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You are here: Anti-Aging Skin Treatments > Noninvasive Methods >

Monopolar & bipolar radiofrequency skin tightening/tissue lift (TriPollar, Accent Unipolar/Bipolar)

Generic name: Monopolar and bipolar radiofrequency

Brand(s): TriPollar; Accent Unipolar/Bipolar

Maker / Website: Pollogen, Inc (, ); Alma Lasers, Inc ( )

Cost: About $200 - $400 per area per session. Some practitioners provide discounts for multiple sessions.

Function / Purpose:
Both monopolar and bipolar radiofrequency are used for tissue tightening. Their effects are somewhat complementary because they deliver energy in different patterns and to different depth. Combining monopolar and bipolar radiofrequency allows to reduce the required intensity of each and thus minimize side effects and possibly increase effectiveness (as compared to each type of radiofrequency used alone). The combination of monopolar and bipolar radiofrequency has been used for skin tightening, facial contouring, body sculpting and cellulite reduction. DIY (home use) versions of radiofrequency devices have been introduced but their effectiveness, if any, remains unclear.

Monopolar and bipolar radiofrequency (RF) are the modes in which radiofrequency can be used in medicine and cosmetics. They can also be used in combination. (See our overview of radiofrequency treatments). As far as cosmetic rejuvenation is concerned, monopolar and bipolar radiofrequency treatments appear somewhat complimentary.

Monopolar RF heats tissue in the treated area rather deeply (usually up to 20 mm) and thus affects both the skin and subcutaneous fat. Bipolar RF heats tissue in the treated area less deeply (usually up to 2-4 mm) and thus primarily affects the skin. The patterns of energy distribution also differ. Whether simultaneous treatment with both types of RF is additive, synergistic or otherwise in not entirely clear and needs further research. The manufacturers of monopolar+bipolar devices believe that such combination is synergistic and allows to reduce the required intensity of each and thus minimize side effects and possibly increase effectiveness.

As of the time of this writing, the primary system of this type is TriPollar by Pollogen corporation. TriPollar combines the electrodes for the monopolar and bipolar RF application in the same hand piece. It also utilizes sophisticated control algorithms for optimizing the concurrent application of the two types of RF as well as tailoring the output to a particular patient and treatment goal.

According to Pollogen corporation, TriPollar RF Technology has the following advantages [as quoted from their materials]:

  • Treatment is not painful -TriPollar RF technology focuses the RF energy right where it is needed requiring much lower energy than other RF technologies, thus avoiding the associated pain for the client.
  • Treatment of both superficial and deeper fat layers - The TriPollar RF technology uses sophisticated algorithms to control the treatment electrodes varying the current and polarity to achieve variable energy focus in different fat layers resulting in visible clinical results from the first treatment.
  • Selective heating of fat tissue - The TriPollar RF technology directs energy selectively to fat tissue avoiding heating to other tissues thus achieving better clinical results.
  • No cooling of skin or applicator is needed - The TriPollar RF configuration and sophisticated control algorithm eliminates the need for skin and applicator cooling resulting in more efficient treatment and requires less treatment sessions.
  • Fewer treatment sessions -TriPollar RF technology delivers focused energy achieving better and faster results.
  • Light technology not required - applicable for all skin types and colors.

Unfortunately, as of the time of this writing, there are few, if any, comprehensive, well-designed independent studies of TriPollar technology. However, the small studies published so-far are encouraging.

An Israeli study (2009) reported "an increase of 49% in dermal thickness, focal thickening of collagen fibers and focal shrinkage of fat cells was shown following TriPollar treatments [i.e. skin thickening and fat/cellulite reduction]". However, the study was small, lacked comprehensive design and its funding source is unclear.

Another Israeli study (2010) found that TriPollar produced significant reductions in body circumferences. The average circumference reduction in main body areas (abdomen, buttocks, thighs) was 3.6 +/- 2.4 cm, with a maximum reduction of up to 10.5 cm in the abdomen. The study also reported improvement in perioral and periorbital wrinkles. This study was also small and lacking comprehensive design and possibly funded by the equipment maker.

A small 2009 Thailand study investigated TriPollar as a treatment for cellulite and circumference reduction. The study found reduction in circumference and cellulite appearance of the abdomen and thighs but no significant reduction in circumference of the buttocks and arms.

More comprehensive, better designed, independently funded studies are still needed to confirm the reported benefits of TriPollar.

Pollagen has also launched two devices for self-administering radiofrequency treatments at home: TriPollar Stop (primarily for wrinkles and skin tightening) and TriPollar Pose (primarily for fat reduction and cellulite). (As of the time of this writing, these devices are available only in Europe but can probably be purchased via the internet and shipped elsewhere.) Apparently, these devices are adapted to use lower energy settings than their professional counterparts in order to reduce potential risks resulting from unskillful or excessive application. It remains unclear whether TriPollar devices for home use can deliver benefits comparable to those of the professional versions - or any benefits at all for that matter. Studies are needed comparing TriPollar at-home versions to the professional ones as well as to placebo (sham treatment).

Another system in this category is Accent RF by Alma Lasers. The system includes two separate hand pieces: Accent RF Unipolar and Accent RF Bipolar. The hand pieces are not used concurrently. In essence, these are two separate RF systems in one. The monopolar and bipolar hand pieces can be used sequentially in the same session, but Accent does not possess the sophisticated integration of monopolar and bipolar RF treatments comparable to the TriPollar device. Whether such sophisticated integration provides extra benefits without sacrificing flexibility remains to be seen (ideally in independent comparison studies).

Related Links
Overview of radiofrequency and combination treatments
Index of noninvasive and minimally invasive methods/procedures
Forum discussions of noninvasive procedures
eMedicine: Nonablative Facial Skin Tightening


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