IBRAMED - Hooke for Radiofrequency Energy

O equipment allows cooling by means of a cryogenic applicator (cooling) to preserve the epidermis before and after the therapy. It also presents a touchscreen control panel, an ergonomic cabinet, built-in wheels that facilitate to move it around and footswitch activation.

An oil of vegetable basis is used during the treatment to avoid friction between the tip of the applicator and the skin. The use of an infrared thermometer is the main factor to determine if the power selected is ideal or not; besides, of course, the sensory information provided by the patient.

The equipment must be used only under the prescription and supervision of a licensed professional.

Accompany the equipment:

• 1 bipolar radiofrequency applicator electrode;
• 1 monopolar radiofrequency applicator electrode;
• 1 cooling applicator (cooling);
• 1 detachable power cable;
• 1 footswitch;
• 1 infrared thermometer;
• 1 digital operations manual;
• 1 spare fuse card;
• 1 bottle of special vegetable oil for radiofrequency 300ml;
• 1 measuring tape;
• 1 banner.

The use of cables, electrodes and other accessories other than those specified above may result in increase of emission or decrease in the Immunity of the equipment. The device and its characteristics may be altered without previous notice.

Technical characteristics

• 127/240V | 50/60Hz;
• Timer (application time): 1 to 30 minutes (+/-5%);
• Dimensions (mm): 400 x 470 x 1200 (W x D x H);
• Weight (Approximate without accessories): 35kg.

What is radiofrequency?

Radiofrequency is electromagnetic energy which propagates rapidly in space and is constituted by an electric field and a magnetic field, forming electromagnetic energy.  It has been used extensively in medicine for more than 50 years.

The effect of electromagnetic energy in the human body depends on the frequency applied. In low frequencies, it causes muscle convulsion and is used, for example, in an electric defibrillator, that is, in the electric current. In more elevate frequencies, electromagnetic energy induces heating in the tissues that are in contact with the electrode and is employed, for example, in an electronic scalpel. In esthetics, its application had its beginnings in 2002, in the United States.

Our Hooke equipment got its name as an homage to English physicist Robert Hooke, who published, in 1676 the law of Elasticity, known as the Hooke law.

Collagen is one of the most abundant proteins in our body, and it is responsible for the structural form of several of our organs, including the skin and the subcutaneous screen. The collagen fibers are constituted by a triple protein helix which, when heated by radiofrequency to a correct temperature for a determined time, suffer deformation and thickening called collagen thermal contraction.

Beginning of therapeutic application

The use of diathermy began in 1892, when d’Arsonval used electromagnetic radiofrequency fields with 10KHz of frequency to produce the heat sensation without the muscle contractions which occur in the lower frequencies.

The interaction between the electromagnetic interaction and the biological tissue varies highly according to the frequency. The radio waves are divided in long-wave bands (KHz) and short-wave bands (MHz). In the Beginning of the 20th century, long-wave diathermy equipment was used, which alternated electric fields in electric fields in KHz. This technology was later employed in electric scalpels.  On the other hand, short-wave diathermy refers to the heating produced by electromagnetic fields alternated by high frequencies in MHz. When compared, the thermal effects of long-wave diathermy are much more superficial than the ones promoted by short waves.

This type of therapeutic heating became popular, because high frequency energy can penetrate more deeply in the tissue, presenting a greater advantage when compared to other methods which heat the tissue in a more superficial manner. Whereas, through a light bath therapy an accentuated decline in temperature is observed.

Fifteen minutes after the end of the treatment, with the use of the high frequency currents, an initial increase in temperature is observed, which is maintained for up to 90 minutes after the end of the treatment. This interesting comparison highlights the thermal effect considerably more lasting than that of the therapy.

There are two effects caused by high frequency currents, which control the dielectric behavior of the tissues: one is the oscillation of the free electrical charges or ions, while the other is rotation of the molecules dipoles which accompany the same frequency of the electromagnetic field applied. These are the effects responsible for the appearance of electric currents and, therefore, for the heating of the tissues.

The effect of electromagnetic energy in the human body depends on the frequency applied. In low frequency, the electromagnetic energy causes muscle convulsion and is used, for example, in an electric defibrillator. In more elevate frequencies, the electromagnetic energy induces current, which causes heating in the tissues that are in contact with the electrode and is used, for example, in an electric scalpel

In high frequency, the electromagnetic field causes polarization and oscillation of water molecules. The friction between the molecules transforms electromagnetic energy in heat.

The radiofrequency equipment

Electromagnetic radiation used for the electromedical equipment is in the RF range used in communications.  Consequently, it could interfere with signals and, to avoid such interference, the Federal Communication Commission (FCC), which regulates all the communication forms, designed specific frequencies for medical applications, which are followed by the National Agency of Telecommunications (Agência Nacional de Telecomunicação – ANATEL). The bands permitted are centralized in 13.56MHz, 27.12MHz and 40.68MHz.

The frequency of 27.12MHz is the most commonly used, because it has the widest range, and besides, the least expensive to be built, and therefore, the most studied. Hooke is the only Brazilian equipment which is within these standards.

Equipment in the frequency range of KHz do not heat tissue by the generated, but by the resistance to the passage of the current. The heating is slower, and many times, the necessary temperature cannot be reached.

