Aesthetic Lasers Blog

YAG 1064 nm Lasers Intense Pulsed Light (IPL) Devices
Applications Hair Removal, Photorejuvenation, Skin Tightening, Active Acne treatment, Telangiectasias (spider veins), Rosacea, Sun & Age Spots, Pseudofolliculitis Barbae. Hair Removal, Photorejuvenation, Sun & Age Spots, Rosacea.
Efficacy High power to dermis: more energy to follicles, vessels, collagen, sebaceous glands. High power absorption in epidermis: less energy to deep dermal structures.
Comfort Less painful due to shorter pulse durations. Very painful due to tendency to super heat epidermal melanin. Skin cooling gels or equipment needed.
Risk of Side Effects Safe on all Skin Types. Higher risk of burning skin; not recommended for use on skin types 4-6 or tanned skin because of pigmentary risk.
Consumables Few or none. Frequent head replacements (on average after 30,000 pulses), filters and gels – annual cost $5,000-$10,000.

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  • Filed under: Device Review, Laser Treatments, RS | IPL and Lasers
  • A White Paper by David J. Friedman, MD

    I recently completed a clinical study of laser hair removal using the LightPod Neo, a 1064nm Nd:YAG laser from Aerolase. I was requested to conduct this study because I have a well established cosmetic dermatology practice in which I perform the laser treatments myself, and hair removal is a key area of my laser dermatology expertise.

    I became intrigued by this laser’s unique 0.65msec pulse duration, which is below the skin’s thermal relaxation time; this unique feature negates the need for skin cooling during treatment that is common with other systems, and it allows for treatment that is virtually pain-free on any skin type. But the main question in my mind at the outset had to do with clinical efficacy: would this device have the capability of delivering long-term results?

    The parameters of the study, conducted during the Winter of 2006/2007, were as follows:

    • Total of 12 patients treated (11 females, 1 male)
    • Ages from 30 to 42
    • Skin types II through VI
    • Multiple anatomic sites: chin and neck, cheeks, upper lip, back, axillae

    Patients were treated without any form of cooling or application of gels or anesthetics, either before, during or after treatment, regardless of skin type. The laser delivered fluences that were appropriate for hair removal, causing hairs to singe and creating perifollicular edema as expected; transient erythema was observed in just a few instances and patients reported that the treatment pain ranged from painless to tolerable. Patients were treated monthly for a total # of treatment sessions ranging from 3 to 7, and they were followed to assess long-term results. The majority of patients reported >75% clearance; those treated 5 to 7 times reported 82% clearance on average and as high as 93%. These assessments were made, on average, 8.3 months after the patients’ final treatment sessions.

    This study demonstrates that, from the standpoint of clinical efficacy, the Neo has the ability to perform hair removal in a similar fashion to Nd:YAG 1064nm lasers that employ substantially longer pulse durations. This is true not only in terms of % hair clearance for a given number of treatment sessions but, of particular importance, in terms of long-term results. When combined with the other advantages of the 0.65msec pulse duration mentioned above – no skin cooling with virtually no treatment pain and the ability to safely treat any skin type – this makes the Neo a unique addition to the field of Nd:YAG lasers from a clinical performance standpoint.

    The physical characteristics of the LightPod Neo laser are also very unique.

    LightPod Neo - Nd:YAG 1064 nm portable aesthetic laser from Aerolase

    Due to its air-cooled emitter design, it is a compact and portable device, in marked contrast to large conventional water-cooled laser systems. The Neo design has eliminated the water circulating system as well as fiber optic cables common in other systems, which results in a highly affordable device that is essentially maintenance-free.

    In summary, the LightPod Neo offers a new and unique set of capabilities to laser hair removal, enabling it to be a foundation laser for a hair removal practice focusing on higher-profit facial, axilla and bikini treatment areas or an extension of an existing practice into treatment of darker skin types, pain-free performance and/or any practice where the laser’s compact size, portability or lack of required maintenance are deemed beneficial.

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  • Filed under: Device Review, New Lasers, Research
  • laser-resurfacing

    Still horrified by laser blasting of facial wrinkles followed by months of redness? This is so 90s!

