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Monopolar + Bipolar: New RF Device "DENSITY", Frontline Treatment for Sagging and Wrinkles

Nariaki Miyata

Miyata Plastic Surgery and Skin Clinic

Nariaki Miyata

  • RF

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Monopolar + Bipolar: New RF Device “DENSITY”, Frontline Treatment for Sagging and Wrinkles

Thank you for visiting the website of Jeisys Medical Japan.

Among many recent treatment devices for laxity and wrinkle treatment, RF devices are one of the most important technologies. Unlike HIFU and lasers, the main effect of RF is tightening.

In this issue, Dr. Nariaki Miyata of Miyata Plastic Surgery and Skin Clinic will introduce the treatment using the new RF device “DENSITY”.

Skin Laxity Treatment with the Next Generation RF device DENSITY (0:30~)

RF skin tightening treatment is based on the wound healing mechanism that repairs heat-induced tissue damage by causing heat damage to the dermis and subcutis.

Among RF devices, we will focus on capacitively coupled monopolar RF devices called ” Capacitive Coupling Monopoles,” in which the current flows directly. RF heating patterns include Joule and dielectric heating, and Capacitive Coupling RF heats at a high frequency, which is very high as Joule heat.

What is Capacitive Coupling RF (7:38~)

The commonly used monopole RF has been unable to deliver high thermal energy to deep layers due to the risk of surface burns. Capacitive Coupling RF was developed to address the problem of how to deliver sufficient thermal energy safely and deeply.

The Capacitive Coupling RF handpiece has an electrode at its end. While the electrode at the end of the handpiece is cooled, the impedance, a type of electrical resistance, is measured in real time to match the impedance of the skin surface, which facilitates the rise of current and efficiently warms the deeper layers of the skin.

How Capacitive Coupling Works (8:45~)

The electrodes of Capacitive Coupling RF devices have conductive and dielectric portions. The dielectric portion increases impedance. Increased impedance allows RF current to flow more easily, and current can flow more easily into the deeper layers while reducing epidermal effects.

Without a dielectric part, RF devices cannot safely conduct strong high-frequency waves through heating by Joule heat. Kapton film, a dielectric film, is sandwiched between the two to achieve both dielectricity and conductivity.

Capacitive Coupling enables superheating by resistive heat rather than dielectric heating, and fibrous connective tissue is heated predominantly over fat and moisture. Further, the use of Kapton films and Kapton frames allows the avoidance of the so-called edge effect, in which the center is not heated.

This results in thermal damage to the dermis and subcutaneous fibrous connective tissue as well, leading to the formation of new, robust collagen through 3D contraction and the wound healing process.

However, most of the actual treatments were painful and less than satisfactory for Asians. Not a few cases were painful but felt ineffective.

The Newly Launched RF Device, DENSITY (15:50~)

In response to this, DENSITY was developed, capable of monopolar and bipolar generation from the same electrode. The use of bipolar in Capacitive Coupling RF is a new concept and the most significant feature of DENSITY. Bipolar approaches mainly on the superficial layers, on the dermis rather than the subcutaneous layers of the skin for immediate results.

Tip with Patented Mono/Bipolar Technology (19:24~)

DENSITY is a device with both monopolar and bipolar properties. Monopolar, like conventional devices, has a slow improving effect that lasts for about six months.

Bipolar, on the other hand, takes about one month to show its effects. The effects are also said to last several months.

Unlike conventional bipolar, the skin not only looks tauter, but also tighter and better textured. This Capacitive Coupling bipolar is able to approach near the surface, allowing the patient to experience a change in the texture of the dermis without the use of injectable agents.

Please refer to the video for the actual experiment of irradiating red tuna meat and the case study.

Utilization of Monopolar and Bipolar Tips (21:10~)

Although POTENZA and DENSITY have different frequencies and energy levels, the combination pattern provides a theoretical reference.

Experiments combined monopolar and bipolar irradiation in multiple patterns were performed on aged skin. The best results, such as collagen increase, were obtained when monopolar irradiation was followed by biopolar irradiation. This is thought to be because the impedance of the dermis is lowered by preheating the tissue with monopolar irradiation, making it easy to energize and more efficient for the bipolar effect to be obtained.

Please refer to the video for a detailed case study of bipolar irradiation after continuous monopolar irradiation.

What is the Ideal Treatment Method with DENSITY (26:11~)

Whether the ideal treatment with DENSITY is in combination with monopolar or bipolar alone is not yet fully understood in practice. In clinical practice, however, it is recommended that irradiation with a monopolar tip be followed by irradiation with a mono/bipolar tip.

This is because we want to obtain both immediate and long-lasting results. To achieve this, we want to first shoot monopolar shots sufficiently, but mono/biopolar tip has electrode with smaller surface area. Since the tips are consumable, it would be best to use monopolar tips to achieve lasting effects while using mono/bipolar to get synergetic effects considering the cost.

Another advantage of this irradiation method is the auto mode. The irradiation is done without vibration, so the treatment can be performed quickly, and heat can be accumulated in a short time. The irradiation time is less than 30 minutes for 300 shots. This allows for less pain and speedy results.

*Please refer to the video for more information about this case.

DENSITY offers a different effect at one-third the cost of conventional RF devices. Therefore, it is a complementary rather than a competing treatment; DENSITY can be used in conjunction with conventional ones. Conventional devices offer more intense heating, but are more painful. For some patients, DENSITY and conventional devices can be used selectively.

Summary (32:36~)

DENSITY employs a bipolar tip to achieve an immediate tightening effect. The short treatment time and mild pain make this treatment less burdensome for patients. By combining monopolar and bipolar, a wide variety of treatment options are possible. This device has further potential and may become quite the trend in 2024.