Radiofrequency for cellulite and skin tightening: how to choose the best RF treatment

Deep tissue radiofrequency: the ultimate technology for skin tightening / cellulite reduction

Deep-acting, high-power radiofrequency (together with high-power ultrasound) is widely accepted as being the most effective cellulite reduction and skin tightening technology available today, for both face and body.

It is far superior to lasers, which do not penetrate anywhere near as deep as radiofrequency does, or any other therapeutic modality, such as HIFU, acoustic wave therapy or mechanical massage.

By applying intensive heat on collagen cells and fat cells, radiofrequency helps increase skin tightness, reduce fat and boost circulation.

These physiological changes in turn improve the contour and texture of body and face for applications such as cellulite removal, skin tightening and lifting and facial rejuvenation.

Not all radio frequency cellulite treatments are the same: how to choose a radiofrequency cellulite treatment

There are hundreds of RF machines in the market today and they all vary in power and in a number of different specifications.

There are also tens of thousands of RF operators around the world and they are all different in terms of their training, knowledge, experience and the technique/protocols they utilise.

Even with the same equipment, each operator provides a different treatment, according to their knowledge, experience and limitations of the equipment:

• A knowledgable therapist can make the most of average equipment and produce good results

• A poorly trained therapist can produce paltry results out of excellent equipment

• A therapist who works at a clinic where profit is the priority, not the client, can also produce paltry results out of excellent equipment, by cutting corners

• And finally, a knowledgable, client-focused therapist can produce excellent results if they also use excellent equipment.

Therefore it can be said that there are tens of thousands of different radiofrequency treatments available today.

Therefore, just like the word ‘massage’, the words ‘radio frequency treatment’ can mean anything or nothing. Not all radiofrequency treatments are the same: effectiveness can range from almost zero to impressive. The best RF treatment is the one applied with the highest specification equipment, provided by the best trained therapist and with the best protocols.

With such variability in technology and experience, the following question arises: how can a customer know which treatment is the best?

This is a very common question that I hear from prospective clients, as they are confused by conflicting information and hype from both the press/influencers and from clinics/salons.

Predictably, everyone claims their treatment or equipment is the best.

If aesthetic practitioners and doctors don't know, then how are consumers supposed to know?

Unfortunately, as a simple client you can't know what is the best equipment - not at least without technical knowledge.

In fact, even most therapists, including most doctors, haven’t got a clue about how to choose a good machine. Choosing a good machine is all about understanding technical specifications (and of course reliability/after-service).

Unfortunately, most practitioners go according to:

• The unrealistic sales pitch (“revolutionary technology” / “miracle results”, “best thing since sliced bread” etc)

• Unrealistic profit projections (“how to rip your clients off in 20 minutes to make quarter of a million £/$/€ out of the machine in one year”)

• Ridiculously fake before and after pictures

• How widely marketed the equipment is

But marketing, fake before and after pics, profit projections and sales blurb are not accurate ways to judge a piece of equipment.

You first want the best for your client and then everything else will fall in place. If you choose with dollar signs flashing in your eyes, you will do a disservice to your client.

For example, the most famous cellulite equipment on the market simply doesn't work, yet it still keeps selling like hot cakes for more than 20 years - both in terms of machine sales and treatment sales.

I go to professional exhibitions and I see that 95% of sales people at manufacturer and distributor booths cannot even give me any technical specs on the equipment they themselves manufacture, sell and charge £30k-£120k for..

I ask them about RF frequency and they give me the machine’s power output. I ask them about power output and they give me power input. For even the most basic questions they have to ask the technical guys back at the factory.

And the reason that equipment salespersons and distributors do not have a clue is that they don’t need to. Nobody ever asks them. 95% of buyers (including doctors and plastic surgeons) do not ask any technical questions, because they do not have much technical knowledge, so they don’t even know what questions to ask in the first place.

Most salon and clinic buyers cannot even understand the specifications. They depend on:

• Marketing/PR campaigns

• What the competition does

• Dodgy "evidence”: research can be - and is - faked regularly

• So called “reviews”: most of them are fake

• So called “before and after photos”: 95% of them are fake - this is obvious to anyone with basic knowledge of photography, lighting or Photoshop

How radiofrequency machines are sold

I was once shown some blatantly fake “before and after” photos by a sales rep from one of the top selling and most famous RF machines and could not hide my anger for his attempt to con me - and consequently, you, my clients.

