田艳丽医生分享：射频美容技术

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styles,Second level,Third level,Fourth level,Fifth level,Sixth level,Seventh level,Eighth level,Ninth level,*,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Sixth level,Seventh level,Eighth level,Ninth level,*,*,田艳丽医生,射频&超声美容技术进展技术,射频基础知识,射频 (,Radio Frequency, RF ),是高频交流变化电磁波的简称。每秒变化小于,1000,次的交流电称为低频电流，大于,10000,次的称为高频电流，即射频电流。,在电磁波频率低于,100khz,时，电磁波会被地表吸收，不能形成有效的传输，但电磁波频率高于,100khz,时，电磁波可以在空气中传播，并经大气层外缘的电离层反射，形成远距离传输能力。,具有无线传输能力的高频电磁波称为射频,热量的产生依赖于组织对在射频场内,电子移动的天然电阻,（欧姆定律），而,并非光子吸收,。,欧姆定律,： 对电子运动的阻抗,Z,（欧姆）生成了与电流量,I,（安培）和时间,t,（秒）相关的热量。,能量（焦耳）,=,I,2,*,Z *,t,例,1,：,2,2,安培,x 5,欧姆,x 1,秒,= 20,焦耳,例,2,：,2,2,安培,x 25,欧姆,x 1,秒,=100,焦耳,射频基础知识,外科,Surgery,切开,Cutting (electro surgery),凝血,Coagulating,透热疗法,Diathermy,真皮下加热,Sub Dermal Heating,1891 D Arsonoval experiment,电流通过,By passing currents,带电粒子移动,Displacement of charged particles,水分子旋转,By rotation of water molecules,加热依靠电流和组织的阻抗,Heating depends on current flow and resistance of tissue:,电流越强加热效果越大,The higher the current, the greater the heating effect,被加热区域越小加热越显著,The smaller the area, the greater the heating effect,组织电阻越大加热效果越大,The higher the tissue resistance, the greater the heating effect,不同组织具有不同阻抗,Different types of tissues have different resistance,BASIC CONCEPT OF DEEP HEATING,能量强度的比较,标准化强度,-,激光和射频,0%,10%,20%,30%,40%,50%,60%,70%,80%,90%,100%,0,1,2,3,4,5,6,7,8,深度,Z (mm),%,标准化射频,Thermage,1.5cm,2,中等深度触头,1320nm,（,CoolTouch,）,10,600nm (CO,2,）,1/e,（,37%,强度）,单激光均质模型,Grd,RF,皮肤,skin,a.,正负两极在同一界面作用,b.穿透深度为两电极距离的1/2,c.治疗有效深度为2,-4,mm,热量汇聚皮肤表层，易灼伤,能量穿透深度不够，效果不明显,对操作者技能要求高,单极射频,准单极 monopolar,单极 unipolar,单极射频的优缺点,a,.,正负两极不在同一界面作用，工作电极表面可集中很高能量,b.穿透深度深,c.治疗有效深度为10,-,15mm,a.治疗者疼痛感明显,b.能量传导可控性相对较差,c.对操作者技能要求高,理想工作状态,Superficial,浅层加热,Medium,中层加热,Deep,深层加热,6,mm,1,8 mm,1,2 mm,单极深度,双极深度,1.5mm,3mm,4,.,5mm,射频波聚焦深度,“,聚焦射频,”,技术,15,“聚焦射频”技术优势,无聚焦技术,100w,，9,0s,，单层累积能量3,kJ,90s,聚焦射频,100w,，,90s,，单层累积能量,9kJ,90s,浅层：,3kJ,中层：,3kJ,深层：,3kJ,聚焦深层：,9kJ,单位体积皮肤，射频作用同等时间，聚焦射频能量累积提升,3,倍,多极射频,N个正负极在同一界面作用，聚集式的热量使治疗更精确、更集中、更可控加热层次更深，可同时加热真皮层和皮下脂肪层，紧肤、除皱的同时又具有消脂、塑形的作用。,能量穿透深，但热量均匀分布。