Tissue rejuvenation by heat

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Tissue Rejuvenation by heat

Richard O. Gregory, MD

ThermiTight is radio frequency (RF) heating of the tissues by induction of very rapid oscillation of the molecular structures. In the process of heating, tissue reacts in a variety of ways depending on the type tissue as well as the rate and degree to which it is heated. Some lethal heating of cellular tissue causes apoptosis or a shriveling of the cells which the die and are absorbed or shed. Sublethal heating may cause the cells to swell and then as they recover stimulates the release of tissue factors which attracts phagocytes, fibroblasts and other reactive cells.

Non cellular structural tissue such as collagen also reacts in a variety of ways. Collagen is a protein which is constructed of coils of linked amino acids much like a bed spring. As it is heated the coils tighten and the tissue shrinks. Eventually as the heat builds the protein is denatured much like boiling an egg in which the protein turns from clear to white and from liquid to solid. The denatured collagen is eventually absorbed and replaced as new fibroblasts invade the area and work to replace the lost collagen.

Lasers and other heat generating devices such as RF, ultrasound and microwave work on the same principles with the goal of tissue tightening, shrinkage due to the loss of cells or generation of new tissue (usually collagen). The results can be very impressive or very subtle and the treatment can be comfortable or very painful requiring pretreatment pain medicine. There is a large variety of heat treatments available each of which has its advocates as well as its advantages and disadvantages (and its detractors).

Having tried many of these treatments myself I found that I like Thermi in its various forms (internal heating by way of probes, ThermiTight, internal heating by way of transducers placed on the surface of the skin, or external heating of the skin, ThermiSmooth). These various treatments each have different targets as well as effects although there is much overlap. Generally skin surface defects are best treated by laser and there is no substitute for a facelift in a patient who needs it.
The question is often asked’ “How long does it last?” This is the subject of another article, but to summarize:Swelling is gone in a few days, Collagen shrinkage lasts several months, and new collagen probably lasts nearly two years.The fact is that collagen in the human body is said to have a half-life of 22 months, but collagen is constantly being remodeled, absorbed and reformed.While we are young collagen is building faster than it is being absorbed, but after early adulthood and our growth is complete the process of absorption is greater than the process of formation. This is why our skin thins as we age accelerated by sun damage and abuse.I think it can be said that ThermiTight lasts as long as collagen lasts in the body, perhaps not permanent, but then what is permanent?
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Orlando Plastic Surgeon