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Ultimate Guide to Attiva Skin Treatment | SurgiSculpt® high-definition body contouring

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Ultimate Guide to Attiva Skin Treatment

H. is short for subdermal-induced heat technology and describes the ability to administer thermal energy to soft tissue cells and collagen fibers with localized heat application. The heat is applied with sleek wands administered without the need for an incision.

Attiva Radiofrequency Skin Treatment Before And After
Attiva Radiofrequency Skin Treatment Before And After
Attiva RF Subdermal Radiofrequency
Attiva Subdermal Induced Heat Technology

What is ATTIVA S.I.H. technology?

S.I.H. is short for subdermal-induced heat technology and describes the ability to administer thermal energy to soft tissue cells and collagen fibers with localized heat application. The heat is applied with sleek wands administered without the need for an incision. ATTIVA is an Italian medical health company that has developed S.I.H.

This novel technology provides the opportunity to deliver controlled thermal energy that effectively shrinks collagen molecules along the undersurface of the skin and throughout the soft tissues spanning throughout the skin, soft tissues, and even the muscle fascia.

The beneficial effects of S.I.H. are observed in an immediate, subacute, and delayed fashion. The immediate benefit of heat induction is to contract the collagen molecules that are located on the undersurface of the skin, i.e. the dermis, throughout the soft tissues, i.e. fibro-septal network, and even the fascial layers located in the deeper soft tissues and overlying muscle bundles. The subacute phenomenon of heat exposure is the vasodilation of vascular cells.

A final delayed benefit of S.I.H. is the stimulation of biological cells that include fibroblasts and myofibroblasts resulting in prolonged increase in collagen and elastin production. The net effect of S.I.H. technology is a safe solution to treating signs of aging without surgery. In summary, S.I.H. technology offers aesthetic enhancements to the quality of your skin and soft tissues with minimal downtime, avoidance of scarring, and long-lasting results.

Cosmetic Surgery for Shape or Aging LA, CA
Cosmetic Surgery for Shape or Aging LA, CA

Aging Effects on the Skin

Aging results in the reduction of both collagen and elastin, the recoil protein that exist within the skin. As the elastin protein density diminishes, the skin loses its ability to recoil, best characterized by a rubber band. As a rubber band ages, it becomes brittle and loses its ability to snap back.

The loss in the recoil effect of elastin is most appreciated following significant weight loss. When you lose significant weight in your 20’s, the skin will snap back since elastin in plenty. However, after age 40 to 45, significant weight loss results in skin sagging and unappealing skin wrinkling and irregularities.

The aging effect is further compounded by gravity that acts like a continuous weight that tugs on the skin and soft tissues. Decades of continued tugging naturally result in the stretching out of the skin. When gravity is combined with loss in elastin, the skin sagging becomes expounded! The above detrimental effects are typically countered by structurally stabilizing collagen fibers located along the undersurface of the skin and spanning throughout the soft tissues. When collagen production slows down with aging, then the skin and soft tissues become further compromised.

The final detrimental effect on the skin is sun radiation, which results in the bombardment of skin cells by the damaging radiation waves of the sun. The net effect of radiation damage is malfunctioning of protein expression of DNA by poorly performing cells, called epigenetics; increasing skin cell expression of beneficial proteins, such as collagen and elastin, will counter premature aging that results in loss of turgor and sheen.

Benefits of ATTIVA subdermal induced heat (S.I.H.) technology

ATTIVA® Subdermal Induced Heat (S.I.H.) Technology is the result of 5 years of advanced scientific research. Three international patents protect ATTIVA subdermal induced heat technology. This technology may be employed by medical professionals such as physicians, naturopathic doctors, nurse practitioners, physician assistants, and registered nurses. This range of medical providers who may treat the signs of aging, prolonged gravity, and sun damage without invasive surgery translates to efficient, safe, and affordable treatments.

