Key Points

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  RF is of particular interest as a safe and effective way to decrease skin laxity in facial rejuvenation; either as a primary treatment or to correct recurrent laxity after a facelift or neck lift (▶ Fig. 19.1 ). ^{1 , 2 , 3}

  
  
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  Thermal devices such as those that are radiofrequency (RF)-based impact the soft tissues at a molecular level by collagen denaturation at 55 to 60°C, leading to subsequent neocollagenesis, ellastogenesis, angiogenesis, and subdermal adipose remodeling over the subsequent 4 to 8 weeks from treatment (Video 19.1). ^{2 , 4 , 5}

  
  
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  RF energy can be delivered using monopolar, bipolar, or multipolar devices. Other variants of RF delivery include fractional, sublative, and combination technologies (laser, light, electromagnetic energy). ^{4 , 6 , 7 , 8 , 9}

  
  
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  RF can be used safely in patients of all skin types, and is most effective in younger patients with mild skin laxity and good skin elasticity. ^{2 , 3 , 10}

  
  
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  Frequently, RF is used in conjunction with liposuction. RF energy is applied first to tighten the fibroseptal network and induce skin tightening, while the subsequent liposuction decreases the underlying adipose tissue volume. ^{2 , 4 , 5 , 11}