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• The SRS or RMD (Structural Remodelling System) is an anti-aging and facial rejuvenation treatment.
• SRS or RMD is a non-invasive alternative to surgical procedures designed to slow the natural aging process.
• Age-related changes affect the face on 3 levels: integument/adipose tissue, muscle, and bone tissue.

Why Skin Remodelling

• Aging affects the skin, muscles, and bones, leading to wrinkles, sagging, and loss of elasticity.
• Machines counteract these effects by stimulating collagen production, muscle memory for toning, and improved circulation.

RMD Technologies

• Five integrated technologies are used in the RMD system.

Ultrasound

• Increases blood flow and fibroblast activity.
• Tightens skin, smooths fine lines, and promotes product penetration.

High Voltage Pulsed Current (HVPC)

• Stimulates muscle tone and accelerates healing.
• Lifts eyebrows & lids, cheeks, chin, and neck, and plumps lips.

High Voltage Short Pulsed Current (HVPC) (Electroporation)

• Creates transient pores in the lipid layer, enhancing product penetration.
• Facilitates active ingredient absorption and tissue repair.

Galvanic Current (Iontophoresis)

• Enhances product penetration and stimulates muscle.
• Improves product delivery and muscle tone.

Pulsed Micro-currents

• Restore cellular balance and improve skin texture.

Benefits

• Anti-aging effects include the reduction of fine lines and wrinkles, lifting, and firming.
• Enhanced product penetration allows for deep absorption of active ingredients.
• Improved skin texture and elasticity result in tightening, smoothing, hydration, and rejuvenation.
• Provides muscle toning and contouring for muscle firming.
• Cellular regeneration and repair include collagen and elastin production and cellular homeostasis.
• Safety and efficiency are achieved through non-invasive and customizable treatment.

How They Affect The Skin

Epidermis (Outer Layer)

• Exfoliation and renewal are achieved as ultrasound removes dead skin cells, promoting faster cell turnover for a brighter complexion.
• Increased absorption occurs as electroporation and iontophoresis temporarily open channels in the epidermis, allowing active ingredients to penetrate deeper.

Dermis (Middle Layer)

• Collagen and elastin stimulation occurs as ultrasound and pulsed micro-currents stimulate fibroblast activity, leading to the production of new collagen and elastin fibers, which promote firmness and elasticity.
• High voltage pulsed current (HVPC) enhances muscle tone under the skin, contributing to a more lifted appearance.
• Improved circulation occurs with increased blood flow, supplying more oxygen and nutrients to skin cells via ultrasound.
• Micro-currents enhance lymphatic drainage, reducing puffiness and promoting detoxification.

Galvanic Unit

• Produces a smooth flowing uninterrupted direct electric current (DC).
• Non-invasive skincare treatment uses a mild electric current to improve absorption of water-based products, stimulate skin, and boost lymphatic circulation and muscle function.
• Iontophoresis uses electricity polarity (+/-) to push active ingredients deeper into the skin.
• Electro-osmosis helps improve hydration and nutrient delivery.
• Galvanism stimulates small facial muscles, improving firmness and tone.

Desincrustation (Using the Negative Pole/Cathode)

• A non-absorbing alkaline solution is applied to the skin (water and baking soda).
• A deep pore cleansing process that liquefies sebum deposits in pores.
• Creates a chemical reaction (sodium hydroxide) that softens the impaction in the follicle.
• Avoid use on dry and sensitive areas of the skin such as eyelids, neck, and areas lacking sebaceous glands.
• A negative charge is activated by an esthetician, attracted to a positive pole held by the client.
• The negative current has 2 effects on the skin: saponification (chemical soap-like reaction) and proteolysis (breaks down protein).
• Benefits include deep cleansing, enhanced product penetration, and detoxification.

Ionization (Using Hydradermie DI and Cirrus 500)

• Aids in the deep penetration of treatment serums and gels into the skin.
• Creates a chemical reaction that pushes ion products into the skin.
• A positive charge is activated by the esthetician, attracted to the negative pole held by the client.
• Excellent for all skin types, especially dry, dehydrated, and mature skin.
• Provides nourishment to the deeper layers of the epidermis, improving skin texture and appearance.
• Benefits include deep product penetration, improved circulation, detoxification, skin firming, and hydration/nourishment.

Indirect HF

• It is an effective treatment that stimulates blood circulation and the activity of the sebaceous and sudoriferous glands.
• Suitable for those with dry skin or suffering dehydration of the skin, aging, including fine lines and wrinkles.
• The current is termed as an alternating or oscillating current.
• This movement creates high-frequency vibrations, resulting in a heating, stimulating effect.
• Action on Skin increases the activity of sebaceous and sudoriferous glands
• Improves blood circulation, nourishing the skin and improves lymphatic circulation, speeding up the elimination of waste products.

Skin Diagnosis: Types and Classifications

Fitzpatrick Typing

• Evaluates genetic disposition, reaction to sun exposure, and tanning habits.
• Commonly used to determine skin type and susceptibility to sunburn and skin cancer.

