There are two different types of radio frequency skin tightening delivery, based on the layout of the electrodes, namely monopolar radio frequency and bipolar radio frequency.
With monopolar radio frequency, the current from the generating machine flows through the body from a single electrode (hand-piece) and meets maximum resistance in the area around the tip of the hand-piece, where tissue heating in the sub-dermal layers then occurs. A grounding, or “return pad” is attached to the patient’s lower back or abdomen, to provide a low resistance path for the current to flow back to the generating machine, to complete the electrical circuit.
As the positive and negative poles are located quite far apart, the current has no other choice but to transverse through all skin layers, through the body to the other pole, and exit there. This means that with monopolar radio frequency, we can treat not only the skin surface (epidermis) but also the middle skin layer (dermis), the deepest skin layer (hypodermis/sub-dermis) and even the subcutaneous fat deposits below the skin itself.
With bipolar radio frequency, the current from the generating machine flows through the tissue between the two electrodes on the handpiece. These electrodes start and complete the electrical circuit. Hence, with bipolar radio frequency delivery, no current flows through the rest of the body, so no grounding or return pad is needed.
Because the poles are close to each other, the current has no choice but to superficially penetrate the skin (as little as 1mm) and then exit again from the other pole, not far from where it entered. In all cases of radio frequency skin tightening delivery types, it is the resistance to the current flow in the tissue, not the electrode that generates the heating effect.
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