At the end of the day, if the consumer makes a decision based on fake ’before and after’ photos they can lose £1,000, £2,000 or £3,000. But when a professional is misled, they can lose £30,000, £70,000 or even £120,000.

In my case, if I was to believe the marketing BS I would buy a worthless piece of equipment for £60,000, and then I would try to make that wasted money off my customers, which in turn would waste their £1,000-£3,000. Of course I wouldn’t do it, but that’s what happens every day all around the world.

On another occasion a famous equipment company tried to sell me an £100,000+ machine that was an utter gimmick. It sells like hot cakes and clinics make lots of money from it by luring unsuspecting clients to pay £800 per session for a course of 4 sessions (yes, more than £3,000 for zero results).

Of course, I didn’t buy it. But the marketing blurb is strong and the temptation to offer the latest highly marketed equipment is big - who doesn’t want to offer the best to their clients (or get rich quick)?

And another manufacturer of an objectively good, top-spec machine also showed me some pathetically fake “before and after” pictures, instead of selling the machine on its technical merits.

Why? Because no-one knows or even cares about technical specs - it’s all about marketing, hype and profit. And the honest, hard working practitioners who do care and want the best for their clients, get conned all the time.

So, if most therapists / doctors do not know how to choose, how are you expected to know how to choose?

Well, you may not become an expert in radiofrequency, but by reading the guide below you will equip yourself with some basic knowledge which, with some common sense, can help you choose the best treatment in your area.

12 technical factors that affect RADIOFREQUENCY cellulite treatment quality

In summary we could say that radiofrequency treatment effectiveness depends on the following important factors:

1. If monopolar vs bipolar/tripolar vs unipolar radiofrequency technology is used: Monopolar and unipolar are best, bipolar/tripolar are a waste of time.

2. Low power vs high power equipment: Low power will be a waste of time (most machines on the market, unfortunately).

3. Cooling vs no cooling function: Cooling is generally preferred, as it protects the epidermis and allows deep treatment.

4. Adjustable settings for custom RF treatment vs fully automatic function: Fully automatic functions are OK for poorly trained therapists but very limiting. Manual is always better.

5. RF combined with other modalities, such as ultrasound or infrared vs stand-alone RF: Combined treatments are always better, but are usually more expensive.

6. Treatment depth: Generally deeper is better, but not too deep, as in that case energy is wasted on deep fat (subcutaneous fat), which is irrelevant

7. Fractional vs normal radiofrequency: Fractional radiofrequency (microneedling with RF at depths up to 7mm) the latest super-expensive gimmick, is ineffective, limiting and inherently unsafe. Great for those providing it, not that great for you. Good luck with that. Literally.

8. Destructive vs stimulating radiofrequency: As the name suggests “destructive” RF works by burning tissues, including collagen. Stimulating RF works by stimulating collagen/fat release. Destructive RF is very expensive, very unsafe, ineffective and limited, great for those providing, not that great for you. Again, good luck with that, literally.

9. RF treatment protocols: RF treatment protocol can “make or break” a cellulite / skin tightening treatment

10. Operator experience and specialisation: Obviously the more the better, both for effectiveness and safety

11. Instant miracles vs down to earth approach: Steer clear from “instant miracles” and “body transformations”. There is no long-term and/or effective cellulite reduction with less than 6 sessions.

12. Reasonably priced vs extremely expensive vs cheap: Usually cheap doesn’t work, but also extremely expensive doesn’t make sense, as you cannot afford the 6-12 treatments typically needed. That’s why the super-expensive treatments are presented as 1-4 session miracles by unscrupulous companies.

Can you help me choose a radiofrequency treatment in my area?

We get this question all the time.

Unfortunately we cannot give advice about the best clinics / treatments in your area, as even if we knew what equipment each clinic uses, we couldn’t know what protocols they use, how they maintain it (very important) and how much they value/care about you, the client.

Different clinics use and maintain the exact same equipment in vastly different ways, according to skill, profit projections and time constraints, so just advertising a machine here does not make sense.

The 15 tips below are the best practical advice we could give you, as we do not know the clinics in your area.

13 common sense tips on how to choose a radiofrequency treatment for cellulite / skin tightening

Obviously, choosing a radiofrequency machine without wasting £30-£120k on the wrong machine is a nightmare even for aesthetic professionals, such as doctors and aesthetic therapists.

But also choosing a treatment that may cost you thousands of £/$/€ as a client is also difficult.