The Glogau Scale

• Classifies the severity of wrinkles and aging signs
  • Type 1: no wrinkles
  • Type 2: wrinkles in motion (dynamic)
  • Type 3: wrinkles at rest (static)
  • Type 4: wrinkles are predominant (mature skin)

Rubin Classification

• Examines histologic depth of skin damage.
• Uses tools like a Wood's lamp skin/skin scanner, visia, or dermlite.
• Levels of photodamage:
  • Level 1: damage limited to the epidermis
  • Level 2: damage affects both the epidermis and papillary dermis
  • Level 3: damage extends to the epidermis, papillary dermis, and reticular dermis

Kligman Rosacea and Acne Classification

• Categorizes rosacea and acne severity:
  • Stage 1: erythema in nasolabial folds, cheeks, forehead
  • Stage 2: inflammation, pustules, papules, larger pores
  • Stage 3: severe condition with large nodules, coarse texture, and an "orange peel" appearance

Classifying the Skin

• Focus on genetic factors, sun response, and tanning with Fitzpatrick typing
• Assess wrinkle severity and skin aging with the Glogau Scale
• Determine the depth of skin damage and photodamage with Rubin Classification
• Evaluate severity of rosacea and acne with Kligman Classification

Nervous System Overview

• Neurology studies the nervous system and its disorders.
• Controls/coordinates all body functions; composed of the brain, spinal cord, and network of nerves.
• Ensures all body systems work harmoniously.

Divisions of the Nervous System

Cerebrospinal (Central Nervous System – CNS)

• Includes the brain and spinal cord.
• Controls consciousness, mental activity, voluntary movements, and senses

Peripheral Nervous System (PNS)

• Consists of sensory and motor nerves extending throughout the body
• Carries messages between CNS and body parts

Autonomic Nervous System (PNS)

• Regulates involuntary functions like heartbeat and digestion
• Sympathetic division is active during stress/emergencies.
• Parasympathetic division is active during rest/relaxation

Types of Nerves

• Neurons are basic units, transmitting impulses.
• Sensory neurons carry messages from sense organs to the brain.
• Motor neurons transmit messages from the brain to muscles.
• Reflex action: automatic response to stimuli.

The Brain and Spinal Cord

• The brain is the largest nerve mass for sending/receiving messages.
• The Spinal cord connects the brain to the body, protected by the spine.
• 31 pairs of spinal nerves extend from the spinal cord to body muscles/skin.

Nerve Fatigue & Stimulation

• Nerve fatigue is caused by overwork, leading to irritability, dull complexion, and exhaustion.
• Nerves can be stimulated by chemicals, massage, electrical current, or heat.

Cranial Nerves

• 12 pairs emerge from the brain and affect the head, face, and neck, and are important cranial nerves for facial services.
• Trigeminal (5th cranial nerve) is a sensory and motor nerve that controls chewing.
• Facial (7th cranial nerve) is the chief motor nerve of the face.
• Accessory (11th cranial nerve) controls neck and shoulder movements.

Important Nerve Branches

• Trigeminal nerve branches include the supra-orbital, infra-orbital, and mental nerves.
• Facial nerve branches include the buccal and cervical nerves.
• Spinal nerve branches include greater occipital and greater auricular nerves.

Skin Layers

• Skin is the largest, most complex organ, part of the integumentary system.
• Healthy skin is elastic, pliable, and soft, composed of water, protides, lipids, and glucides.
• The thickest skin is on palms/soles, the thinnest on eyelids.
• The skin contains miles of blood vessels and millions of sweat glands.

Skin Functions

• Protects inner organs, provides a barrier, prevents invasion, and protects against UV.
• Waterproofing, eliminate toxins
• Synthesis vitamin D
• Regulates body temperature.

Skin Layers Breakdown

Epidermis

• It is a waterproof barrier against infection.

Dermis

• Contains appendages like hair follicles and sweat glands.

Hypodermis

• Subcutaneous basement membrane.

Epidermis and Its Layers

• It is thin, soft outer layer of the Skin is thin, soft, outermost layer, contains stratified epithelial layers, largely responsible for health .
• Five layers:
  • Stratum corneum
  • Stratum lucidum
  • Stratum granulosum
  • Stratum spinosum
  • Stratum germinativum (basal layer).

Cells of the Epidermis

Keratinocytes

• 90-95% of epidermal cells, born in the stratum germinativum.
• Undergo mitosis and apoptosis, maintaining the skin barrier function.

Melanocytes

• Produce melanin (UV protection).

Langerhan Cells

• Immune response.

Merkel Cells

• Sensory receptors.

Keratinocyte Life Cycle

• Starts at the stratum germinativum, a highly mitotic layer where keratinocyte stem cells differentiate and move.
• Moves through Stratum Spinosum
• Pickle like projections (desmosomes) provide strength
• Melanocytes transfer melanin to keratinocytes
• Enters stratum granulosum
• Keratinization starts
• Odland bodies contribute to skin barrier
• Desomoses begin to dissolve for eventual shedding

Stratum corneum

• Outer protective layer where cells undergo desquamation

Desmosomes

• Adhesive proteins holding cells together that provide epidermal strength and resistance.
• Reduction with age can lead to fragile skin.

Contraindications

• Medical conditions (pacemakers, cancer, diabetes, epilepsy, blood disorders)
• Skin conditions – severe acne, fragile skin, active inflammation
• Recent dental treatments (within 3 months)
• Pregnancy and metal implants

Consultation

• Ensures safe, effective treatments with assessment of health history, lifestyle and skin conditions
• Health History
• Identifies conditions such as heart issues, diabetes and medications that will affect the treatment
• Screen for allergies and contraindications
• Lifestyle Factors
• Evaluate diet, dehydration, stress, smoking and alcohol use
• Skin & sensitivities
• Determines skin reactions to head, cold and the sun
• Treatment history and goals
• Avoids adverse reactions from previous treatments
• Aligns procedures with client objections
• Safety & compliance
• Updates records for legal and ethical accountability
• Ensures informed consent

Indirect HF Contraindication

• Skin inflammation, disorder or disease
• Excessive dental metal work
• Hypersensitive skin
• Oedema
• Nervous client
• Facial / body piercing