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IMCAS Paris 2004 'Uses of Radiosurgery in Aesthetic Medicine'
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IMCAS Paris 2004 'Uses of Radiosurgery in Aesthetic Medicine'

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Radio Surgery (Radiofrequency or Radiowave Surgery) is used to remove moles, warts, skin tags and other so called ‘lumps and bumps’. It can also be used to remove small blood vessels by …

Radio Surgery (Radiofrequency or Radiowave Surgery) is used to remove moles, warts, skin tags and other so called ‘lumps and bumps’. It can also be used to remove small blood vessels by thermocoagulation effect. The procedure involves the passage of radio waves into the epidermis or dermis of the skin to perform the removal or reshaping of a lesion. Different types of electrodes are used depending on the type of lesion, e.g. fine needle for incision and blood vessels, wire loop for intradermal nevi, scalpel blade etc.
Patients can expect minor swelling, redness, bruising and tenderness in the area for a few days as it heals. There should not however be any bleeding due to the tissue coagulation during treatment.

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  • 1. An Introduction For the Treatment of Radiosurgical Procedures in Cosmetic Medicine Presented by Dr Patrick J. Treacy Ailesbury Clinic Dublin IRELAND
  • 2. DISCLOSURE: • Dr. Patrick J. Treacy is a Cosmetic Doctor registered in Ireland for the purposes of aesthetic medicine • I have previously been registered in United Kingdom, United States, Australia, New Zealand, South Africa. • I purchased my own Radiosurgery equipment. • I have no financial interest or stock in Ellman • I receive no additional remuneration or other compensation for equipment bought by you as a result of your attendance at this IMCAS lecture.
  • 3. THE ULTIMATE RF ENERGY SOURCE
  • 4. MEDICAL APPLICATIONS • Dental • Dermatology • Neurosurgery • OB/GYN • Ophthalmology • Otolaryngology • Plastic Surgery . General Practice ……. and Cosmetic Medicine
  • 5. HISTORY RADIOSURGERY •In 1976, Dr. Irving Ellman was granted a U.S. Patent on 3.8MHz high frequency 4 waveform dental RADIOSURGICAL device. There are now many studies showing the efficacy of using the 3.8MHz Frequency and the different waveforms for soft tissue applications.
  • 6. WHY 4.0 MHz?
  • 7. ELECTRICAL ENERGY IN MEDICINE HIGH TEMP LOW TEMP
  • 8. ELECTRICAL ENERGY IN MEDICINE HIGH TEMP LOW TEMP
  • 9. HIGH FREQUENCY VS. LOWHIGH FREQUENCY VS. LOW FREQUENCYFREQUENCY • Ultra High Frequency: • Low lateral heat • Excellent cosmetic results • Scalpel like incisions • European and FDA approved • Safe • Low Frequency: • High lateral heat • Poor cosmetic results • Poor surgical quality • Limits on approved procedures • Unsafe
  • 10. HISTOPATHOLOGICAL COMPARISON TISSUE DAMAGE
  • 11. FREQUENCY and LATERAL HEAT HIGH FREQUENCY LH = T x P x W x S F H=lateral heat, T=time, P=power intensity, =waveform, S=surface area, F=frequency
  • 12. HISTOPATHOLOGICAL COMPARISON TISSUE DAMAGE
  • 13. HISTOPATHOLOGICAL COMPARISON HIGH FREQUENCY LOW FREQUENCY
  • 14. WAVELENGHT and LATERAL HEAT LOW FREQUENCY LH = T x P x W x S F LH=lateral heat, T=time, P=power intensity, W=waveform, S=surface area, F=frequency
  • 15. Types and Characteristics of Waveforms
  • 16. 3 BUTTON FINGERSWITCH HANDPIECE
  • 17. CUT/COAG - Fully Rectified • 50% Cut - 50% Coagulation • Cutting with Hemostasis
  • 18. HAEMOSTASIS - Partially Rectified • 10% Cut - 90% Coagulation • Coagulation/Retraction Direct and Indirect
  • 19. FULGURATION • Intentional Destruction of Diseased Tissue • Deep Coagulation by Spark-gap
  • 20. THE ELLMAN RADIOSURGERY unit I use the Surgitron Radiolase
  • 21. SURGITRON Patented 4.0 Dual RF
  • 22. Comparison between RADIOSURGERY and LASERS in Cosmetic Medicine
  • 23. RADIOSURGERY vs. LASER in Cosmetic Medicine • Radiosurgery: • Very reasonably priced (Euro 2,995- 15,000) • Great aesthetic results • Superior incisions & excisions • Less lateral heat • Performs more procedures • Easy to use • Laser • High Cost • (Euro 40,000- 130,000) • High Maintenance • Lacks tactile feel in incisions • High heat build up • Inferior biopsy results • Poor in in dense
  • 24. • Permits high degree of hemorrhage control • Good visibility of tissues • Sterilizes the incision site as it cuts • No maintenance required • Electrodes never need resharpening Advantages of 4.0 MHz Radiosurgery::
  • 25. CUT - Fully Rectified/Filtered • 90% Cut - 10% Coagulation • Micro smooth Cutting • Minimal lateral heat • Fastest healing
  • 26. • Permits precise planing of tissues • Little thermal effect on adjacent tissues • Good biopsy control • Electrodes are self sterilizing Advantages of 4.0 MHz Radiosurgery:
  • 27. INCISION
  • 28. EXCISION / BIOPSY PROCEDURES
  • 29. COSMETIC REMOVAL OF SKIN LESIONS
  • 30. EXCISION / BIOPSY
  • 31. HAEMOSTASIS Monopolar Bipolar
  • 32. BIPOLAR COAGULATION • Discrete, Pinpoint Coagulation @ 1.7MHz • Use in Hemo or Bipolar mode with Special Bipolar Cord and Foot pedal.
