With Attiva Subdermal Radiofrequency
Dr Catherine de Goursac
ATTIVA (CE and FDA) is a technology that delivers RF through subdermal cannulas
and enables us to firm up, smooth and revitalise the face and body.
HOW TO SMOOTH THE ARMS
Many women over fifty have a complex about their arms, meaning they reluctantly stop wearing sleeveless dresses or tops in summer.
The upper arms age in one of two ways, sometimes both:
So-called “bingo wings” develop, which are caused by sagging skin and muscle, and/or the skin on the inner arms becomes wrinkled, making it look a bit like crumpled cigarette paper. This sagging sets in very quickly and, until now, we had very few solutions except for surgery (brachioplasty), which leaves a long scar that can look unsightly.
GENTLE REJUVENATION WITH WARM TEMPERATURES
Subdermal radiofrequency with a heated ATTIVA cannula allows us to densify the skin by carefully warming the tissue to between 48 and 52°C. This targeted temperature allows us to boost elastin synthesis, as elastin is highly thermosensitive: its synthesis is increased around 50°C but it is destroyed at temperatures of around 60°C. At these warm temperatures, collagen I is bio-stimulated by this gentle rejuvenation, unlike collagen III which is more fibrous and is synthesised at a higher temperature, so the extracellular matrix is regenerated. Thanks to this fully adjustable heat, we can also treat a cellulite-like appearance on the arms, if required. We mark out the treatment zone and heat it to 65°C, which destroys the collagen bridges between the fat cells that give this orange-peel appearance, and it also liquefies the fat, which is then eliminated naturally.
To achieve good results, the ideal situation is that the skin is only slightly saggy on top of a good mass of muscle, and so the area can be prepared with cosmetic and muscular treatments. However, in the case of severe skin atrophy, it will not be capable of regenerating itself sufficiently and the results will be disappointing. It is important to measure the skin’s thickness and to gently bend the arm so that we can see how “crumpled” the skin is on the worst areas, which is the inner part of the arm, from the armpit to mid-way down the arm. If the volumes are too important, the treatments will also be ineffective: we therefore need to be careful when selecting suitable candidates and must not hesitate to warn patients, if they insist on having the treatment, that they may not get the result they want and that it would be better to consider another technique.
WHAT HAPPENS DURING THE SESSION
The treatment zone is marked out on the inner arms, where they are most creased. To put them in the optimal position for this, we turn the forearms towards the outside. We then take photos from different angles. Next, we administer a light anaesthetic. The heated cannula is equipped with a heat sensor to make the window for temperature delivery extremely precise. We slide the cannula underneath the skin and it methodically heats up the whole treatment zone. It is important to thermo-stimulate the whole area for at least half an hour per arm.
AFTER EFFECTS
The after-effects are very mild, as we are within the temperature window of gentle rejuvenation, so there is no destruction (nerve, tissue), no pain, usually no bruising, and the patient can get back to sport and lifting the next day. However, they do need to avoid swimming, saunas and jacuzzis, given that the skin has been cut. A gentle massage is recommended in the three days following treatment.
ASSOCIATING OTHER TREATMENTS
We sometimes associate this with other treatments in order to optimise the results and, in the case of very wrinkly arms, we can associate it with regenerative medicine in the same session, with polynucleotides and/or growth factors.
THE PROTOCOL
Given that the results appear later on, it is important to schedule the sessions three months prior to when the patient would like to start wearing sleeveless tops. We recommend one or two sessions, depending on how crumpled the skin is.
Though there used to be nothing we could do to combat the creased appearance of the arms, we now have solutions that allow us to treat this stubborn area without causing a scar all the way along the arm. We use gentle rejuvenation methods in order to respect the skin’s physiology.
Dr Catherine de Goursac: Expert in medical aesthetics techniques for 30 years. Teacher at the faculty of medicine since 2017, board member of the AFME (French Association of Aesthetic Medicine) and the FSMEA (Union of Aesthetic and Anti-aging Doctors). Permanent member of the French Society of Aesthetic Medicine.
More informations: esthetiquemedicale.com
