D
Patient 1
PATIENT REPORTED A 1.5 INCH SECOND DEGREE BURN ON THE NECK. THE PHYSICIAN APPLIED SILVADINE TO THE AREA OF THE BURN. THE PATIENT MENTIONED THAT SHE HAD SEEN THE PHYSICIAN TWICE AFTER THE INITIAL EVENT ON (B)(6) 2015 AND HAS A FOLLOW UP MEETING SCHEDULED TODAY ((B)(6) AT 11:15AM PST). SHE MENTIONED THAT SHE CONSULTED WITH A DERMATOLOGIST WHO RECOMMENDED THAT SHE SEEK A SECOND OPINION FROM A LOCAL THERMI PHYSICIAN. PATIENT ALSO STATED THAT SHE HAS BEEN ABSENT FROM WORK FOR THE PAST 3 WEEKS DUE TO THE BURN ON HER NECK. FOLLOW UP WITH THE PHYSICIAN WAS PERFORMED AND HE PROVIDED THE FOLLOWING ADDITIONAL INFORMATION: PREOPERATIVE DIAGNOSIS: NECK LAXITY (ICD9 701.8) WITH LOCALIZED ADIPOSITY (ICD9 278.1). NAME OF OPERATION: SUCTION LIPECTOMY, NECK (CPT 15876). RADIOFREQUENCY SKIN TIGHTENING (CPT 17999). OPERATIVE PROCEDURE: THE PATIENT WAS EXAMINED IN THE SITTING POSITION AND THE AREAS OF CONCERN AS WELL AS A STANDARD SUBMENTAL INCISION WERE OUTLINED WITH INDELIBLE INK. THESE NAMELY CONSISTED OF THE ANTERIOR AND ANTEROLATERAL NECK REGIONS. SHE WAS GIVEN VALIUM AN HOUR PRIOR TO HER PROCEDURE. THE PATIENT WAS POSITIONED ON THE OPERATING TABLE AND THE SURGICAL SITES WERE PREPPED AND DRAPED IN AN APPROPRIATE FASHION. WARMED 0.25% MARCAINE WITH EPINEPHRINE WAS INFILTRATED INTO THE SURGICAL FIELD. A SUBMENTAL CREASE AND BILATERAL POST AURICULAR STAB WOUNDS WERE MADE AND THE 3.0MM. TRIPLE APERTURE CANNULA INTRODUCED INTO EACH OPENING. THE AREA WAS CRISSCROSSED AND A TOTAL OF 25 CC. REMOVED. THE WOUNDS WERE MILKED TOWARD THEIR OPENINGS AND FOUND TO BE DRY. THE 10 CM, THERMIGEN RF PROBE WAS INSERTED BENEATH THE SKIN OF THE NECK, SET MAX TEMPERATURE 50 DEGREES C, BASELINE SKIN TEMP WAS 35.6 DEGREES, AND DURING THE TREATMENT, MAXIMUM SUBDERMAL TEMPERATURE WAS 53 DEGREES, AND MAXIMUM EXTERNAL SKIN TEMPERATURE WAS 42 DEGREES. EACH SIDE OF THE NECK WAS TREATED FOR FOUR MINUTES, THE CENTRAL SUBMENTAL AREA FOR SIX MINUTES. THE WOUNDS WERE CLOSED WITH DERMABOND AND DRY DRESSINGS APPLIED. NO OTHER NOTES PROVIDED.