  • 33. PRIMARY CARE APPLICATIONS
  • 34. MATRIXECTOMY
  • 35. LID LESION
  • 36. PRIMARY CARE PROCEDURES • Skin tags • Spider Veins • Venous Lakes • Pyogenic Granulomas • Dermatofibromas • Benign Nevi • Actinic keratoses • Basal cell cancers • Biopsy for pathology • Sebaceous cysts • Lipomas • Wart Removal • Matrixectomy • Rhinophyma • Snoring procedure • Haemorrhoids • Xanthelasma • Lletz/Leep procedure • Condyloma acuminata.
  • 37. Excision of PYOGENIC GRANULOMAExcision of PYOGENIC GRANULOMA from scalp tissuefrom scalp tissue ©EMZimmerman, 10, 2003 ©EMZimmerman, 10, 2003
  • 38. Excision of PYOGENIC GRANULOMAExcision of PYOGENIC GRANULOMA from nail tissuefrom nail tissue ©EMZimmerman, 10, 2003 ©EMZimmerman, 10, 2003 Pre Radiosurgery Post Radiosurgery 2 months
  • 39. Excision of WARTS from hand tissueExcision of WARTS from hand tissue ©EMZimmerman, 10, 2003
  • 40. Excision of WARTS from hand tissueExcision of WARTS from hand tissue ©EMZimmerman, 10, 2003
  • 41. Excision Basal Cell Carcinoma from NoseExcision Basal Cell Carcinoma from Nose
  • 42. Excision Basal Cell Carcinoma from NoseExcision Basal Cell Carcinoma from Nose ©
  • 43. Excision of SEBACEOUS CYST from scalpExcision of SEBACEOUS CYST from scalp
  • 44. SPECIALISED PRIMARY CARE APPLICATIONS
  • 45. VASECTOMY ©EMZimmerman, 10, 2003
  • 46. LLETZ/LEEP PROCEDURE
  • 47. LLETZ/LEEP PROCEDURE
  • 48. Excision of CondylomaExcision of Condyloma
  • 49. Excision of CondylomaExcision of Condyloma ©EMZimmerman, 10, 2003 ©EMZimmerman, 10, 2003
  • 50. UPPER LID BLEPHAROPLASTY
  • 51. MEDICAL AESTHETIC APPLICATIONS
  • 52. COSMETIC MEDICINE PROCEDURES • Acne Scarring • Peroral Commisures • Milia • Intradermal Nevi • Skin tags • Telangiectasia • Spider Veins • Venous Lakes • Compound Nevi •Scar Revision •Epilation
  • 53. LESION REMOVAL
  • 54. Facial Teleangiectasia
  • 55. Thermocoagulation of Leg VeinsThermocoagulation of Leg Veins ©EMZimmerman, 10, 2003
  • 56. Thermocoagulation of RED Leg VeinsThermocoagulation of RED Leg Veins
  • 57. NEW MEDICAL AESTHETIC PROCEDURES
  • 58. Excision of PERIORAL COMMISURES from UPPER LIP ©EMZimmerman, 10, 2003 PRE RADIOSURGERY POST RADIOSURGERY
  • 59. Excision of PERIORAL COMMISURESExcision of PERIORAL COMMISURES from UPPER LIPfrom UPPER LIP
  • 60. Excision of PERIORAL COMMISURESExcision of PERIORAL COMMISURES from marionette areafrom marionette area ©EMZimmerman, 10, 2003 PRESENTING PROBLEM PRE PROCEDURE
  • 61. Excision of PERIORAL COMMISURESExcision of PERIORAL COMMISURES from UPPER LIPfrom UPPER LIP ©EMZimmerman, 10, 2003 PRE RADIOSURGERY PRE RADIOSURGERY
  • 62. Excision of PERIORAL COMMISURESExcision of PERIORAL COMMISURES from UPPER LIPfrom UPPER LIP POST RS PROCEDURE POST RADIOSURGERY
  • 63. RHINOPHYMA WITH LOOP SHAVING TECHNIQUE
  • 64. RHINOPHYMA
  • 65. Excision of ACNE SCARRING from faceExcision of ACNE SCARRING from face ©EMZimmerman, 10, 2003
  • 66. Excision of ACNE SCARRING from face ©EMZimmerman, 10, 2003
