The gold standard treatment for the many aesthetic aspects
of aging has for many years been surgery in its many forms. However, with
increasing patient demand for cosmetic rejuvenation and with the strong desire
and drive by patients to attain aesthetic enhancement with minimal risk and
rapid recovery, there has been a strong surge inspiring the field of
nonsurgical skin rejuvenation. Traditionally, most of the nonsurgical methods
have centered around those that destroy the epidermis and cause a dermal wound,
with resultant dermal collagen remodeling and secondary skin tightening and
rhytid improvement. Currently, there is growing interest in a wide range of
nonablative interventions that, predictably, are claimed to rejuvenate skin and
subcutaneous tissue "safely and effectively." Several nonablative
systems have been cleared by the U.S. Food and Drug Administration (FDA) and
been CE marked in Europe for the purpose of skin rejuvenation and
lipocontouring.
Today I would love to review a particular nonablative
radiofrequency device currently in use for skin rejuvenation, which utilizes Mono,
Tri and Hexa polar mode of delivery to rejuvenate skin, zap fat and improve cellulite.
The device is called Mabel Pro it
has been CE Marked in Europe and currently awaiting FDA approval in the US.
First question that most people want to know is what is
radiofrequency and how does it work?
Radio waves are basically high frequency waves on the
electromagnetic spectrum (300 KHz-300GHz), which we use for TV, Radio, & Phone
transmissions in our daily lives. When applied to skin or sub cutaneous tissue
these high frequency waves generate a RF field by rotation of water molecules, which
translates into friction and heat generation. Heat energy is absorbed in the
dermis to generate collagen and elastin through fibroblast activation. Heat
transmitted into hyo-dermis results in fat membrane disruption and heating up
of the collagen bundles, thus reducing fat cells circumference and improving
cellulite.
Radiofrequency can be used in Monopolar, Bipolar or
Uni/Multi polar modes. Using Monopolar mode of application a single electrode is
applied to the treated area and the opposing electrode is applied relatively
far removed; in the form of a back plate, so that when the current is applied
to the skin it heats up point of application and then goes deeply through the
body disperses and gets removed from the second plate. The treated area is
heated rather deeply (usually up to 20 mm) & we can achieve skin
rejuvenation as well as fat contouring. If too much energy is delivered it can
lead to serious side effects like burns and scars.
Building upon the success of monoploar mode of delivery and
trying to avoid the side effects Bipolar mode was put into practice. Bipolar
mode lets the energy pass between two electrodes approximated few cm apart,
hence heating the superficial tissue (dermis) only. This mode is used mainly
for skin tightening and collagen production.
Unipolar mode is further improvising of Monopolar mode to
avoid side effects associated with it, yet retaining the efficacy. This mode sends
smaller amounts of energy into the body through a single probe, as the amount
of energy deposited into the skin is very small it does not need to be removed
by a second remote electrode. This energy produces the desired effect near the
application probe and then disperses into the body without causing any harm. More
heat is absorbed at the point of application and that is where main action
takes place dermis and hypodermis.
Multi-Polar (tri, hexa) mode uses multiple Unipolar heads to
apply energy to the treated areas. This combination is synergistic and allows to
reduce the required intensity of energy through each probe and application of
multiple probes covers bigger surface area and speeds up the treatment time,
thus minimizing side effects and possibly increasing effectiveness.
Mabel pro uses Mono,
Tri and Hexa polar heads. Which means through its sophisticated control
algorithms for optimizing the concurrent application of the two types of Radio
Frequency it can transmit multiple energies at lower frequencies synonymously to
reduce the side effects and increase the efficacy of treatment compared to the
other RF devoices in the market.
Mabel pro is typically used to treat
skin laxity and sagging, usually of the face and neck but also elsewhere on the
body. It also has good potential to treat cellulite and perform body sculpting.
If I divide my patients into categories; around 50-60% come
to see me to loose weight and contour their bodies. Diet and exercise are the
two focus subjects we talk about during our body contouring consults. We all
know it often takes more than a healthy lifestyle to give your body the shape
you want.
Some of the technologies I have been using successfully in
my practice include: Liposuction, Radio frequency( Accent XL, Mabel Pro),
Mesotherapy, Low Level Laser and vaccum massage (Triactiv). Recently we have added
a new and exciting Ultrasound Technology (Luvitra Twin) at our Al Tababah
Clinics to zap away those unwanted lumps of fat.
Ultrasound body contouring is now a clinically proven body contouring solution
to combine totally non-invasive with durable measurable results. The treatment,
involves focused ultrasound waves that target that "impossible to diet
away" fat found on the hips, thighs, arms, and stomach. There is no incision,
each session lasts about 40 minutes to an hour, and patients can go right back
to work after a treatment. We get clinically demonstrated fat thickness and
circumference reduction. The lysed
fat cells (adipocytes) are removed via the body’s natural physiological and
metabolic pathways. Average circumference reduction ranges between 10-15
centimeters with each session. Multiple treatments deliver incremental
circumference reduction. Most patients need three or four treatments.
