Beauty Tech Review: Body Contouring - Radio Frequency Assisted Lipo (RF Lipo)

New advances in liposuction technology provide the beautiful contours many patients desire.



Body sculpting is the next level of liposuction technology where physicians are able to not just remove fat, but sculpt their patients' bodies. New technologies are constantly being developed and one of the latest is Radio Frequency Assisted Lipo (RFAL). Recently, we spoke to two physicians who have worked with this impressive new technology.

RFAL is new to the US and is currently undergoing FDA testing. "It's regulated and used under what's called an FDA clinical guideline or clinical protocol, which means that the company has gone to the FDA and agreed with the FDA on a treatment protocol that certain investigators like myself will follow," says Dr. Richard D'Amico. "So it's very limited in the United States and the patients are all volunteers for the clinical study. The device has been used in Europe and other countries for several years. It has what's called a CE mark in Europe, which is like their FDA and the Canadian equivalent of the FDA approved the device in 2009."

Dr. Malcolm Paul describes the difference between RFAL and other liposuction technologies like laser lipo and ultrasound assisted lipo, "Well the fundamental difference is that this is the only technology that can simultaneously dissolve the fat cells, coagulate the blood vessels (so that there's less bleeding and bruising) aspirate the fat that is dissolved, and as importantly, tighten the collagen from the skin down to the muscle."

RFAL Results of Dr. Malcolm Paul


The current RFAL device on the market uses bi-polar radio frequency, and has both internal and external monitoring. Dr. Paul says, "[This] is a bi polar radio frequency device. There are two electrodes, internal and external. The external delivers a little of energy to the skin but also monitors the skin's temperature. The internal probe delivers the energy, dissolving the fat but because it requires a closed circuit, because it's a bi-polar device, the energy only goes from the internal cannula to the external so there's no spread to the other areas. You know exactly where the energy is being delivered." This differs from the 360 degree energy delivery in laser lipo devices from which energy can spread to other areas.

RFAL Results of Dr. Dennis Hurwitz


Dr. D'Amico says it's useful on not only superficial fat, but deep fat as well and it works well to tighten collagen. "The best analogy I can give to why this is more powerful for skin retraction and skin tightening is to use a parachute analogy. If you want to pull a parachute in, you don't go up and grab the parachute itself - the skin - what you do is you pull on those strings and the parachute comes in. And that's what this technology can do. Down deep in the fat, that honeycomb is like strings and it pulls the strings in. So it's a very powerful and efficient technology, in my review."

He also says that RFAL is useful on many parts of the body, "The tummy is a particularly useful area because after pregnancies, a lot of women's skin is very stretched out and has lost its elasticity. So just taking out the fat with lipo isn't enough, and we try to avoid doing cutting procedures like tummy tucks. This technology allows us to get more skin contraction, more skin shrinkage, so we can actually take more fat out with a better result.... Anyplace where the skin is lax has a potential. Women hate their arms, especially their upper arms and lax skin in the upper arms is a big complaint that patients have, and I believe this technology has a lot to offer in that area as well."

RFAL Results of Dr. Diane Duncan


Dr. Paul believes RFAL provides an alternative to standard liposuction techniques and is impressed with the device's ability to perform several steps in one. "It's a replacement for standard liposuction. It's a replacement for ultrasonic liposuction because it accomplishes everything in one step, four things at once. We typically will add traditional liposuction the end to get additional fat out. Or power assisted liposuction but the most incredible thing is the skin tightening. So skin tightening and the decrease in the amount of bruising which typically occurs because the radiofrequency energy much like a cautery unit that's used in surgery, actually coagulates the blood vessels which diminishes the bruising, therefore it's more comfortable."

Both physicians noted the improvement in bruising. Dr. D'Amico says, "There seems to be a bit less bruising, and a bit less pain. I don't want people to think that these are painless procedures, but I think we're going to improve the recovery. I've noticed that particularly in the tummy area and particularly in patients who need a lot of contouring."

RFAL Results of Dr. Stephanie Mulholland


Dr. Paul has also found RFAL to be useful in treating cellulite. "It also has incredible value in treating cellulite because nothing treats cellulite like this does. Because you can release the little fibrous bands that pull the skin like a mattress button, you release that and you can add fat or you can smooth it with just the machine alone. The technology is much better than anything else we have."

According to Dr. D'Amico, patients can expect to see their final results in about 6 months and the recovery is easier than with traditional liposuction. "Right after surgery, in that first week, there's actually swelling because what happens when we're recontouring and removing fat, the body puts fluid and we get swelling. So a week later, you don't look much better although some people, when we do a lot of body contouring, it's very obvious, even at a week. The thinner patients with more subtle results, they take a few weeks to start to see it. If somebody said when is my result final? I would say six months because the skin contracture takes place over time. So we get an immediate result by removing unwanted fat but we get a more long term further improvement with skin tightening over six months."

Dr. Richard D'Amico
Dr. Richard D'Amico
Dr. Richard A. D'Amico is a board certified plastic surgeon in New Jersey and the Medical Director of the Plastic Surgery Skin Care Center in Englewood. A previous President of the American Society of Plastic Surgeons, Dr. D'Amico is also on the Board of Directors of the Society of Plastic Surgery Skin Care Specialists and the prestigious American Society for Aesthetic Plastic Surgery where he serves on the Innovative Technology Committee, which evaluates and makes recommendations on the latest procedures and techniques performed in cosmetic surgery. Currently, Dr. D'Amico is a faculty member at Mt. Sinai School of Medicine, where he is the Assistant Clinical Professor of Plastic Surgery, and is Chief of the Department of Plastic Surgery at Englewood Hospital and Medical Center in Englewood, New Jersey.

Dr. Malcolm Paul
Dr. Malcolm Paul


Dr. Malcolm Paul is a board certified plastic surgeon who has been selected for and included in Best Doctors in America, Orange County Top Doctors, and Guide to Top Doctors (Center for the Study of Services Publication). Following his postgraduate training at Mount Sinai Hospital in New York, Dr. Paul went on to complete his residency at George Washington University Medical Center. Since then he has held various offices such as Past President, American Society for Aesthetic Plastic Surgery, and Past President, Orange County Society of Plastic Surgeons, Inc. Click on Affiliations and Memberships for a complete listing. Dr. Paul is currently affiliated with the University of California, Irvine Medical Center and The Hoag Memorial Hospital Presbyterian in Newport Beach, CA.


American Health and Beauty Beauty Tech Review Body Contouring
American Health and Beauty, in an effort to provide the most up-to-date information to our readers, presents the Beauty Tech Review. The next installment in this ongoing series discusses Body Contouring technology. Join American Health and Beauty editor, Keith Veseleny, as he speaks with leading physicians who share their knowledge on each body contouring platform.

The Beauty Tech Review: Body Contouring - will include: Dr. Mark Schusterman on Traditional Liposuction, Dr. Thomas Barnes on Laser Lipolysis, Dr. Jeffrey Hall and Dr. Victoria Falcone on Tickle Lipo, Dr. David Broadway on Ultrasonic Assisted Liposuction, Dr. Todd Malan on Water Assisted Liposuction, Drs. Rox Anderson, Henry Chan and Lori Brightman on Zeltiq, Dr. Elizabeth VanderVeer on Injection Lipoloysis and Dr. Thomas Barnes and Dr. Richard D'Amico on Radio Frequency Liposuction.

Previous Beauty Tech Reviews have included the following topics: Laser Lipoloysis and Fractional Resurfacing.