Back

Matteo Vigo

Matteo Vigo

American Academy of Cosmetic Surgery Hospital
UAE

Title: Face and Neck tightening: Minimally invasive radiofrequency assisted liposuction

Biography

He is an accomplished surgeon offering over 10 years of experience in performing challenging surgical operations encompassing plastic and reconstructive surgeries. Outstanding in performing fat grafting and breast surgeries (both aesthetic than reconstructive ) as well as possessing impressive skills in facial cosmetic and body recontouring surgeries. Exceptional and hands-on experience in Liposuction procedures. Skilled initiator of innovative procedures and strategies while evaluating and managing clinical practices ensuring exceptional customer services and quality patient care. Established cosmetic surgery expert with exposure to global locations and sound knowledge of standard practices and ethics in medicine; conversant with legislation and standards ensuring patient care, vigilance and safety during interventions while achieving clinical excellence.

Abstract

The face and the neck areas are presenting different aesthetic issues than the body. With our aging population, cosmetic neck and facial surgery for skin laxity, texture and rhytides has been a growth area in aesthetic plastic and cosmetic surgery. However, the long downtime and the hazards of general anesthesia, wound healing and scaring associated with excisional rejuvenation procedures and fully ablative skin resurfacing are deterring many patients from taking the surgical approach. The facial aesthetic issues have been treated with non-ablative modalities, using IPL, lasers and radiofrequency (RF ), botox and fillers that can be performed without anesthesia or with a local one and have little or no downtime. However, the results are less dramatic than excisional procedures and often require several treatment sessions over several months to achieve the best results. An intermediate approach of non- or minimally invasive and ablative technologies was then developed, deploying fractional lasers and RF, using higher fluence than non-ablative modalities but sparing a significant proportion of the skin to act as a “healing reservoir ”. These fractional ablative devices give better results than non-ablative technologies and a shorter downtime than fully ablative approaches, without the need of general anesthesia. The new technology RFALTM (radiofrequency assisted liposuction ) nowadays is the best solution to correct these blemishes. It provides optimal sub dermal RF energy, with precise and uniform dermal heating. The neck is also a challenging area for aesthetic treatments. It is a small and delicate area that often presents with laxity challenges, with or without fat excess. The aging neck, often having a thin fat layer has not been an ideal target for conventional liposuction, where the main concern of skin tightening was not addressed. The FaceTite and NeckTite hand pieces differ in their dimensions and in some features that stem from the anatomical differences between face and neck. Both hand pieces have an external electrode with embedded temperature and impedance sensors, allowing it to directly monitor skin temperature, skin contact and internal impedance in real time. The internal electrode passes immediately under the reticular dermis in the superficial hypodermal fat, while the external electrode glides along the superficial epidermal surface. The RF generated heat coagulates very superficial adipose tissue, coagulates blood vessels, minimizing aspiration-induced or mechanically-induced ecchymosis. The internal electrode also induces a thermally mediated coagulative disruption of sequential hydrogen bonds and un-raveling of the collagen triple helix in the reticular dermis, resulting in an immediate “on the table ” tightening of the skin. Over the 6-12 weeks following treatment there is an RF thermally mediated neocollagnesis and neoelastogenesis which also adds to the tensile and elasticity of the dermis, improving the clinical appearance of skin laxity. Lastly, the external electrode delivers a gentle papillary supra-physiological heating which results in papillary dermal collagen and elastin production. The short and long term effect of the FaceTite and NeckTite treatments is skin and soft tissue tightening. As there is a complete “thermal containment ” between the internal and external electrode, there is no risk to deeper structures, such as motor nerves and vascular structures in the face, and neck (occasionally body ) for safer procedures.