Radiofrequency treatments: what can we expect?

Among non-ablative procedures in aesthetic medicine, the radiofrequency (RF) is one of the most popular for the treatment of face and body skin laxity. It can be classified as a physical bio-stimulation that produces a temperature increase on biological structures, using electromagnetic waves. The term encompasses devices having substantial differences in energy, wavelengths, handpieces dimension and structure. Moreover, for some of these, the protocols are only partially defined. The aim of this short review is to clarify some aspecst of the RF therapy starting from the physics, passing through the mechanism of action and finally, with the most suitable protocols. Contrary to mechanic waves, electromagnetic waves, physics are always transversal to the impulse and this leads to the different energy distribution in capacitive (monopolar) or resistive (bi- or multi-polar) applications. The thermal damage as therapeutic effect is a postulate that needs to be discussed and the same is true for the terms “non-surgical” and “non-ablative”, often recurrent in the scientific literature. Protocols must be optimized according to the machine and the patient, keeping in mind the possibilities of biostimulation in terms of immediate improvement and of long lasting investment in skin rejuvenation. It is mandatory to understand the possibilities and limitations of each device to perform useful, safe and correct medical treatments.