Capacitive-Resistive Monopolar Radiofrequency at 448 kHz as Coadjuvant Treatment in Plastic Surgery CRMRF in Plastic Surgery

Main Article Content

Julián Andrés Hernández Beltrán

Keywords

capacitive-resistive monopolar radiofrequency, subthermia, edema, inflammation, hematoma, plastic surgery

Abstract

Radiofrequency is widely used in the clinical practice thanks to the physiological effects of therapeutic heat on pain relief, reduction of inflammation and edema, and tissue regeneration. Capacitive-resistive monopolar radiofrequency (CRMRF) at 448 kHz has proven to have effects applied as diathermal and subthermal power. Work subthermally allows to focus on acute processes immediately after surgery, where hyperemia is contraindicated, and no other radiofrequency can be applied. The study focuses on the effect of applying 448 kHz as a coadjuvant treatment in plastic surgery, both before and after surgery, and the results have shown that, when applied before surgery, particularly in patients with risk factors, it prepares tissues by ensuring their oxygenation and accelerating recovery, reduces postoperative time, and obtains better results. When applied after surgery, it has the same effects aside from reducing tissue inflammation and hematomas and resolving fluid retention, which favors lymphatic drainage without pressotherapy. CRMRF applied as a coadjuvant treatment of plastic surgery is a safe, painless, and well-accepted treatment for patients, which reduces the time of surgery by 20%–30% in patients with fibrosis and the time of recovery by 40%–50%. It obtains better results, reduces costs, and patients can see the results of surgical treatments sooner.

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References

1. Hernández-Bule ML, Paíno CL, Trillo MÁ, Úbeda A. Electric stimulation at 448 kHz promotes proliferation of human mesenchymal stem cells. Cell Physiol Biochem. 2014; 34(5):1741–55.
2. De Sousa-De Sousa L, Tebar Sanchez C, Maté-Muñoz JL, et al. Application of Capacitive-Resistive Electric Transfer in Physiotherapeutic Clinical Practice and Sports. Int J Environ Res Public Health. 2021; 18(23):12446.
3. Chang MC. Conservative Treatments Frequently Used for Chronic Pain Patients in Clinical Practice: A Literature Review. Cureus. 2020; 12(8):e9934.
4. Guo L, Kubat NJ, Nelson TR, Isenberg RA. Meta-analysis of clinical efficacy of pulsed radio frequency energy treatment. Ann Surg. 2012; 255(3):457–67.

5. Yu C, Peng R-Y. Biological effects and mechanisms of shortwave radiation: a review. Mil Med Res. 2017; 4:24.
6. Kumaran B, Watson T. Thermal build-up, decay and retention responses to local therapeutic application of 448 kHz capacitive resistive monopolar radiofrequency: A prospective randomised crossover study in healthy adults. Int J Hyperthermia. 2015; 31(8):883–95.
7. Hernández-Bule ML, Martínez MA, Trillo MÁ, Martínez L, Toledano-Macías E, Úbeda A. Response of human cancer cells to simultaneous treatment with sorafenib and radiofrequency current. Oncol Lett. 2021; 22(5):807.
8. Hernández-Bule ML, Martínez-Botas J, Trillo MÁ, Paíno CL, Úbeda A. Antiadipogenic effects of subthermal electric stimulation at 448 kHz on differentiating human mesenchymal stem cells. Mol Med Rep. 2016; 13(5):3895–903.
9. Hernández-Bule ML, Medel E, Colastra C, Roldán R, Úbeda A. Response of neuroblastoma cells to RF currents as a function of the signal frequency. BMC Cancer. 2019; 19(1):889.
10. Hernández-Bule ML, Toledano-Macías E, Naranjo A, de Andrés-Zamora M, Úbeda A. In vitro stimulation with radiofrequency currents promotes proliferation and migration in human keratinocytes and fibroblasts. Electromagn Biol Med. 2021; 40(3):338–52.



11. Trillo MÁ, Martínez MA, Úbeda A. Effects of the signal modulation on the response of human fibroblasts to in vitro stimulation with subthermal RF currents. Electromagn Biol Med. 2021; 40(1):201–9.
12. Naranjo P, López R, Pinto H. Reduction of erythema after laser on rosacea by subthermal 448 khz monopolar radiofrequency. Int J Dev Res. 2015; 5(3):3775–7.
13. Kumaran B, Watson T. Treatment using 448kHz capacitive resistive monopolar radiofrequency improves pain and function in patients with osteoarthritis of the knee joint: a randomised controlled trial. Physiotherapy. 2019; 105(1):98–107.
14. Yokota Y, Tashiro Y, Suzuki Y, et al. Effect of Capacitive and Resistive Electric Transfer on Tissue Temperature, Muscle Flexibility, and Blood Circulation. J Nov Physiother. 2017; 7:325-331.
15. Clarke A, Fraser K. Why does metabolism scale with temperature? Funct Ecol. 2004; 18(2):243–51.
16. Naranjo P, López-Estebaranz J, Shoaib T, Pinto H. Non-ablative capacitive resistive 448 kHz radiofrequency for wrinkle reduction pilot study. Aesthetic Medicine. 2020; 6(2):27-34.
17. Yokota Y, Sonoda T, Tashiro Y, et al. Effect of Capacitive and Resistive electric transfer on changes in muscle flexibility and lumbopelvic alignment after fatiguing exercise. J Phys Ther Sci. 2018; 30(5):719–25.



