If this were a movie, it could be called ‘Save the Adipocyte Soldier’. But neither are we Spielberg, nor are we in Normandy, although we are determined at all costs to prolong the longevity of the skin. Including the deepest tissues, those that are not part of the skin, but that provide support and turgor to the entire structure.
That is why, when Cynosure Lutronic announced a few days ago the launch of XERF, their new platform of monopolar radiofrequency capable of reaching very deep layers, the medical-aesthetic community applauded this new R&D milestone.
Although the important thing is not what is already known. What matters is what is still in the research phase and that could revolutionize cell regeneration therapies based on adipocytes.
Preserving the Skin’s Functionality
The person who will live to 120 years has already been born, said researcher Manel Esteller at the last WeLife Longevity edition. Others may not reach centenarians, but we will almost surely live longer than the generations that preceded us. In this long-term scenario, it makes no sense to tackle wrinkles or sagging in the short term. The sensible thing is to preserve the full functionality of the tissues, improving their appearance as much as possible.
But caring for the skin with an eye toward a future that is increasingly distant is not only an objective for dermatologists and medical-aesthetics specialists. It is already a priority for engineers and physicians who develop skin rejuvenation devices. Or, as they like to call it, technologies for tissue regeneration. This is where XERF has arrived to take the conversation to another level.
And it does so by focusing not only on collagen, but on the survival of fat tissue.
Working on Two Planes at Once
This new device consists of a monopolar radiofrequency that combines two frequencies, 6.78 MHz and 2 MHz. This dual energy discharge allows in a single session to distribute energy across different planes and reach from the dermis to deeper structures related to the fibroseptal system and the superficial muscular aponeurotic system (SMAS).
Reaching such deep layers, this new radiofrequency goes beyond simple tissue tightening and stimulation of collagen and elastin. “Now we can improve the density, elasticity and overall quality of all tissues,” says Jaime Tufet, an aesthetic physician and expert in facial rejuvenation at Grupo Pedro Jaén. For the patient, the treatment becomes more tolerable by incorporating a temperature monitoring system that must not exceed 43°C, and a skin cooling technology to avoid the sensation of ‘burning’.
The results begin to show gradually in the months following the procedure and aim to maintain the features and naturalness of the treated face.
Fat Is Much More Than a Filler
This gradual view of rejuvenation treatments clashes with the radical, piecemeal approach of the last decades. For years aesthetic medicine has waged a relentless war against wrinkles. Sagging was tackled with very invasive surgical lifts, and spots with chemical peels not without risks. “It wasn’t for lack of knowledge. We worked with the tools at hand, whether a scalpel or phenol. Today we know that the face ages in all its layers and that there is a constant relationship between them. What we needed were tools that would allow that global, safe approach,” says Dr. Tufet.
In the words of this veteran physician, the passage of time leaves its mark on the epidermis, the dermis and on collagen, whose production falls to dramatic levels. “Moreover, the extracellular matrix is altered and the fat compartments, fibrous septa, ligaments and the superficial muscular plane (SMAS) also evolve,” he adds.
It stops at reaching the facial fat. “Earlier it was considered little more than a simple filler. Today we know that it is a living tissue with mechanical and metabolic functions, participating in hydration, cushioning and cellular signaling. Over the years it can not only lose volume or change position; it can also lose functional efficiency.”
Avoiding the Hollowed Face
From this more global perspective, rejuvenation cannot stay at “filling what sinks or tightening what descends,” argues Dr. Tufet. “It is about caring for and improving the state of all tissues, including fat tissue. Until now we killed it. Now we no longer do.”
He insists that this is not only about preventing “your face from looking hollow because you have lost fat. The adipocyte has a hormonal function and if you destroy it, it does not send signals. The future of rejuvenation is not the fibroblast. It is in adipose tissue.”
Nurturing Adipose Tissue
Traditionally, radiofrequency damaged adipocytes, but it was regarded as a minor evil in this attempt to reverse sagging. Today we know that adipocytes must be cared for, among other things, because they are one of the natural reservoirs of mesenchymal stem cells.
And this is the great ongoing battleground of cellular longevity research. “There are very interesting lines of research on the cellular microenvironment, the function of adipocytes, senescence and aging-related inflammation,” says Tufet.
Some of these studies focus on the adipocyte’s capacity as an epicenter of stem cells. A radiofrequency that heats and stimulates, without causing apoptosis (the correct term for cell death), could stimulate vascularization and even cellular oxygenation, courtesy of adiponectin, a hormone produced in adipose tissue that stimulates the creation of new mitochondria.
But that still lies ahead, years of research.
