.
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The visual appearance of cellulite or the‘orange peel’look of skin is a common cosmetic problem for many women. Cellulite, or more correctly lipodystrophy, is a modification of the adipose tissue, whereby the fat lobules are swollen as the result of a disturbed blood and lymph micro-circulation and fibrosclerose of connective tissue. In the wealthy diversity of products against cellulite, objective methods to measure their efficacy are of growing importance. The purpose of this study is to establish the effectiveness of a skin massage treatment by quantifying the changes in the skin via ultrasound imaging, during and following treatment.
Article
Resumen Antecedentes: Además de la dieta y el ejercicio, la genética juega un papel importante en el aspecto de hoyuelos en la piel, difíciles de ocultar a cualquier edad. La demanda de un tratamiento de la celulitis no quirúrgico, no ablativo ha inspirado a muchos fabricantes a invertir en una nueva generación de aparatos sofisticados y terapias de tratamiento para reparar la piel y mejorar la figura. Aunque muchas de estas nuevas opciones han demostrado un efecto de suavizado (producto de múltiples sesiones), la documentación objetiva es, en la mayoría de los casos, limitada a biopsias, medidas circunferenciales y evidencias fotográficas. Hipótesis: Nosotros creemos que la aplicación de radiofrecuencia (RF) no invasiva de alta potencia sobre la piel de los muslos y nalgas calienta el tejido adiposo subcutáneo, provocando contracción de las fibras de colágeno. El impacto resultante al tejido subcutáneo y al colágeno, se espera que mejore la arquitectura externa de la piel. Dada que el tejido subcutáneo y adiposo son difíciles de evaluar a través de métodos histológicos, esta investigación pretende demostrar los cambios que ocurren cuando se aplican 2 tratamientos de RF de alta energía en el tejido subcutáneo de muslos y nalgas utilizando un registro de imagen de ultrasonido en tiempo real. Materiales y Métodos: Veintiséis pacientes mujeres sanas (edades de 18 a 50) con celulitis bilateral visible (grados 1-3) en nalgas y/o muslos recibieron 2 sesiones de tratamiento (espaciadas 15 días) de RF Unipolar usando el equipo de RF Accent (Alma Lasers Inc.). El equipo utiliza un aplicador de RF Unipolar que se enfría eléctricamente para favorecer la comodidad del paciente durante el tratamiento. . Se eligió la energía apropiada y el tratamiento se hizo con 3 pases de 30 segundos cada uno. La evaluación del espesor del tejido subcutáneo en nalgas y muslos se realizó antes del primer tratamiento, del segundo, y 15 días después de del segundo tratamiento, con equipo de imagen de ultrasonidos en tiempo real (Philips Medical Systems). La mejoría clínica se evaluó de forma objetiva mediante la comparación de las medidas pre y post tratamiento, de la distancia entre el estrato córneo a la fascia de Camper y desde el estrato córneo al músculo. El estudió también evaluó la estructura y los cambios del colágeno (engrosamiento y realineamiento de los septos) resultantes de los dos tratamientos con RF. La fotografía se empleó para documentar los cambios en el contorno y en la superficie. Resultados: Mediante la medición de la distancia entre el estrato córneo y la fascia e Camper y desde el estrato córneo y el músculo, podemos demostrar que un 68% de los pacientes presentaban una reducción de volumen de aproximadamente un 20%. Conclusiones: Basado en los resultados demostrados con el registro de imagen de ultrasonido en tiempo real, hemos observado que 2 tratamientos de RF en el tejido subcutáneo de nalgas y muslos proporciona un efecto de contracción volumétrica en la mayoría de los pacientes. Esto valida la hipótesis primaria de nuestro protocolo y establece que la energía de RF trabaja en el tejido conjuntivo del tejido celular subcutáneo. Este efecto debería ser el mismo en cualquier otra parte del cuerpo. Introducción Mediante ultrasonidos hemos observado el tejido subcutáneo y la grasa posicionada entre la piel y el músculo. Es posible observar en las vistas anatómicas la capa entre el tejido subcutáneo y la capa adiposa, así como la integridad de las bandas fibrosas que las dividen. Al envejecer, la calidad de las bandas fibrosas se pierde y aparecen deformaciones que pueden observarse mediante ultrasonidos.
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Regional Meeting of the International Society for Bioengineering and the Skin, Orlando, Florida, October 28–30, 2004. Gynoid lipodystrophy (cellulite) is the irregular, dimpled skin surface of the thighs, abdomen, and buttocks in 85% of post-adolescent women. The distinctive surface morphology is believed to result when subcutaneous adipose tissue protrudes into the lower reticular dermis, thereby creating irregularities at the surface. The biomechanical properties of epidermal and dermal tissue may also influence severity. Cellulite-affected thigh sites were measured in 51 females with varying degrees of cellulite, in 11 non-cellulite controls, and in 10 male controls. A non-contact high-resolution three-dimensional laser surface scanner was used to quantify the skin surface morphology and determine specific roughness values. The scans were evaluated by experts and naїve judges (n = 62). Body composition was evaluated via dual-energy X-ray absorptiometry; dermal thickness and the dermal-subcutaneous junction were evaluated via high-resolution 3D ultrasound and surface photography under compression. Biomechanical properties were also measured. The roughness parameters Svm (mean depth of the lowest valleys) and Sdr (ratio between the roughness surface area and the area of the xy plane) were highly correlated to the expert image grades and, therefore, designated as the quantitative measures of cellulite severity. The strength of the correlations among naїve grades, expert grades, and roughness values confirmed that the data quantitatively evaluate the human perception of cellulite. Cellulite severity was correlated to BMI, thigh circumference, percent thigh fat, architecture of the dermal-subcutaneous border (ultrasound surface area, red-band SD from compressed images), compliance, and stiffness (negative correlation). Cellulite severity was predicted by the percent fat and the area of the dermal-subcutaneous border. The biomechanical properties did not significantly contribute to the prediction. Comparison of the parameters for females and males further suggest that percent thigh fat and surface area roughness deviation are the distinguishing features of cellulite.