Therapeutic effects

Hooke induces heating in the biological tissue, through the rotational effect of the water molecules (dipoles), which is promoted by the alternated electromagnetic field in high frequency of 27.12MHz. The equipment has two radiofrequency applicators: the bipolar applicator, for a superficial application (up to 4mm of depth) and the monopolar applicator, for a more volumetric application (from 15 to 20mm of depth).

1. Rotational movement of water molecules (dipole) in the alternated no electromagnetic field (monopolar);
2. Resistance to the tissue to the conduction of the magnetic field of radiofrequency (bipolar).

The energy emitted by the Hooke applicators is converted to heat, mainly by the increase of the kinetics of the water molecules in the tissue, and consequently, the energy is dispersed to tridimensional volumes of tissue in controlled depths.

The temperature of 57 to 61°C is frequently described as the temperature of retraction of collagen, in which the quantity of contraction is determined by a combination of time and temperature. The best combination between time and temperature must be chosen prioritizing the maximum protection of the epidermis.

Hooke present a cooling applicator (cooling) which allows a more comfortable and effective action, because it acts as a mechanism of care with the epidermis. The superficial temperature of the skin, constantly evaluated by an infrared thermometer (IR), must be kept between da 40 and 42°C.

Immediate effects of Hooke on the skin with the bipolar applicator

The skin has a support basis formed by collagen and elastin fibers, which determines its degree of firmness and elasticity, which progressively decreases in time, forming the wrinkles and giving the skin a flaccid aspect. The collagen fibers are constituted by a triple helix of proteins.

The heating of this structure, with the correct temperature for a determined time, can induce immediate tissue contraction and its thickening. This effect results from thermal contraction of collagen.

The retraction ability of collagen with thermal energy is not a new concept in the esthetics medicine area and it is extremely attractive when it occurs with minimum or no epidermal damage.  This causes a smoothing of wrinkles and expression lines, as well as a powerful aid in the treatment of skin flaccidity, including after liposuction. Therefore, the immediate contraction of collagen can be induced by Hooke, aiming at rejuvenation, skin flaccidity treatment and other treatments for facial and body ageing.

A – Schematic representation of the collagen triple helix; B – Contraction of the collagen promoted by heat in form of an amorphous coil (adapted from Ruiz-Esparza, 2006).

Immediate effects of Hooke on the treatment of cellulite and localized fat with the monopolar applicator

The treatment with Hooke promotes changes in the structure of collagen, causing morphological alterations of the septum and conjunctive tissue, which contains the fat cells. The increase in local temperature generates the activation of blood flow, favoring lipolysis and drainage.

Hooke promotes the volumetric contraction effect of the treated area (reduction of measures) in most patients.

Effects of Hooke on the treatment of cellulite and localized fat in the medium and long term

The therapeutic effects of Hooke are double: initially, the treatment promotes an immediate collagen contraction; nest, the trigger of the signal cascade, involving mediators of the inflammatory process, of repair and tissue regeneration in response to the light thermal lesion mediated.

This mechanism involves deposition and remodeling of collagen (neocollagen), as well as elastin (neoelastogenesis), which can last for months. Such process, while restructuring the skin and the subcutaneous tissue, makes the appearance firmer and smother.

• Rejuvenation and stretching of the skin;
• Reduction of cellulite;
• Reduction of localized fat;
• Improvement in the appearance of scars;
• Treatment of stretch marks;
• Treatment of skin flaccidity.

• Pregnant women must be at a distance of at least 15 meters away from the generator;
• Malignant tumors;
• Implanted electronic device. It is recommended that a patient with an implanted electronic device (for example, a cardiac pacemaker) is not subjected to radiofrequency, except a specialized medical opinion has been previously obtained;
• Hearing aid devices must be removed. If exposed to radiofrequency, hearing devices may suffer irregularities in functioning. Individuals with pacemakers and hearing aids, therefore, must not remain in the vicinity of radiofrequency equipment when this equipment is on;
• Tuberculosis;
• Fever;
• Rheumatoid arthritis;
• Recent use of isotretinoin (less than a year before) for the treatment of acne vulgaris, because it may induce an intense renovation of the epidermis, sensitizing the skin;
• Over dermal fillers;
• Irritated skin or adverse conditions. The application of radiofrequency must occur only over the intact skin;
• Large metallic implants because metal concentrate electromagnetic energy. To prevent possible concentration of energy around the implant and the dangers resulting from it (burns), the application of radiofrequency must be used only if the indications were more important than the possible adverse effects;
• Chronic systemic diseases, such as diabetes, hypertension, coronary artery disease, renal insufficiency, etc.;
• Sensitivity alterations. The application of radiofrequency must be used with precaution over areas with sensory alterations. It is necessary to take special care also with debilitated patients, as the dosimetry depends in great part on the sensation of heat felt by the patient. The pain is an indication that excessive heat is being produced;
• Contact lenses. There are indications that localized heating may appear if the eye wearing contact lenses is exposed to radio frequency. Therefore, it is recommended that the patient removes contact lenses before the application of radiofrequency Hooke;

Ischemic tissues. The treatment must be avoided over ischemic tissues, because the increase of metabolic demand cannot be satisfied with a corresponding vascular response, so pain and necrosis may appear as a consequence.