RFQ And Lesion Removal

Question 1

Pre op for RFQ

Answer 1

• Pre-operative photos
• Signed consent to procedure
• Blood pressure/pulse/visual acuity
• Allergies to medication, latex, materials?
• List of current medications?
• Pacemaker?

Question 2

Skin prep and injection for RFQ

Answer 2

• Clean injection site with alcohol prep pad
• Prep syringe with Lidocaine 0.5% with epinephrine 1:200,000
– X EPI
• Hypertension, current or recent cardiovascular problems, sulfite sensitivity, hepatic disease,
tricyclic antidepressants, monoamine oxidase inhibitors, specific locations
• Mark lesion
• Intradermal Inject: bevel up, pointing away from globe
– Aspirate first → inject while pulling back
• Mechanical deturgescence

Question 3

What is the first Q to ask when considering removing a lesion

Answer 3

If they have a pacemaker

Cannot do RFQ if they have one

Question 4

Prepping the lesion

Answer 4

• Clean lesion and surrounding area with povidone-iodine 10%
• Place sterile drape
• Test lesion with toothed tissue forceps
• Turn on machine and vacuum
• Choose appropriate setting
• Place yourself and patient in comfortable position (with ground plate underneath
patient)

Question 5

Procedure of RFQ

Answer 5

• Perpendicular tip
• Press footplate to begin (only active when pressed)
• Cut at ~7mm per second
• Never stop moving electrode while activated • Keep tissue moist and taught
• Never push downward on lesion

Question 6

Tissue dragging

Answer 6

– Dry surface
– Too little energy
– Carbon build-up on tip
– Ground plate out of place

Question 7

Sparking or burning

Answer 7

– Too much energy

– Stationary tip

Question 8

Langer’s Line

Answer 8

Scalp, forehead, lateral to eyelids, labella, middle of cheeks

Question 9

Cox’s lines

Answer 9

Scalp, forehead, chin

Question 10

RUbin’s line

Answer 10

Labella, middle and lower cheeks

Question 11

Kraissel’s line

Answer 11

Nose, crows feet, chin

Question 12

Straith’s lines

Answer 12

Columella, labella, mentolabial fold

Question 13

Bulacio’s lines

Answer 13

Forehead, lower crows feet, upper and lower lips, upper neck

Question 14

Sleep/Borge’s line

Answer 14

Forehead, crows feeet, nasolacrimal folds, glabella

Question 15

Post op RFQ

Answer 15

• Clean area with povidone-iodine 10% (optional)
• Apply antibiotic ointment
• Blood pressure/pulse/visual acuity
• Patient instructions/wound care handout
• Follow-up appointment