Radiofrequency1

Question 1

Radiofrequency overview
-electrocautery
—how it works

Answer 1

Passive electrical current -> direct pressure -> burn

First electrical medical device used for hemostasis
-thermal: 3,000 BC

Question 2

Radiofrequency overview

• ideal frequency
• high frequency
• lateral heat

Answer 2

3.8-4.0 MHz

High freq = low temp = less lateral heat

Lateral heat is what radiates out of other tissues

Question 3

Radiofrequency overview

-resistance of human tissue causes heat (4)

Answer 3

Tissue desiccation

Protein coagulation

Intracellular cytoplasmic liquid-to-gas conversion -> volatilization/vaporization

Results in frictional forces that elevate cell temp

Question 4

Radiofrequency overview

-indications (12)

Answer 4

Papilloma
Seborr K
Verruca
Sebaceous cysts
Benign nevi
Pyogenic granuloma
Trichiasis
Punctal occlusion
Xanthelasma
Biopsies
Chalazion incision
Cutaneous neurofibromas

Question 5

Radiofrequency overview

-waveform settings (4)

Answer 5

1. Pure cutting (90/10)
   - dry lesions, biopsy
2. Blended (50/50)
   - verruca
3. Coagulation/hemostasis (90/10)
   - epilation, punctal occlusion, bleeding
4. Fulguration (coag/destruction)
   - ODs don’t use, bed of BCC/SCC, cyst remnants

Question 6

Tissue properties
-sectility
—what
—high
—low
—how to incr

Answer 6

Degree to which tissue fibers separate compared to how much energy is applied

High = pigskin (high tension, hard to pull apart)

Low = chicken skin, EYELIDS

Increase sectility by incr tension and mechanical support
-e.g. tension b/w fingers

Question 7

Radiofrequency overview

-advantages/benefits (5)

Answer 7

Minimal damage to tissue biopsy

• more localized heat
• fine-control

Minimizes collateral tissue damage

Simultaneously cuts/coagulates

Rapid healing, minimized infection
-cuts of cap beds and lymph system

No muscle contractions (Faradic effects)
-occurs in freq <100KHz

Question 8

Radiofrequency overview

-hazards/precautions (6)

Answer 8

Smoke and fire hazard
-avoid flammables

Smell and particles
-incl isolated HIV/HPV

Excess lateral tissue damage

No tactile sensation

DO NOT do shave excision on pigmented lesion unless you are CERTAIN it’s not melanoma

Pacemaker
-first question

Question 9

Pelleve

• use
• how it works
• timeline post-op

Answer 9

Wrinkle removal
-non-invasive soln to reduce app of fine lines and wrinkles w/o surgery or needles

Gradually delivers radiofrequency energy thru epidermis into dermis -> heats penetrating dermal layer, GENERATES NEW COLLAGEN

1-3 days = “post-treatment glow”
4-15 days = fibroblast formation, collagen begins to rebuild
15+ days = collagen synth and formal remodeling occurs

Question 10

Pelleve

• procedure/treatments
• costs

Answer 10

Each full face takes 45-60 minutes

Requires 3-5 treatments
~4 weeks apart to boost the rebuilding process

Eyes: $500-600
Full face: $1500-2000

Question 11

Pelleve

-advantages/benefits (5)

Answer 11

Blepharitis
-works similarly to Lipiflow due to residual heat from handpiece

Removal of demodex mites

Soothes crow’s feet or eyelid wrinkles

Hide creases or smile lines

Reduces smoker lines

Question 12

Pelleve

-risks/precautions (7)

Answer 12

Redness
Swelling
Blistering
Infection
Poorly heal -> scarring
Disabling a pacemaker
Disappointment