Surface irregularities post-radiofrequency tissue tightening rare, preventable, treatable

Subcision with autologous fat transfer is an effective technique for managing patients who have developed surface irregularities after undergoing a radiofrequency tissue tightening procedure, said Rhoda Narins, M.D. at a symposium yesterday.

"These defects are largely preventable with the use of proper technique, but we can help affected patients who do not respond adequately to minimal intervention," comments Dr. Narins.

The corrective technique she described was devised based on limited histological studies showing the presence of fat necrosis and scarring at the sites of irregularities. When performing the fat transfer, Dr. Narins uses tumescent anesthesia at the donor and recipient sites and harvests fat with a 10-cc syringe and Coleman extractor. After centrifuging the material for one minute, the infranate and oily supranate are discarded, extra supranate is wicked off, and the fat is transferred into 1 cc syringes. A baby Toledo cannula is used to undermine the scarred tissue prior to fat transfer.

Dr. Narins notes the risk of surface irregularities has been virtually eliminated with adherence to published treatment guidelines that are designed to minimize tissue overheating. Those guidelines recommend use of multiple passes, moderate settings, the new fast tip and no local anesthesia.

"Seventy percent of the contour irregularities that have been reported occurred in patients who underwent the radiofrequency procedure after being blocked with a local anesthetic or IV sedation," she says.