Complications from Radiofrequency and Ultrasound Modalities

Dr. Karen Law discusses complications associated with radiofrequency (RF) and ultrasound treatments, drawn from personal experience and studies. She emphasizes the importance of understanding RF mechanisms, particularly regarding tissue impedance and energy transfer, which can lead to adverse effects like swelling, erythema, blistering, and ulceration, especially in older patients or those on blood thinners. She references a multicenter study indicating a low complication rate with monopolar RF but notes specific risks such as burns from grounding pad misuse. The interaction of tattoos and RF is highlighted as a potential risk, showing that energy can behave unpredictably near metallic inks. Dr. Law shares case examples that underscore the necessity for careful patient counseling on potential side effects, as many treatments occur outside dermatology offices. She advises meticulous grounding pad application, addressing any patient discomfort promptly, and suggests using cooling devices correctly to avoid issues like cold panniculitis. For RF microneedling, she warns of grid marks and post-inflammatory hyperpigmentation while stressing the need for thorough consent documentation covering burns and ulcerations. Finally, Dr. Law addresses ultrasound safety, particularly the risk of eye injuries and nerve damage, advocating for careful technique and using dental rolls in sensitive areas. Overall, she encourages practitioners to stay informed on potential complications to mitigate risks during these aesthetic treatments.