Accent Technical Information
How the Accent and the Accent XL dual radio frequency systems work.
The Accent¨ provides controlled radio frequency energy using Unipolar and Bipolar handpieces, for deep (up to 20mm) and superficial (2-4mm) penetration of RF field, respectively. The Accent RF Unipolar handpiece alleviates cellulite symptoms by means of three major mechanisms: (1) Dermal tightening of the fibrous septae due to thermal injury affecting the vasculature, which in turn initiates a cascade of inflammatory events, including fibroblastic proliferation and apparent up-regulation of collagen expression (neocollagenesis/remodeling); (2) Enhancement of local blood circulation (vasodilatation and hyperemia) and drainage of fatty deposits to the lymphatic system; and (3) fatty acid dissolution and thermal-induced fat cell apoptosis.
In addition, the Bipolar handpiece promotes local dermal heating and subsequent contraction of the collagen tissue and a tightening of the skin.
Thermogram of Accent™ Unipolar handpiece temperature gradient and depth of penetration.
The deeper RF field of the Unipolar causes tightening of the fibrous layer of tissue at the interface between the dermis and the subcutaneous tissue, thus promoting reduction in cellulite symptoms. Controlled thermal injury may result in tissue shrinkage followed by an inflammatory response accompanied by the migration of fibroblasts into the area. The intentional and directed infiltration of fibroblasts to the thin layer of tissue, including the interface, may be used to reinforce its structural integrity, resulting in amelioration or elimination of the subdermal fat protrusion that causes skin bulging. The area is reinforced with additional connective tissue deposits as part of the tissue repair and healing phase. This phase is followed by a period of maturation of the newly deposited connective tissue, thereby resulting in contracture and tightening of the injured tissues and the tissue overlying the dermis-epidermis interface.
Subcutaneous fat before treatment.
Subcutaneous fat after treatment.
Fig. 6. Subcutaneous fat: thermal damage after Unipolar exposure @ 150 Watts (H&E).
This newly deposited connective tissue matrix may be used to strengthen the natural fibrous layer between the dermis and subcutaneous tissue. Adipose tissue is highly sensitive to blood flow. The thermally-induced hyperemia caused by the Unipolar RF field increases blood flow and the release of free fatty acids (FFA) to a local adipose tissue bed and may increase lipolysis stimulating catecholamines available in the local area, thus promoting release of FFA into the bloodstream. Because of the thermal trauma to the fat cells, triglycerides may be released from the fat cells. These triglycerides are likely broken down into free fatty acids and glycerol by the enzyme lipoprotein lipase (LPL). The free fatty acids (water insoluble) bind to albumin and are slowly transported to the liver. Glycerol (water soluble) is transported to the liver via the interstitial fluid compartments tissue fluids and blood fluid. In addition, it has been shown that adipocyte apoptosis plays an important role in adipose tissue homeostasis and can be altered under a variety of physiological and pathological conditions such as hyperthermia.
The information provided above is taken from clinical studies performed by Alma Lasers Israel.
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