Dr. Sam Lam Plastic Surgery Forum

Hi Doctor!
As you know I work surrounded by doctors. A dermatologist I know who specializes in cosmetic dermatology (although not my usual dermatologist, no), knows that I use restylane and at one point a bit of artefill for cheeks, to make my face a bit rounder, since I already have a long face and lose weight from there first. Anyway, she suggested a procedure that made me go "hhhmmmm", but wanted to ask you if it sounds crazy to you or not.
She uses tripolar radiofrequency equipment in her patients, for tighetning/some sort of lifting effect in their faces. I have seen the results and they are great. Anyway, what does have that to do with me? She says that even though I am by no meas fat "there", that I have enough fat in my cheeks at the buccal area-height, so to speak (the lower cheek) as to use the tripolar rfrequency to tighten those tissues. She says the RF tends to push the tissue "upward" and that it in turn would push my own fat and fillers (the latter is said by me) "up", making me look a bit rounder without having to have resatylan so often. Does that sound crazy? I also worry that I have a bit of artefill, and am not sure how artefill reacts to radiofreqnency. Could it cause lumps as it onsets the process of collagen formation or whatever is onset by that technology? sorry for the typing mistakes, the keyboards is not working ok!

i am not familiar with "tripolar" but i do use RF (accent xl) to tighten things. i am particularly low wattage on my facial RF treatments because i do not want to risk any fat loss. i would say that tightening of the face and lifting of the face are two separate things. i personally think it is an overstatement to say that the face will magically lift with RF but then again i am a skeptic when it comes to light lasers/devices always erring on the side of underpromising the results. i think your artefill should be fine.
best,
sml

Hi!
THANKS FOR ANSWERING

I had to research for other doctors what's tripolar frequency, and it is similar to what you have, with one more frequency so to speak, that helps in some ways... the equipment is new and the derm traveled to US to buy it, so that is not the part that worries me... She saw experts, had the treatments performed on herself, etc.

Neither the lifting effect because she did use it on herself. She used on one side a bipolar one (during a congress in US she got that done) and the tripolar on the other half. To the untrained eye you don't see a difference,but if you look well (she will later fix things but on purpose has not yet, to show how it works to patients), the side with tripolar frequency treatment is tighter and (this is my own language, not hers) her features are higher up in her face (not weird, just no sagging, with the other side with bipolar having the same features a couple of millimeters lower, and less juvenile looking (I say it only because I witnessed it myself) - say, clear in nasolabial folds -> So it clearly has worked for her and I have seen others for whom it has worked. I know she uses low settings and many treatments rather than big settings and few treatments, to see how the skin reacts.

But I fear the same... when and how can RPF cause fat loss? I want to get the area tighter if it really makes my cheeks "lift" like in her, since it gives an "oomph" by somehow moving the fat "up" (my words, not hers, from what I've seen and from what she suggests) -> with the lower fat apparently moving up IN HER, ANYWAY, but I am scared of losing fat (not what I want) in the buccal area (versus moving it up, only) and looking weird.

Also scared of the artefill beads of PMMA reactng weird. You think the later would not happen, right?

Still think it is too crazy of an idea? again, I don't want to lose my facial fat,, reposition it, maybe, but lose it? not. If there is that risk, I'd rather not go through it. Please le met know what you think...
My ideal would be have a fat graft, but you know I can't treavel yet there nor have the means to, or the time off for it but it really is getting too costly to use restylane (I need quite some of it!) and the arteill lasts more but I fear having many PMMA beads on my cheeks... or shouldn't I?
Sorry again for the typos, this keyboard want crazy

Would you consider dangerous having ONE pass one day of the tripolar ONLY in that area? (very lower cheeks) - (she suggested not a whole treatment, but to try one time with a low setting, see if it make a difference, then maybe try again)
Or should I not have anything at all?

While this doctor has PHD ad whatnot, I still trust you more with this!

PS: her idea seems to be the one of having one pass of a low setting of the tripolar RF equipment only in that lower cheek area, then see how the skin reacts, then see if I need one more... but I still don't know if that is crazy. I trust you more!

honestly, i do not like to answer questions about technology that i am not familiar with. my comments would be as much conjecture as yours. the other thing about split face studies that are a bit dangerous is 1) one side of the face is always worse than the other. what i have seen interestingly (non-scientific) is that the right side is worse in about 80% of people even though this is not the side with more sun in a car obviously. so if one side were worse to begin with then you could be tricked afterward to think it was worse because we never look at our face that carefully until after a treatment 2) the placebo effect is huge. how we think we see something and convince ourselves that it looks or feels different has a great degree of psychological bearing on how we perceive it to be. just my thoughts. i think you will be safe but go by your doctor if you trust her. i really cannot help you further on this one.

Thanks for the feedback!!!