By Doctor Phryné Coutant Flouc

A must for skin and intra-vaginal tightening.

Monopolar radiofrequency enables us to tighten up the skin or genitals in 3 to 4 sessions with no side effects or downtime. It is important to offer these treatments to patients while their dermal fibroblast stimulation is still decent.

Radiofrequency is a current of electromagnetic waves whose impedance – the tissues’ resistance to the electrons’ movement – causes the target area to heat up. The more water there is in the tissue, the better it conducts the energy and the higher the temperature will rise in the area. The skin temperature rises to around 40 to 42°C, which increases the tissue temperature to around 55°C.

The heat created within the target area stimulates the fibroblasts and leads to new collagen production, reshaping the dermal layers and improving the skin’s tonicity.

Radiofrequency can be monopolar, bipolar or multipolar, depending on the position of the electrodes.

Monopolar radiofrequency allows us to treat deeper within the skin, as the magnetic current circulates between a control electrode placed on the patient’s stomach or back and the electrode in the hand piece. The RF Exilis Elite from BTL has an integrated surface cooling system that can be adapted according to the depth of treatment (dermal or adipocytary layer) as well as a temperature control sensor that allows us to monitor the therapeutic efficiency throughout the duration of the treatment.

The indications for RF are slackness in the skin or vaginal mucosa. In the skin, the oval, the area under the eyelids, the neck and the décolleté are all excellent examples of mild slackness.

RF can be used on all areas of the body that are starting to slacken, such as the inner arms and the abdomen. However, it is important not to promise the patient more than neocollagenesis will be able to achieve (over age 50, dehydrated skin, smoking and heliodermia all suggest that results will be unsatisfactory).

We can also achieve superficial subcutaneous lipolysis, making the heat penetrate deeper with surface cooling. Three to four sessions are performed, spaced 8 to 14 days apart, with a collagen boost at 6 months then a top-up session every 6 to 12 months. All phototypes are eligible for RF treatments.

There is no downtime required. Very recently, the Exilis Elite Ultra Femme 360° hand piece for intimate areas was launched. It can be used to treat the labia majora, the fourchette and the vagina with a single-use probe reserved for the genitals.

Pain-free and with no side-effects, these treatments are very effective on vaginal slackness and early urinary incontinence. Patients have become very partial to these pain-free, downtime- free treatments, whether for the skin or the genitals. It is important that the practitioner chooses the right time to select them from their arsenal of therapies.


Doctor Phryné Coutant Foulc

Dermatologist specialising in aesthetic dermatology and pathologies of the vulva. Centre Dermatologique & Esthétique de la Femme in Nantes, France.

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