ATTIVA® S.I.H. Technology offers patients dramatic aesthetic enhancements to the quality of their skin and soft tissues with minimal downtime, no scarring, and immediate results. A new benchmark in the medical treatment of aging, sun damaged, and loose skin without the need for general anesthesia and prolonged recovery is now available. ATTIVA subdermal induced heat S.I.H. technology provides several real advantages not offered by any other medical device alternatives that include:

  • Minimally invasive treatment that can be completed in the office while you remain awake
  • Avoidance of incisions that can result in subsequent scars
  • Precludes need for infiltration of fluids and/or gasses prior to treatment
  • Immediate improvements following a “lunch time” procedure
  • Quick recovery period means no income loss or setbacks in your social calendar
  • Reducing mechanical trauma resulting in unnecessary soft tissue injury or swelling
  • Minimizing risk of skin compromise with external skin monitoring and temperature safety gauges
  • Less inconvenience associated with frequent postoperative visits to the clinic

How does ATTIVA S.I.H. work

Subdermal induced heat technology describes a minimally invasive procedure that improves skin laxity and appearance previously achieved only by surgery. The beneficial effects of ATTIVA are multi-fold. The first occurs immediately following contraction of collagen molecules in both the soft tissues and the deep layer of the skin, called the dermis. The shrinking of collagen molecules exposed to heat is coined subdermal coagulation and is permanent, best appreciated by the analogy of grilling a steak. Grilling a steak results in immediate shrinkage as the collagen molecules become denatured.

Denaturing of collagen proteins occurs by breaking intramolecular bonds, resulting in contracture of its helical configuration that converts to shorter and thicker helixes. The next benefit of ATTIVA is subacute and involves vasodilatory expansion of capillary and arteriolar microcirculation directly resulting in hyper-oxygenation and removal of pro-inflammatory products thereby expediting tissue regeneration.

The final benefit of ATTIVA is delayed and involves its biological effects at a cellular level. The heat exposure of fibroblasts and myofibroblasts results in increased collagen and elastin production respectively. Specifically, the proteo-synthetic effects of ATTIVA have been shown to increase production of type I and type III collagen. The increase in collagen production has led to an increase in dermis consistency and density, that can be appreciated both visually and by feel best described by reduction in skin elasticity.

ATTIVA® is a Radiofrequency (R.F.) System approved in the United States ATTIVA® Radiofrequency (R.F.) System (generator, electrodes/handpieces, and accessories) for treating skin and soft tissues. Radiofrequency emits electromagnetic waves, leading to a rise in the internal temperature of tissues involved in treating electrocoagulation and hemostasis termed subdermal coagulation.

The rise in internal temperature has additionally fostered collagen contraction, vasodilation with beneficial consequence of increase in cell oxygenation, as well as bio-stimulation of cellular components. ATTIVA® device should be used on adult patients only.

ATTIVA Mechanism of Action

ATTIVA is a special radio frequency device that transfers controlled a unique combination of radiofrequency waves through a sleek probed that is introduced through imperceptible ports created without the need of an incision. The applied radiofrequency waves have proved effective in the structural and functional restoration of collagenous matrix for the following reasons.

  1. ATTIVA utilizes proprietary wavelengths in the radiofrequency designed to obtain maximum interaction with the treated tissues. In fact, the heat produced by the energy, maintained below 60 ° C, is safely transferred to the tissues causing an electrical stimulation on the fibroblast cells.
  2. The mechanical effect of the probe, applied subcutaneously, produces a specific stimulus on the fibroblast cells that supplements the electrical-thermal stimulation described above.
  3. Direct action on the stem cells of the treated structure, so that in addition to the fibroblasts already mentioned, the radiofrequency wavelength produces both a thermal vasodilation and regeneration of arterial-veno-lymphatic capillaries, resulting in optimized delivery of nutrients and removal of catabolites of all soft tissue cells.
  4. The deconstruction and reconstruction of the fibrillar fascia and its functional restoration through the regeneration and neo-production of proteins, such as collagen and elastin.

Beneficial effects observed above are made possible by the precise and safe delivery of energy which in turn translates into a controlled heat of up to half a degree through each pass. The subjective effectiveness of the results are supported by histological studies in which no secondary fibrosis has been detected.