My best advice when choosing a treatment is to:

1. Never go for an RF body treatment with less than 250 Watt power and never go for bipolar RF (or tripolar, tetrapolar, octipolar) - only monopolar/unipolar

2. Consequently you can talk to 4-5 clinics in your area and have treatment in a couple of those places. See how treatment feels, how customer service is, how knowledgeable your therapist is. Real life feedback is the best feedback

3. Never go for extremely expensive treatments - they are NEVER, EVER worth it

4. Never go for one-session miracles - you will regret it

5. Never go for treatments that require anaesthesia and/or downtime - it’s never worth it and you may have to deal with serious adverse reactions. Radiofrequency should NOT be painful.

6. Putting tips 3, 4, and 5 together, never go for radiofrequency microneedling - too small area, too little benefit, too high cost, too high chance of adverse effects

7. Never go for the cheap treatments either - there is a reason they are cheap (cheap equipment and cheap labour is used) and there is no such thing as a free lunch

8. Take into account but don’t just follow the customer reviews - they can be faked

9. Take into account but don’t just follow the “before and after” pictures - they are almost always fake

10. Take into account but don’t just follow the “research” - it can be faked

11. Don’t care much about press articles - in most cases they are just PR “blurb”

12. Don’t care much about influencer reviews - they usually haven’t got the slightest clue and their reviews are often paid / disingenuous

13. And then it’s time to put it all together: put all the above together and using your COMMON SENSE to decide which clinic is the best for you

Extra advice for our American readers

Overall, aesthetic treatments in the US are overpriced and overhyped, so take everything with a (huge) pinch of salt. America is a great nation, but it has a big problem with unbridled consumerism and hype.

Perhaps choose a clinic with a more nuanced and down-to-earth approach, instead of those who promise eternal youth in 20’ and for $10,000 (yes, they exist).

Having said that we, here in the UK, are gradually following on America’s steps in this regard.

Not good…

Get the best possible radiofrequency cellulite treatment by asking the right questions

To make the right decision it is important to quiz the person who is providing/selling you the treatment a few questions, based on the above information.

This will offer you important clues about the quality of the treatment you are about to receive and help you decide by the answers you get whether you would like to invest your head-earned cash in them or not.

11 crucial questions to ask:

1. What frequency does your RF equipment use? Most don’t have a clue. Quite often they will confuse frequency, with power. If they don’t have a clue, that’s a bad sign. If they do know this bit of information, this is an excellent sign :)

2. What is the maximum output power of your equipment? Same as above. And if it is 250 Watts or higher, bingo!

3. Is this treatment resistive or capacitive RF? Give kudos to those who know it :)

4. Is the treatment bipolar, monopolar, tripolar etc? This question is a bit easier, but still useful…

5. How does the treatment work? If they start talking about “toxins”, “melting the fat which is then naturally removed via your kidneys” and “breaking down the cellulite”, run…

6. How many sessions do I need and how often? Normally 6-12 weekly/fortnightly/twice-weekly sessions are needed. If they promise results with 1-4 sessions or with monthly sessions, then you know they are trying to take you for a ride.

7. How much does the treatment cost? A £90/area treatment probably won’t be good. But then again a £750/area treatment is a clear sign they are trying to rip you off. Of course, if you fall for the £2,500/area-you-only-need-one treatments, it’s your fault for living in the clouds, not theirs.

8. Is it so painful that I will I need a numbing cream or numbing injections? If the answer is yes, then you are having what we call “destructive radiofrequency”, very unsafe and ineffective too. Good luck with that…

9. Is it fractional radiofrequency (does it involve microneedling with RF): Again, good luck with that…

10. Do you combine RF with ultrasound? If yes, this will cost more (more time per session) but may be better overall.

11. How many sessions have you already provided? Obviously the more experience, the better.

Swipe left ☹️

If nobody at the clinic/salon has a clue what you are talking about or how to answer those questions, then you know that the clinic or salon you visited are not worth spending thousands of £££ / $$$ / €€€ money on.

And the same applies if they make promises of a “body transformation” in one session or similarly worded miracle promises.

Swipe right 😀

On the other hand, if your therapist can answer those questions confidently and propose a reasonable treatment which feels “strong” but not painful, then it is most probably worth committing to a course of treatments.

Always combine it with lifestyle changes (healthy eating, exercise, smoking cessation, reduced alcohol consumption etc) and a good cellulite cream in order to achieve maximum results.