,3DEEP,射频技术,射频,+,多源相位控制射频,革命性的新方法传递能量到深层皮肤,6个发射器控制6个电极,控制深层能量的流动到特定区域,少量表皮能量流动,不需要强烈的冷却，绝对安全且无痛,个性化的参数由多个皮肤特定的感应反馈机制得出,射频,射频,射频,射频,射频,电极,发射,器,“,+,”,和,“,”,交叉的多电极同时将能量传达到脂肪组织，形成了世界上最早的非接触式，选择型的,RF,射频。,最早的真正的多极射频设计,行业内治疗面积最大,The Device,多极射频,选择性,RF,19,+,热量,胶原三股螺旋分子,变性的胶原纤维,作用机理,初始作用,：,直接胶原收缩,真皮收缩以紧缩,纤维中隔收缩以塑形,伤口二级愈合反应：随时间胶原沉积、重塑和塑形,原始资料：“以射频为基础制造的非烧灼皮肤重塑形设施的组织学和超微结构作用” ，,皮肤病学文献,，,2004,年,2,月。,B.Zelickson,医学博士等。,治疗时间,疗效,3,天,1,个月,3,个月,1,、胶原新生期：治疗后,3,天到,1,个月，成纤维母细胞不断释放胶原蛋白，新胶原不断合成，胶原层得到补充；,2,、胶原巩固期：治疗后,1-3,个月，随着胶原的新生，数量增多，排列更致密，受损的胶原层得到补充，老化松弛皮肤进一步得到修复。,3,、胶原稳定期：整个疗程结束后，胶原数量和状态仍会在,3,个月之后维持较高水平。,胶原新生,21,嫩肤：紧肤、除皱、,美白,溶脂：塑身、减肥、吸脂后治疗,痤疮：,活动期痤疮,、痤疮瘢痕,瘢痕：萎缩性瘢痕,三重效应,3 Effects,非致热,Non-thermal,生物刺激,Biostimulation,致热,Thermal,生物刺激,Biostimulation,+,微循环,Microcirculation,高热,Hyperthermal,生物刺激,Biostimulation,+,微循环,Microcirculation,+,高活化,Hyperactivation,深层再生效应,Deep Regenerating Effects,健美效果,Beauty efficiency and wellbeing :,平复橘皮样组织,Smoothes cellulite,提升面部,Lifts the face,平复皱纹,Smoothes the wrinkles,提升乳房,Lifts the Breasts,塑形,Helps Contour the Body,嫩肤,the skin,细胞再生,Cell regeneration,溶脂,Lipol,y,sis,重塑组织结构,Reshaping,紧实,Firming,改善肤色,Skin tone,增氧,Oxygenation,保湿,Moisturising,提升,Lifting,ThermaCool,系统,FDA 510K,认证的面部皱纹清除功能,330,瓦,6,兆赫 高频射频发生器,R134A,冷却控制模块,手柄,Radiofrequency energy penetrates deep into the skins tissue, heating the treatment areas and remodeling the collagen.,Final delivery of cryogen to cool the epidermis.,A specially designed treatment tip is placed against the skin in targeted areas,Treatment begins with a cooling effect on the skin for comfort and safety of surface layers.,DH-308,MD-320,INDIBA,33,高周波温熱脂肪滴蓄積抑制効果,高周波温熱酸誘導体（,APS,）併用形成脂肪滴分解,（,SEM,形態観察）,症例写真（,28,歳）,体重,/47kg.,体脂肪,/28,/66cm,体重,/,45kg.,体脂肪,/,22,/,58,cm,GP699A,射频治疗仪,RF,频率：,1.15MHz,最大输出功率：,1200W,最大能量：,500J,冷却温度：,-10,10C,治疗头：,8,、,24.5,、,43,亚光单极射频,40.68 MHz,ebox,技术参数,输入电压：AC220vAC110v 50Hz60Hz,额定输入功率：500VA,Rf频率：1MHz10MHz,最大输出功率：300W,操作头直径：15mm/20mm/30mm/43mm,主机及支架净重：14kg,体积：450mm*375mm*260mm,支架：300mm*450mm*700mm,工作模式：连续工作,Aluma,TM,多极射频联合强力磁脉冲,多极射频能量（,RF,）：,造成真皮中的轻微热损伤从而刺激机体的自然修复反应，可立即导致胶原纤维收缩，从而产生即时拉紧皮肤的效果，射频能量中的热刺激能促进胶原纤维和弹性纤维的合成，促进脂肪分解，重组脂肪细胞，消脂塑型同时进行；,强力磁脉冲技术（,PMF,）：,磁场能引导热能传递，引导磁刺激纤维细胞增殖，促进血管再生，帮助合成新的胶原纤维。