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There are glaring discrepancies in the microanatomical descriptions of cellulite in the literature. We revisited this common skin condition in women with a microscopic examination of 39 autopsy specimens. A control group consisted of 4 women and 11 men showing no evidence of cellulite. The lumpy aspect of the dermohypodermal interface appeared to represent a gender-linked characteristic of the thighs and buttocks without being a specific sign of cellulite. Incipient cellulite identified by the mattress phenomenon was related to the presence of focally enlarged fibrosclerotic strands partitioning the subcutis. Such strands possibly serve as a physiologic buttress against fat herniation limiting the outpouching of fat lobules on pinching the skin. These structures might represent a reactive process to sustained hypodermal pressure caused by fat accumulation. Full-blown cellulite likely represents subjugation of the hypertrophic response when connective tissue is overcome by progressive fat accumulation. Histologic aspects reminiscent of stretch marks are identified within the hypodermal strands, resulting in clinical skin dimpling.
Article
Cellulite is a common clinical condition, with few proven effective therapeutic options. Subcision is a surgical technique that is useful in treating advanced degree cellulite. This study was designed to determine the usefulness of the treatment of cellulite by subcision. From January 1995 to January 1998, 232 female patients, aged 18-52 years, with cellulite on the thighs and buttocks were treated on an outpatient basis by the subcision technique. In the postoperative period, all the patients had pain, bruises, and hemosiderosis. An improvement in the surface depressions was observed and the patients reported a high degree of satisfaction. This outpatient procedure is effective in the correction of surface depressions on the thighs and buttocks, clinically classified as cellulite.
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Heat shock protein 47 (HSP 47), a molecule expressed constitutively in cells that synthesise collagen, is involved in collagen type I biosynthesis, and after insult acts as a stress response molecule to sequester abnormal procollagen. Photodynamic therapy (PDT) is claimed not to result in extensive collagen damage, such as that which can occur after other laser treatments, e.g. hyperthermia (HT) or coagulation, thereby conferring on PDT a potential therapeutic advantage. In previous studies on mouse fibroblasts in vitro we demonstrated HSP47 elevation in the first hours after the application of conditions known to damage collagen, and an absence of HSP47 elevation following PDT with two well-established photosensitisers, haematoporphyrin ester (HpE) and meta-tetrahydroxyphenylchlorin (mTHPC). The present study examines HSP47 metabolism in murine skin following (1) HT, (2) PDT with HpE and (3) PDT with riboflavin (RB). Riboflavin was examined because of reports of collagen injury induced by its photoactivation. All three stresses were applied at grossly equitoxic, ‘tolerance’ doses. Three months after these doses, linear extensometry revealed the skin to have fibrotic characteristics after HT and RB PDT, but not after HpE PDT. HSP47 expression levels were analysed at transcriptional (Northern) and translational (Western) levels at early time intervals up to 24 h after the treatment application, starting immediately after the treatment for mRNA and 6 h post-treatment for protein. Highly significant upregulation of HSP47 was detected following HT, and PDT with RB. PDT mediated by HpE did not have any impact on HSP47 levels. These results were thus consistent with those from in vitro work and support the hypothesis of early elevation of HSP47 expression only by modalities affecting collagen or its precursors.
Article
Gynoid lipodystrophy (cellulite) is the irregular, dimpled skin surface of the thighs, abdomen, and buttocks in 85% of post-adolescent women. The distinctive surface morphology is believed to result when subcutaneous adipose tissue protrudes into the lower reticular dermis, thereby creating irregularities at the surface. The biomechanical properties of epidermal and dermal tissue may also influence severity. Cellulite-affected thigh sites were measured in 51 females with varying degrees of cellulite, in 11 non-cellulite controls, and in 10 male controls. A non-contact high-resolution three-dimensional laser surface scanner was used to quantify the skin surface morphology and determine specific roughness values. The scans were evaluated by experts and naive judges (n=62). Body composition was evaluated via dual-energy x-ray absorptiometry; dermal thickness and the dermal-subcutaneous junction were evaluated via high-resolution 3D ultrasound and surface photography under compression. Biomechanical properties were also measured. The roughness parameters Svm (mean depth of the lowest valleys) and Sdr (ratio between the roughness surface area and the area of the xy plane) were highly correlated to the expert image grades and, therefore, designated as the quantitative measures of cellulite severity. The strength of the correlations among naive grades, expert grades, and roughness values confirmed that the data quantitatively evaluate the human perception of cellulite. Cellulite severity was correlated to BMI, thigh circumference, percent thigh fat, architecture of the dermal-subcutaneous border (ultrasound surface area, red-band SD from compressed images), compliance, and stiffness (negative correlation). Cellulite severity was predicted by the percent fat and the area of the dermal-subcutaneous border. The biomechanical properties did not significantly contribute to the prediction. Comparison of the parameters for females and males further suggest that percent thigh fat and surface area roughness deviation are the distinguishing features of cellulite.