By the doctor Laurent Benadiba
The number of aesthetic procedures performed every year is continuing to rise, reaching 17.7 million in 2019, which is a 163% increase since 2000. One of the most common demands is treating the figure.
Several factures are at play. First, all those images of “perfect bodies” on Instagram, though most of the time they have been tweaked, not through surgery but with Photoshop. More seriously, many patients do not like to see how their body has been affected by significant weight gain and loss, whether due to pregnancy or fluctuations caused by an unbalanced diet, often after the lockdowns which, in addition to psychological problems, have led to serious weight gain in many very young patients. The resulting sagging skin and excess fat become the main reasons for seeking treatment.
It is not rare for these patients to have already tried various non-surgical techniques before coming to see a plastic surgeon. These “gentle” yet often expensive methods can improve their appearance, but the results are modest. Over the last few decades, laboratories and doctors have used different types of energy either to destroy fat, tighten up the skin or stimulate the muscles. Today, there are many such technologies on the market, and it is sometimes difficult for patients, and even doctors, to choose the right one. Here is a short overview of the current technologies available for treating the figure.
EXTERNAL RADIOFREQUENCY (RF)
Radiofrequency acts upon the skin by emitting very high frequency electromagnetic waves. When these VHF waves are applied to the skin, they heat up the subcutaneous tissue, thus stimulating the synthesis of collagen and elastin fibres, which is how we achieve a lift with an external action. This is the case of a number of machines that use either monopolar RF or bipolar RF (between two electrodes). The best known and most often used are (non-exhaustive list):
• Thermage FLX is the oldest version and FLX is the new version of Thermage technology, which uses monopolar RF and requires one single session.
• Potenza: mono or bipolar RF with microneedling, acting upon the superficial skin.
• Exilis and Morpheus 8, etc.
These machines use external radiofrequency and present almost no risk of burns and very few counterindications, even on pigmented skin. There may be an improvement to the skin quality, though this is not systematic and is difficult to predict. It often requires several 20 to 30-minute sessions per area, which can sometimes be painful or at least uncomfortable for the patient, making them less likely to want to have several treatments.
Renuvion
J-plasma or Renuvion is an internal radiofrequency device that combines helium gas with radiofrequency (RF) in order to create a plasma, which is the most powerful form of energy deliverable (a sort of lightning bolt). The procedure uses a special single-use cannula that heats up the subcutaneous tissues to 85° thanks to the helium gas, which acts as a conductor. The technique can only be performed by surgeons and takes time because the cannula must be passed across all of the skin in order to deliver the energy that causes the skin to retract. The results are sometimes visible immediately, but the final results can only be seen after 3 to 5 months. All areas of the body can be treated, such as the neck, arms, belly, thighs, knees, buttocks, etc. This operation can be combined with liposuction in order to further retract the skin and reshape the figure. Very popular in the US and South America, this technology is not very well-known in France but is already a real revolution in terms of correcting skin sagging without any scarring.
Vaser
Vaser is a technology that combines ultrasounds with liposuction. This combination is not new, as it was first introduced back in 1990 by Zocchi. Vaser is not designed to cause the skin to retract, instead it emulsifies the fat while preserving the surrounding noble tissue (vessels, nerves, etc.). The procedure is carried out in three steps: infiltrating the fat, emulsifying the fat using cannulas that deliver the ultrasounds, and suctioning the adipose emulsion. It requires specific training because some cases of burns have been reported, but it makes liposuction much easier, particularly “HD lipo” (high-definition) techniques.
Emsculpt and its equivalents
A pioneer in this field and much copied, this machine stimulates the muscles to firm up the figure. By sending focused electromagnetic energy (electric impulses) through the skin to the muscles, its action is the equivalent of several thousand contractions (sometimes more than 20,000/session). It can be used on the abdomen, buttocks and arms. Four to six sessions are required for noticeable results, followed by top-up sessions and physical exercise.
Cryolipolysis
This technology, which was introduced by Coolsculpting (patented brand) destroys localised fat through cold. There are a number of machines on the market, all with different capacities. It can be used to treat the neck, arms, abdomen, thighs, knees, etc. but the results vary according to the area, the machine used and how the patient’s fat responds.
This technology does not replace liposuction because, at best, it reduces the fat thickness by a few millimetres. However, care should be taken when using it because it can aggravate any sagging in skin that has already been stretched, as well as there being a serious risk of burns if the machine used is not suitable and, above all, if the procedure is not carried out by a doctor. There are many different techniques that enable us to improve the figure, and they are constantly evolving. However none of them offer a miracle solution! No technology is able to act on all three tissues at the same time, so these technologies must be combined, and the patients must be informed about the results they can expect and any potential risks.
By the doctor Laurent Benadiba.
Plastic surgeon in Paris and Geneva, qualified in Plastic, Reconstructive and Aesthetic Surgery for over 20 years.
He teaches Aesthetic Medicine at the Paris medical faculty and is co-director of the DUTIC and DUMEG diplomas.
He is the pioneer and doctor trainer for Renuvion technology.
More information on benadiba.fr