[Development of collagenous matrix without fibrosis]

ATTIVA Radiofrequency S.I.H. Recovery

What makes ATTIVA Radiofrequency S.I.H. recovery unique is its seamless transition from treatment to full recovery. Since patients avoid general anesthesia patients may drive to the office or utilize ride sharing companies such as Uber to and from their procedure. Since patients avoid surgical intervention such as incisions or infiltration of fluids such as tumescent solution or gases used by alternative skin and soft tissue tightening machines, typical procedure side effects are avoided.

Recovery advantages include negligible discomfort in the procedure area, only transient redness, and minimal swelling. Instead, improvements in the appearance of and reduction in skin looseness are immediately appreciated.

Clients today demand efficient and safe procedures from their physicians to improve the quality of their skin quality and body contour. The realization that topical treatments are often not adequate to solve their skin problems, coupled with their fear of surgery, leads many to opt for a non-surgical, minimally invasive technology such as ATTIVA. ATTIVA® S.I.H. Technology achieves long-lasting results with minimal downtime and no scars.

The first reason for ATTIVA’s expedited recovery is the ability to avoid surgical incisions. Instead, small pokes created with an Awl or needle stabs are utilized to create imperceptible ports for the introduction of the treatment wands.

Furthermore, the safety of ATTIVA S.I.H. technology stems from its unique technology and protocol. The use of a thermi-camera in real time allows for double temperature control. Specifically, the temperature of the probe tip where radiofrequency energy is administered is confirmed; temperatures of 42 to 50 degrees

Celsius are integral to obtaining collagen contraction and bio-stimulation of soft tissue cells. Additionally, the temperature of the external skin is monitored so that harmful temperature of 42 degrees Celsius is avoided at all times. Patented technology self monitors and automatically lowers energy fluences when preset maximum internal temperatures are reached.

Attiva Nonsurgical Cheek Lift
Attiva Nonsurgical Cheek Lift

ATTIVA S.I.H. Safety

Both male and female clients today demand effective, safe, and minimally invasive alternatives to improving their appearance. Our clients are keen on researching various radiofrequency options searching for the best treatment solutions. Most clients realize that not all Radio Frequency (R.F.) technologies are identical. They understand the importance of the safety of a temperature-controlled procedure to ensure the integrity of their skin.

Thanks to the high precision of the ATTIVA® treatment, medical providers can obtain the best results in skin tightening and body contouring without scars and with minimal downtime. The subdermal-induced heat technology has proven to be extremely efficient and safe. A built-in Double Temperature Control ensures the safety of subdermal-induced heat technology on the device.

This feature, combined with an external thermo-controlled camera, allows constant monitoring of the probe inside the tissues and of the superficial skin temperature. The highly sensitive thermal imaging camera allows for accurate control of skin temperatures.

[During the entire session, the physician monitors the parameters and the results.]

To ensure the patient’s safety, ATTIVA® RF has a built-in double temperature control on the cannula. This technology, combined with an external thermos-controlled camera, allows constant monitoring of the probe inside the tissues and the superficial skin temperature.

ATTIVA® S.I.H. Technology delivers optimal results through minimally-invasive facial lifting, body contouring, and skin tightening procedure. The double real-time temperature control and the high precision of the thermocouple provide an unequaled safety level during the entire procedure with a complete focus on the treated area.

The proprietary software and patented subdermal-induced heat technology allow your medical provider precise control of the thermal diffusion from the deep tissues up to the skin’s surface. Patented ATTIVA capacitive transducers work with tensions up to 10 times lower than any.

ATTIVA Clinical Applications

ATTIVA –Reduced Skin Elasticity

The old technology of radiofrequency lifting consisted of heating the skin’s surface long enough for the subcutaneous tissue to heat up to 42 ° Celsius for over 1 minute or up to 82 degrees for a fraction of a second. The limitation of these procedures were the excessive heating of the skin surface and the possibility of burns.

With the new ATTIVA subdermal induced heat technology, signs of skin aging are effectively and safely reversed without prolonged recovery periods and the risk of scarring. The advantage of ATTIVA thermal heating of collagen fibers is that therapeutic internal temperatures are safely controlled until desired resulting in in immediate collagen contraction as well as delayed production of collagen fibers result in active retraction of skin against the underlying muscle fascia.