18. Naranjo GP. First Assessment of the Proionic Effects Resulting from Non-Thermal Application of 448 kHz Monopolar Radiofrequency for Reduction of Edema Caused by Fractional CO2 Laser Facial Rejuvenation Treatments. J Surgery. 2015; 3(1):21–4.
19. Carralero-Martínez A, Muñoz Pérez MA, Pané-Alemany R, Blanco-Ratto L, Kauffmann S, Ramírez-García I. Efficacy of capacitive resistive monopolar radiofrequency in the physiotherapeutic treatment of chronic pelvic pain syndrome: study protocol for a randomized controlled trial. Trials. 2021; 22(1):356.
20. Pinto R, Frisari P, Landivar P. Radiofrecuencia monopolar capacitiva/resistiva de 0, 5 MHz en celulitis. Med Estética. 2009; 19:32–7.
21. Yupakorn K, Amornvittayachan O, Udompataikul M. Efficacy of Monopolar Radiofrequency Device on Cellulite Treatment. Srinagarind Med J. 2010; 25(4):258–264.
22. Manzari A, Armenesi R BM. Nuovo approccio al trattamento del paziente ustionato con radiofrequenza fissa a 448 kHz. In: AGORÀ 20o Congresso Internazionale di Medicina Estetica. Milano; 2018.
23. Anderson J, Cramer S. Chapter 2 - Perspectives on the Inflammatory, Healing, and Foreign Body Responses to Biomaterials and Medical Devices. In: Badylak SF, editor. Host Response to Biomaterials. Oxford: Academic Press; 2015. p. 13–36.


24. Dixit VV, Wagh MS. Unfavourable outcomes of liposuction and their management. Indian J Plast Surg. 2013; 46(2):377–92.
25. Gassia V, Marie-Anne D, Naranjo P. INDIBA Proionic® RF: reach the excellence in aesthetic treatments. In: Dermatology, oculoplasty and post laser surgery recovery AMWC. Monaco; p. 2015.
26. Calleja J, Fernández S, Corral-Baqués MI SS. Pilot study to evaluate the biological changes induced by radiofrequency thermal therapy on the genital area. Toko - Ginecol Práctica. 2021; 80(1):6–13.
27. Lim RK, Verner I, Wambier CG, Kolodchenko Y, Goren A. Nonablative radiofrequency for the treatment of androgenetic alopecia: An open-label study. Dermatological Rev. 2021; 2(3):129–31.
28. Leon GR, Koscheyev VS, Stone EA. Visual analog scales for assessment of thermal perception in different environments. Aviat Space Environ Med. 2008;79(8):784–6.
29. Tashiro Y, Hasegawa S, Yokota Y, Nishiguchi S, Fukutani N, Shirooka H, et al. Effect of Capacitive and Resistive electric transfer on haemoglobin saturation and tissue temperature. Int J Hyperthermia. 2017;33(6):696–702.
30. Greene RM, Green JB. Skin tightening technologies. Facial Plast Surg. 2014;30(1):62–7.
31. Dayan E, Burns AJ, Rohrich RJ, Theodorou S. The Use of Radiofrequency in Aesthetic Surgery. Plast Reconstr surgery Glob open. 2020;8(8):e2861.
32. Danielle M-A, Gassia V, Naranjo P. INDIBA Proionic® RF: reach the excellence in aesthetic treatments. Dermatology, oculoplasty and post laser surgery recovery. In: IMCAS 2015/AMWC 2015. Paris; 2015. p. 2–3.
33. Kaoutzanis C, Gupta V, Winocour J, Layliev J, Ramirez R, Grotting JC, et al. Cosmetic Liposuction: Preoperative Risk Factors, Major Complication Rates, and Safety of Combined Procedures. Aesthetic Surg J. 2017;37(6):680–94.
34. Vitagliano T, Garieri P, Lascala L, Ferro Y, Doldo P, Pujia R, et al. Preparing Patients for Cosmetic Surgery and Aesthetic Procedures: Ensuring an Optimal Nutritional Status for Successful Results. Nutrients. 2023;15(2):352.