Skin laxity is a common cosmetic complaint of aging patients. Improvement in skin laxity can be difficult to achieve without invasive surgical lifting procedures. The radiofrequency (RF) system is based on an entirely different treatment principle than the photothermal reaction created by most dermatologic lasers. Unlike a laser, which uses light energy to generate heat in targeted chromophores, based on the theory of selective photothermolysis (Anderson and Parrish 1983), RF technology produces an electric current that generates heat through resistance in the dermis and subcutaneous tissue.

Radiorefresce uses Surgitron Dual Frequency RF (Radiowave Technology, Ellman International), which develops a proprietary capacitive coupling method to transfer higher-energy fluences through the skin to a greater volume of dermal tissue than nonablative lasers, while protecting the epidermis (Hardaway and Ross 2002).

The components of the device include (1) an RF generator producing a 4-MHz alternating-current RF signal, the energy level of which is set by the clinician, and (2) a handpiece for directing the RF energy to the skin. The neutral plate of the apparatus is placed approximately 15–20 cm from the patient. Spherical handpieces (5, 10, 15, and 20 mm in diameter) are used. The application of RF energy has been carried out in ambulatory settings, with no need for skin sterilization.

The Surgitron 4.0 Dual Frequency RF has various operative modes. For ideal treatment, the manufacturer recommends a setting of 4.0 Mhz.