ATTIVA – Radiofrequency skin lifting

What does ATTIVA radiofrequency lifting look like? The procedure is painless because the anesthetic is given via injection to the site with a flexible microcannula. A thin electrode is then applied to the anesthetized skin, emitting radiofrequency and moving carefully through the skin, soft tissues, and even the underlying muscle fascia depending on the depth of treatment and desired region.

The entire treatment is controlled by a camera that measures the temperature of the skin surface and internal therapeutic temperatures in completely safe fashion. After the treatment, the skin’s appearance is unchanged. Occasionally, transient bruising or mild swelling may develop after treatment.

The lifting effect is two fold; the immediate effect results from contraction of soft tissue collagen fibers and muscle fascial planes. Additional lifting becomes visible after 4 to 6 weeks and more pronounced over time due to new collagen production. Further lifting results may be achieved with additional treatments that can be repeated after several years.

ATTIVA – Improvement in skin appearance

Immediately after the first session, most patients will see improvements that continue to improve with full results in 2 to 3 months following the treatment. The reason for continued improvements is the bio-stimulation that the radiofrequency energy conveys to produce new elastin and collagen fibers. The optimal result are achieved by 3 to 6 months as observed by histological samples and will be appreciated long-term for several years.

ATTIVA Frequently Asked Questions

ATTIVA Treatment Areas

Facial Treatment Regions

[Need Image]

Forehead/Brow Lift

Upper and Lower Eyelid Tightening

Jowl Reduction

Neck Contouring

Peri-oral fine Wrinkles

Body Treatment Regions

[Need Image]

Under Arm Laxity

Abdominal Redundancy/Stretch Marks

Inner thigh Laxity

Armpit Laxity

[Need Image]

Arm Laxity

Back Rolls and Skin Laxity

Gluteal Reshaping

Hip Dip Reshaping

Inner Thigh Tightening

Buttock and Posterior thigh Cellulite

ATTIVA Treatment Protocol

Depending on your chosen treatment and your anxiety or sensitivity, we will anesthetize your area of treatment with numbing solution. Since the ATTIVA cannulas are sleek, < 1mm, a single needle stick is all that is needed, which means a tincture of numbing solution is all that is needed. This area is first cooled with your topical freezer which means that you will not feel any discomfort! If deemed necessary, numbing solution may be employed to anesthetize the entire area being treated.

The anesthetic solution is created with 1% lidocaine mixed with epinephrine as well as bicarbonate solution to expedite its numbing capacity. The numbing solution is delivered through the use of a small 22 spinal needle. The amount of anesthetic solution is directly proportional to the area being treated, to the treatment times, and always titrated to the patient’s sensitivity. The solution is kept at room temperature to make it more comfortable when exposed to your tissues.

Once numbing has been established, the treatment probes which are less than one mm in girth are easily introduced through a small needle hole created with an 18 gauge. The treatment probes are of varying lengths that include 5cm, 10cm, 15cm, and 20cm depending on the area of the region being treated. The introduction of the cannula needle must be done as follows: The needle penetrates the skin perpendicularly for about 0.5 cm, and then it is tilted by 90° to span the area of treatment in the soft tissue plane parallel to the skin.

Once the distal point of the established track is reached, the energy inducer is turned on with the foot pedal. Within a few seconds, the treating temperature is reached (between 45 to 50 degrees Celsius), and treatment is initiated by pulling back the cannula needle very slowly, paying much attention to remain as close as possible to the constant set temperature.

The machine signals the continuation of the set temperature with an oscillation of 2°C, with a green light, which becomes blue if oscillation exceeds of 2°C. While treatment is being rendered, the thermal camera provides continuous feedback, assessing the homogeneity of the delivered heat both at the tip of the probe internally as well as the external skin temperature. Subdermal induced heat therapy is rendered as needed based on the region and desired effects as below

  1. Skin Laxity Program

The skin laxity program is intended to treat excessive skin laxity that is correlated with dermal thinning, observed following dramatic or quick weight loss. These patients presenting with dermal thinning that result in loose and thinning skin of the arms and inner thighs, stretch marks and wrinkling of the abdomen and back, or cellulite of the posterior thighs and buttocks. Treatment protocols is defined by region and thickness of skin being treated, selecting the number of tracks, as well as the number of passes planned.