    New generation of aesthetic lasers is safer and more selective in treating just what the doctors says you need: wrinkles, age spots, broken capillaries, saggy skin, etc. The result? Faster healing, so you can get back in makeup and return to work with smoother skin in as little as 24-48 hours. Well… it depends. Here is a brief guide to different laser treatments so you can better understand your options.

    Ablative Carbon Dioxide (CO2) Resurfacing

    This is the skin-wounding original 1990s procedure.

    Used for: hard-core lines and acne scars; can also tighten loose skin but is safe only for fair skin types only.

    How it works: By blasting and burning away the skin’s top layer, this aggressive single treatment bulldozes wrinkles and everything else in it path.

    How it feels: you should not feel anything during the procedure since it is performed under general anesthesia. Recovery time: you are a burn victim for several days with open wounds, which ooze and bleed, followed by 7-10 days of rawness while your obliterated epidermis regenerates, and pinkness for 4-5 months.

    Price: $4,000 to $8,000

    Efficacy/Results: Excellent (if done right) but in a few months after the treatment.

    Ablative  Erbium Laser Resurfacing

    Used for: fine to deep wrinkles and acne scars; can also tighten loose skin, doctor must be cautious with darker skin types.

    How it works: By evaporizing layers of epidermis (the skin’s top layer).

    How it feels: This proceudre is performed under a topical or local anesthesia and you may experience some burning discomfort. Recovery time: depending on the depth of resurfacing, you will feel from slight to mild oozing for 2-5 days, followed by 7-20 days of pinkness, which can be covered by make-up.

    Price: $1,500 to $3,000

    Efficacy/Results: Good to excellent depending on the depth of resurfacing.

    Ablative Fractional Resurfacing

    Types of lasers used: either CO2 or Erbium (Er:YAG).

    Used for: Smoothing fine-to-deep lines and evening out brown spots in a single treatment. Can also help tighten lax skin and remove some small spider veins.

    How it works: The laser beam strikes the skin in thousands of tiny spots, destroying tissue a millimeter deep in those microscopic spots only (think perforated paper). Surrounding skin remains intact, allowing for faster recovery than the original ablative devices but more intense results than the nonablative fractional laser. The hole-punching fires up the body’s wound-healing response, which generates collagen and smooths wrinkles. It’s ablative and therefore riskier for patients of color, but can be executed successfully at a doctor’s office.

    How it feels: Typicaly performed with local anesthesia similar to what you’d get in a dentist’s office. After 15 minutes of post-treatment discomfort and an application of ice packs, pain is minimal. For 24 to 36 hours, skin oozes, bleeds and peels, followed by five days of crustiness. Once crust peels, new, pink skin emerges and makeup can be worn; complete healing within two weeks.

    Price: $1,500 to $5,000

    Efficacy/Results: Average to good.

    Nonablative Fractional Resurfacing

    Non-ablative simply means that your skin will not actually be resurfaced, i.e. top layer of the skin, aka epidermis, will remain intact.

    Used for: Smoothing fine-to-moderate lines, evening out brown/age spots, and improving overall texture and glow.

    Downtime: typically none, but the skin may be red for a couple of days.

    How it works: The laser penetrates deep into the skin, heats and provides controlled thermal injury to the connective tissue, which stimulates collagen production. No oozing no raw skin. It’s typically performed over a course of three to five 25-minute treatments, one to two months apart. This procedure is safe for darker skin types.

    How it feels: like the heat is building up in your skin, but no pins and needles. May feel like a bad sunburn for a few minutes after the procedure is over; afterward, skin is pink and sandpapery for three to five days but can be camouflaged with concealer.

    Price: $600 to $1200 per treatment depending on the actual laser modality and doctor.

    Efficacy/Results: Average to good depending on a number of treatments.

    Intense Pulsed Light (IPL)

    Used for: Eliminating brown spots and other sun-induced discoloration and spot-treating broken capillaries. No effect on wrinkles.

    How it works: IPL devices are not lasers, unlike lasers they emit a broad spectrum of light. Short pulses of bright white light pinpoint brown pigment cells and redness, which are damaged when they absorb the light and the heat it creates. Safe for most skin types, but a doctor may dial down intensity for darker skin tones to avoid slim risk of de-pigmentation.