  • 67. Protection of Dermis with Fixomull •Leave on 3-5 days •Depending on exudate •Apply Olive Oil •Remove after 30mins
  • 68. Excision of MILIA from faceExcision of MILIA from face ©EMZimmerman, 10, 2003
  • 69. Excision of KERATOTIC SCAR from faceExcision of KERATOTIC SCAR from face
  • 70. Excision of Acne KERATOTIC SCARSExcision of Acne KERATOTIC SCARS Special Electrode
  • 71. Excision of large congenitalExcision of large congenital COMPOUND NEVUS from lumbar areaCOMPOUND NEVUS from lumbar area Histopathology required
  • 72. Removal of Benign INTADERMAL NEVI
  • 73. Removal of Benign COMPOUND NEVUS
  • 74. Removal of Benign Intradermal Nevus
  • 75. Excision of COMPOUND NEVUS from lipExcision of COMPOUND NEVUS from lip
  • 76. Removal of VENOUS LAKE from LIPRemoval of VENOUS LAKE from LIP
  • 77. VENOUS LAKE on LIPVENOUS LAKE on LIP
  • 78. Removal of Benign Intradermal Nevus
  • 79. Removal of Benign Intradermal Nevus
  • 80. EARLOBE REPAIR Electrode is suited to precision incision . Excellent healing is demonstrated
  • 81. Excision of SEBACEOUS CYST from NeckExcision of SEBACEOUS CYST from Neck
  • 82. Excision of Dermal Nevus from AbdomenExcision of Dermal Nevus from Abdomen
  • 83. Excision of Dermal Nevus from AbdomenExcision of Dermal Nevus from Abdomen
  • 84. Excision Seborrheic Keratosis from BackExcision Seborrheic Keratosis from Back
  • 85. Excision Seborrheic Keratosis from BackExcision Seborrheic Keratosis from Back
  • 86. CUTTINGCUTTING
  • 87. 4.0 MHz DEVICE, ELECTRODES AND ACCESSORIES
  • 88. SURGITRON Patented 4.0 Dual RF
  • 89. VAPOR-VAC™II
  • 90. THE RADIOSURGERY SYSTEM
  • 91. 3 BUTTON FINGERSWITCH HANDPIECE
  • 92. STANDARD PRIMARY CARE ELECTRODES
  • 93. DISPOSABLE ELECTRODES
  • 94. EMPIRE NEEDLE ELECTRODES: for Cutting and Coagulation
  • 95. HAEMOSCALPEL
  • 96. INSULATED MATRIXECTOMY ELECTRODE
  • 97. BIPOLAR FORCEPS
  • 98. LLETZ ELECTRODES
  • 99. for treating broken FACIAL RED VEINS (telangiectasias) and SPIDER VEINS INSULATED MICROELECTRODE
  • 100. INSULATED NEEDLE ELECTRODE for Telangiectasia and Epilation
  • 101. COAGULATION /HAEMOSTATIS • Partially rectified, partially filtered. • Direct touch or grasp (bipolar forceps) • Tissue damage minimized by lifting area or vessel to be coagulated. • Penetrates more deeply, more tissue damage • If carbon/eschar forms, it acts as an insulator and will not control bleeding. Wipe it away or use another form of haemostasis.
  • 102. RELATIVE CONTRAINDICATIONS • Pacemakers • Pregnancy • Bleeding disorders • Systemic and local infections.
  • 103. INFORMED CONSENT: • Should educate the patient about the procedure, • risks and expected, realistic results for a procedure. • Should include all components of the procedure, • Cleaning, anesthesia to care and cosmesis. • Gives you a chance to establish patient rapport
  • 104. QUESTIONS??
  • 105. THANK YOU!
  • 106. An Introduction For the Treatment of Minor Cosmetic Procedures in General Practice Presented by Dr Patrick J. Treacy Ailesbury Clinic Dublin IRELAND