During the session there may be slight tingling, but patients don't find this
to be painful. There is some ringing of ears; which can be a bit annoying but
easily tolerated.
How Does Ultrasound
FatBlaster Work?
The UltraSound treatment uses scientifically proven focused
ultrasound energy that selectively targets fat cells in the chosen body area
and disrupts them without harming surrounding tissues such as nerves and blood
vessels. During the UltraSound treatment, the membranes of the fat cells are
disrupted. The fat cell content, primarily comprised of triglycerides, is
dispersed into the fluid between the cells and then transported through the
vascular and lymphatic systems to the liver. The liver makes no distinction
between fat coming from the ultrasound blasted fat and the fat originating from
consumed food. Both are processed via the body’s natural mechanisms.
The procedure is not for
people who want to get rid of a lot of excess body fat. Instead, it is for
those who have isolated areas of extra fat that are not helped by diet and
exercise.
I usually write about topics which pop up frequently at my
busy practice at Al Tababa
Clinics. Today we are going to analyze what options do we girls have for
improving frames of our eyes as we age ; Eyebrows !
Lets analyze, with aging, gravity causes the eyebrows (brow)
to move downwards. We compensate for this by contracting the muscle
(frontalis), which raises the eyebrows. Contraction of this muscle causes
wrinkle lines across the forehead. Eventually the muscle relaxes and the
eyebrows become lower. This typically makes you look slightly sad and
tired. It can also increase the fold on the upper eyelid making it
difficult to apply makeup.
Brow lift treatments are aimed at elevating the eyebrows. This
widens the eyes and makes you look less tired. After surgery people are
often asked if they have been on holiday as they look refreshed. The
effects are subtle and most people will not be able to pinpoint the exact
change in you but will notice that you look fresher.
The eyebrow in females should be gently arched with its’
highest point lying 2/3rds of the way out from the centre. In men the
eyebrows are usually flatter and raising them is not usually appropriate as
this can make them look slightly surprised.
In the past, the only satisfactory way to perform Brow lifts
was with a surgery operation. This procedure is normally carried out by
keyhole surgery. Small incisions are made within the hairline and the
tissue is gently separated allowing the eyebrows to rise. Most people
recover quickly from the procedure and are back at work within 10 days.
Chemical Brow Lift
More recently, however, medical aesthetic injection
techniques have been used to lift the eyebrows. Selectively weakening the
muscles which pull down the eyebrows (using Botulinum Toxin) will result in
them rising. The muscles which pull down the inner part of the eyebrows
cause frowning in the centre of the forehead. The muscles which pull down
the outer part of the eyebrows cause the crows-feet smile lines which occur on
the temple on the side of the eye.
Unlike surgery, injections to weaken these muscles can be
performed as a quick and easy outpatient procedure. Many people have the
treatment during work breaks or at the end of the day. The effects are
not immediate with most people noticing a gradual decrease in the frown and
crows feet wrinkles a week following treatment. This effect last between
4-6 months and will need to be repeated. Usually after a 3 treatments in
a year the muscles relax more permanently and the effect last for longer and
longer.
Non Surgical Thread
Lift
Botox or chemical lift of the eyebrow is dependent on the
strength of your (frontalis) muscle, if the muscle is not very strong and the
forhead skin is drooping you might not be the right candidate for chemical brow
lift. The thread lift is an exciting new non surgical approach to brow or face
lifting and represents a significant advance in minimally invasive facial
rejuvenation. A lunchtime procedure, the thread lift uses plastic non
absorbable, bio-compatible threads to lift and support sagging skin. The
threads used in this type of lift are lined with numerous small directional
fibers; which are able to fix onto the soft tissues underneath the skin. Once
the threads are inserted the sagging tissue is lifted the fibers anchor the
soft tissue in the corrected position. Over a number of months, new collagen
formation around the threads strengthens the support.
Accordingly, the threads are able to lift and support a
drooping eyebrow. The thread lift is a very safe procedure as the threads are
made of bio-compatible material and their safety has been established over the
years as permanent sutures. Unlike face lift surgery results are natural and
there are no scars. It’s a simple walk-in walk-out procedure which takes 30
min.s or so to perform. Recovery is quick and you can get back to work in 2-3
days. Studies demonstrate that the threads stimulate collagen formation around
them and results are long lasting. Unlike surgical lift this procedure can be
reversed if requested.
It is important to remember that everybody’s face is
different and the consultation process is important to assess which treatment
is most suitable for your patient. This should ideally start with a skin
analysis and discussion of the treatments available.