,42,射频加超声系统,单极射频具有最深的穿透深度,实时皮肤温度监测和冷却控制,-,可控射频,TM,EFC(,能量流控制系统）可减小皮肤灼伤的风险,治疗头上可控制所有治疗参数,无昂贵耗材,非手动,聚焦,场,RF,Accent,TM,and Tenor Radio Frequency System,40.68MHz,是国际电工委员会批准的可用于医疗系统的射频频段。射频波每秒钟交变次数高达,4,000,万次，使靶组织,-,极性水分子在交变电场作用下高速旋转，相互摩擦产生热量，从而达到给胶原组织及脂肪细胞加热的目的。,环形双极手具采用专利环形电极技术，保证每次发射的射频场分布非常均匀，避免了在加热区域内出现热点而造成皮肤烫伤的危险，保证治疗轻松而安全。,PMT,波相匹配技术摒除了传统的回流电极束缚，将射频能量严格准确的聚焦在皮下的特定深度，从根本上确保了射频发射的精确性，从而保证了疗效和安全性。,左图显示为一个切开的苹果（厚度约,25mm,）在波相射频作用下,15,秒后的温度分布图。,图中白色表明温度最高区，蓝色表明温度最低区。红外图中可见温度最高区距离苹果加热表面有一定波相深度（,10mm,左右）,环形双极,(150W),加热真皮浅层,波相单极,(300W),加热真皮深层及皮下脂肪层,眼周单极,(90W),加热眼周真皮深层及皮下脂肪层,RF Energy,Plasma,Skin Structure,像束射频技术,射频能量将空气中的氮气电离成为等离子，发射的光谱峰值在可视区（主要为靛青和紫蓝色）和近红外区。,氮气可使皮肤表面隔绝氧气，减少热损伤、炭化和瘢痕形成的风险。,当等离子接触到皮肤，能量立即转移到皮肤表面加热皮肤，而不会对组织产生爆破效应或即刻剥脱，待新生表皮修复后痂皮才开始脱落。类似一种生物敷料，保护创面，降低感染风险，降低色素沉着等副作用。,同步单级射频对胶原组织加热，两种能量协作，促进深部胶原层的增生和重新排列，快速有效重建。,离子束（,Micro-Plasma,）在皮肤上建立微通道，微通道内气体离子浓度很高，炽热的气体离子在表皮上产生直径,70-120,微米的微小热损伤点，其深度为,150,微米或更深（随功率加大而加深）。微通道末端的热效应可以达到皮下,500-1000,微米，有效加热真皮层。,治疗头设计,滚轮治疗头,Roller Tip,Tip,紧贴皮肤处为,RF,热效应，前后两端未接触皮肤处为,plasma,剥脱效应,定点套筒治疗头,Stationary Tip,利用皮肤弹性，使,Tip,自然贴合皮肤,产生明显的,RF,热效应,定点治疗头,Stationary Tip,Tip,与皮肤间距,1mm,产生明显的,Plasma,效应,治疗前,3,次治疗后,30,天,外伤后瘢痕,4,年,治疗前,3,次治疗后,30,天,外伤后瘢痕,9,年,外伤后瘢痕,10,年,治疗,4,次后,30,天,治疗前,GSD,点阵射频,双极发射器,1.15MHz,64/144,个阵列电极针,功率可调,8-15W,能量释放速率可调,频率可调,治疗前,1次治疗后,额部祛皱紧肤治疗,痤疮瘢痕,治疗前,治疗后,额头疤痕治疗,妊辰纹治疗,eMatrix,射频在正,/,负电极之间流动,控制电流可以实现不同程度的组织损伤,在电极之间可保留完整的正常组织,全面潜剥脱,水滴点阵治疗系统,镀金电极,加热组织,剥脱组织,凝固组织,- - -,独特组织损伤,多层损伤,特定几何形状,+,eMatrix Sublative,潜剥脱示意图,黄金微针 工作原理,双极,单极,领梵,黄金微针射频,黄金微针手持件,无创紧肤手持件 （选配）,黄金微针点阵平台,频率：,1Mhz,最大功率,：,75W,治疗头面积,：,1cmX 1cm,能量调节范围：,18,级,治疗模式：,单、双极射频,参数,RF, , ,Inserting needles (0.02sec),RF emission,(0.03 0.10sec),Removing needles (0.02sec),67,技术特点,:,49 根黄金微针，形成射频回路,0.2,mm,0.30,mm,特殊材料绝缘处理,微针尖端释放射频能量,68,INTRAcel,Vaporization,(100 drew,),Necrosis & Coagulation,(58-85,),Protein Denaturation,( 60,),Epidermis,Dermis,LASER,biomodulation,(40,),COMPARISON ON TISSUE INTERATION,BETWEEN LASER AND INTRAcel,酷塑结合了单极射频、双极射频、红外光和负压四种先进技术，是一款多功能的仪器。,针对脂肪团提供非侵入、舒适及有效的治疗。