Liposuction and Skin Tightening by Plastic Internal Low-angular Retraction Technique to Direct Skin Retraction with Monopolar Radiofrequency.

Background: Liposuction remains one of the most commonly performed aesthetic procedures; however, its ability to address skin laxity is limited. Energy-based technologies such as radiofrequency (RF) have been introduced to improve dermal contraction, though their reproducibility and efficiency remain variable. This study aimed to describe the plastic internal low-angular retraction (PILAR) technique and evaluate its clinical outcomes compared to conventional RF-assisted liposuction. Methods: A prospective observational cohort study was conducted, including 100 patients undergoing liposuction between 2022 and 2024. Patients were divided into 2 groups: conventional RF-assisted liposuction (n = 36) and PILAR technique (n = 64). Outcomes included energy delivery, device use time, complications, and patient satisfaction measured using the BODY-Q scale. Results: Baseline characteristics were comparable between groups. The PILAR technique was associated with significantly lower total energy use (44,195 J versus 84,939 J; Conclusions: The PILAR technique was associated with improved efficiency, reduced complication rates, and high patient satisfaction while maintaining comparable contouring outcomes. These findings suggested that targeted subdermal RF delivery may enhance skin retraction and procedural safety. Further controlled studies are warranted to confirm its long-term efficacy and generalizability.