The cannula needle probe then delivers heat energy with slow back and forth movements always paying attention to keep the selected internal temperature within 2°C. Running time is always assessed by your medical provider based on patient’s starting condition and desired end points. The chosen cannula needle probes should measure 10 cm to 20 cm in length to cover these larger treatment areas. The desired internal probe temperatures should range between 45 to 60 degrees Celsius depending on the depth of treatment and thickness of skin.

Improvement in cellulite is a unique benefit of ATTIVA S.I.H. therapy. This therapy is predicated on the pathophysiology of cellulite formation that involves both localized tightened bands as well as increased skin laxity and redundancy. Release of localized tight retaining ligaments using a controlled and distally accessed releasing instrument such as Aveli followed by S.I.H. therapy to counter skin laxity can be used to effectively reduce the appearance of undesirable cellulite that forms along the lower buttock and posterior thighs.

[Cheek, anterior body, posterior body, inner thigh, and arm skin laxity correction with Attiva]

  1. Skin Lifting Program

This program is used when an important skin redraping is desired to counter sagging of the face. All treatments are defined by the area being treated which determines track design and the number of passes. With this program the movement of the cannula needle must be done exclusively in retraction, namely from the distal border towards the access port.

Running time depends on tissue conditions and passes must be limited to 1 or 2 in number. Treatment of the neck, jowls, cheeks, and forehead are most popular. Needle cannula probe lengths can range between 5 to 15mm depending on the chosen area. The desired internal probe temperatures should range between 45 to 50 degrees Celsius depending on the depth of treatment and thickness of skin.

[Brow, Cheek, Jowls, and Neck Lifting with Attiva]

  1. Fine Wrinkle program

The fine wrinkle program is intended for reducing both superficial fine wrinkles around the mouth and eyes. Once access holes are made, 2 or 3 depending on the area intended for treatment, introduce the cannula needle PERPENDICULARLY for about 0.3 cm in those ones more superficial, and 0.5 cm for deeper ones; then rotate of 90° until parallel with the cutaneous level and advance the cannula needle in the treatment area until the treatment area border is reached.

Once the set temperature is reached, with slow movements pull back the cannula needle with linear movements ALWAYS from a distal to proximal direction. Running times depend on tissue conditions and the number of passes should be limited to a single pass to avoid skin injury. The aim is to reduce the prominence and depth of the wrinkle by keeping the depth to near the subdermal level.

Running time is always assessed by the operator on the basis of patient’s tissue conditions, keeping temperature within 2°C of oscillation ranging between 42 to 45 degrees Celsius. The thermal camera should be followed closely to avoid reaching the safe limit of external skin temperature of 42 degrees Celsius. You must assess the homogeneity of the heat reached with precision during treatments.

[Perioral and lateral eyelid fine wrinkle reduction with Attiva]

ATTIVA S.I.H. Pricing

Please see the following list of pricing defined for treatment of specified regions. Please inquire regarding package pricing which will be discounted based on the number of desired treatment regions.

AreaPrice Range
Upper brows and forehead$2000
Upper Eyelids$2000
Lower Eyelids$2000
Cheeks$2000
Jowls$2000
Neck and Double Chin$3000
Knees$2500
Medial thighs$3000
Under Arms$3000
Arm pits$2000
Abdomen$4000
Upper and Middle back$4000
Lower back and flanks$4000
Buttock and posterior thighs$5000

Attiva Skin Treatment Conclusion

In summary, Attiva provides a non-invasive treatment for improving skin laxity, lifting sagging tissues, and improving fine wrinkles throughout the body. Due to its thin treatment wand, it has the unique ability to treat areas throughout the body and the face. In addition, due to its proprietary technology involving three radiofrequency waves,

it has the capacity to treat the facial areas without the need for anesthesia or infiltration of tumescent solution. This advantage allows for quick recovery with return to daily activities within just a few days. Additionally, avoidance of the need for a surgical facility makes this treatment affordable. If you are interested in exploring how Attiva can help you, we encourage you to make a consultation with one of our SurgiSculpt providers.

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Ultimate Guide to Attiva Skin Treatment | SurgiSculpt®