同时还有,塑身,、舒缓肌肉疼痛、,提升并收紧肌肤,等功效，使肌肤变得嫩滑，体型变得优美。,酷塑冰电形体雕塑,负压探头：,结合了负压红光和双极射频技术，针对脂肪组织进行吸捏运动，配合滚轴设计，操作更舒适。,红光和双极,射频,控制按钮,负压,能量调节阀,集中加热脂肪层细胞，强力治疗橘皮纹，治疗更安全,滚轴,：操作更舒适,负压促进血液循环和代谢,双极射频,：,射频辅助吸脂术,R,adio,F,requency,A,ssisted,L,iposuction,RFAL Clinical Effects,Large Area Coverage,Uniform Thermal Profile,Uniformity,聚焦超声技术,Focused Ultrasound Technology,声学接触传感器,Low acoustic energy everywhere except in the focal area,聚焦超声治疗换能器,Skin,Muscle,Fat Layer,超声波是一种频率高于,20KHz,的声波，因其频率下限大约等于人类听觉上限而得名。虽然因人而异，基本上健康、年轻的成年人的听觉上限是,20KHz(20000,赫兹,),，所以人耳无法听到超声波。,超声波设备的操作频率从,20KHz,到几兆赫兹，被广泛应用于医疗领域,Understanding Ultrasound:Acoustic Wave,EM Waves,Acoustic,Waves,decompression,机械效应,:,超声波穿过的组织，组织微粒将持续运动。,热效应：热吸收和热弥散：超声波被组织吸收后转化成热能 ，同时开始热弥散,化学效应,:,超声波将暂时改变皮肤的,PH,值和细胞膜的通透性,CAVITATION,空化作用,工作原理,:,Cavitation formation,B,HIFU,HIFU,是“高强度聚焦超声波（也称为极限音波）”,(High-Intensity Focused Ultrasound),的简称，是利用超声波的温热效应，用,HIFU,的热能消除生物体内病变组织的医疗技术。, HIFU,技术最早应用于肿瘤,(,癌,),治疗系统，后来发现这项技术对皮肤改善及脂肪消除有显著效果，进而逐步应用到了相关治疗领域。,作用原理,优提美,UTIMS A1,极限音波拉皮可以精密控制施术深度，按照,1.5mm, 3.0mm, 4.5mm,三段深度，将治疗用聚焦超声波能量准确地注入皮肤的真皮、皮下组织及,SMAS(,面部表浅肌肉腱膜系统,),筋膜层。,极限音波的热效应会使目标部位的温度上升，当温度上升到,47C,以上时，开始形成热治疗点，拉紧周边皮肤组织并提升，改善支撑皮肤的皮下结构，启动胶原蛋白再生机制，促进胶原蛋白和弹力纤维蛋白的再生。这时，皮肤肌肉会恢复弹性、紧致提升，达到消除皱纹的效果。极限音波拉皮被公认为紧肤除皱领域的黄金标准！,真皮层,SMAS,1.0 mm,1.5 mm,3.0 mm,4.5 mm,皮下组织,肌肉,30,40,55,60,70,100,初步胶原,蛋白再生,全面启动胶原,蛋白再生机制,组织气化,RF,射频,体温,激光消融术,温度对胶原蛋白的影响,常见拉皮治疗类型比较,2024/9/21,2024/9/21,2024/9/21,2024/9/21,Accent Ultra: The Dual Mode system,Ultra sound probe for Lipolysis,RF probes for tightening and drainage,Acute,6,3 Days,6,7 Days,6,Selectivity,Intact nerve and blood vessels surrounded by damaged adipocytes,6,双源超声 轻松享瘦,适应症,橘皮样病变,游泳圈,局部肥胖,U,（超声）手具,L,（淋巴按摩）手具,U,（超声）手具 通过两束低频超声波，使能量直接作用于治疗部位,符合人体工程学的卓越外观设计，拥有专利的低频率双超声手具，可有效地精准定位治疗部位,提供安全有效治疗,达到聚焦效果，避免痛感困扰,L(,按摩 ）手具打开淋巴结和用于淋巴按摩，加速淋巴循环,淋巴按摩帮助身体通过淋巴结,排除体内超声治疗产生的液体和代谢物,14,Before,After 1 treat.,After 2 treat.,After 3 treat.,HALF AN HOUR TREATMENT ONLY ON LEFT,SIDE,聚焦超声常见不良反应,潮红,水疱,水肿,条索状水肿性红斑,周围神经损伤,瘢痕,2024/9/21,不良反应发生原因,能量过大,密度过大,手具选择不当,治疗手具未能垂直紧密贴附皮肤,2024/9/21,2024/9/21,换能器必须紧贴皮肤！,不然，换能器无法将,HIFU,能量传输至指定的目标组织，无法达到预期的效果。甚至，还有可能会造成不可预料的副作用！,