    How it feels: Like a sunburn. Patients experience slight swelling and pinkness the day of the procedure, but there’s no downtime, which is why it’s often categorized as a “lunchtime” treatment.

    Price: $400 to $600 per treatment.

    Efficacy/Results: Average and multiple treatments are required.

    What is Fractional Eyelift

    Fractional Eyelift Procedure is used to reduce eyelid drooping and wrinkles without having to go under the knife and arguably with minimal downtime. In good hands the right type of fractional laser offers excellent results that are similar to a surgical eye lift without incisions.

    Fractional Eyelift represents one of the latest advancements in fractional laser resurfacing technology and is used by many cosmetic surgeons as a safe and effective alternative to surgery.

    “The Fractional Eyelift dramatically reduces the appearance of dark circles and eye wrinkles, tightens upper and lower eyelid skin and helps to elevate drooping eyebrows,” says Bruce E. Katz, M.D., board certified dermatologist and director of the Juva Skin & Laser Center in New York City. “It has a number of the benefits of a surgical eyelift without the risks and downtime. The only problem it doesn’t address is bulging fat pads.”

    Metal eye shields are used during treatment to protect a patient’s eyes from injury. The only anesthesia needed for the procedure is a numbing cream that is applied to the eyelids. In a recent study of Fractional Eyelift involving more than 300 participants, patients showed dramatic and consistent results, Katz said.

    The fractional laser resurfacing procedure works by breaking up the laser light beam into columns that target the area intended for treatment and leave surrounding skin tissues intact. The laser beam ablates damage elastic and collagen fibers in the skin, allowing new tissue to grow back in their place. Healing occurs quickly and is virtually painless. The end results are fewer wrinkles, a reduction in dark skin pigmentation and tighter skin in the treated areas.

    In order to achieve the best results from the Fractional Eyelift, surgeons typically recommend three to five sessions delivered at two to three-week intervals.

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  • Filed under: LT | fractional
  • Plastic Surgery Is Not Forever

    There is an excellent story with recommendations for a few typical plastic surgeries in Great Britain published today in MailOnline.

    Anastasia Stephens, 37, a writer and holisitic health expert in London, underwent a surgical procedure to remove hereditary eye-bags that made her look haggard, even after a good night’s sleep. After the cosmetic surgeon had scraped out two bags of fat from beneath each eye, she couldn’t have been happier.

    Ten years later, her eyes had prematurely aged. Having the fat removed had loosened the skin under them, and over time, this has wrinkled more than it would have, and in an unnatural way. Lots of lines developed directly under each lower eyelid where the bags used to be.

    She recently discovered that a few affordable laser procedures could tighten the skin under her eyes and reduce the wrinkles. She saw the effect after the third treatment and was relieved completely as she realised that her condition can be safely treated without the knife, and the results would last for many years to come.

    Aloette Perfect Lift Plus

    Aloette is a new anti-aging product that contains natural skin moisturizing agents. Clinical testing has shown that this herbal blend decreased fine lines and wrinkles while increasing skin firmness.

    Aloette Perfect Lift Plus

    More skin care recommendations by

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  • Filed under: LT | skin tightening
  • Clinical Procedures in Laser Skin Rejuvenation - Recommended by
    Technological advances in medical aesthetic lasers have been dramatic in the last few years. It is important to keep up and update your armamentarium as well as treatment protocols. This well illustrated book by respected authorities in the field provides the answers for the commonly encountered problems. Even established laser practitioner will be interested to learn about new generation of lasers and combination treatments.

    This is the book that should be in every aesthetic practice.

    ASLMS 2009

    American Society for Laser Medicine and Surgery Hosts Annual Scientific Conference in National Harbor, Maryland, April 3-5, 2009.

    The world’s top laser experts will gather in National Harbor, Maryland, to share innovations in lasers and emerging technologies at the 29th Annual Scientific Conference of the American Society for Laser Medicine and Surgery (ASLMS). “LASER 2009” will be held April 3-5, 2009, at the Gaylord National Resort and Convention Center. Headlining the scientific program are acknowledged leaders in the field who will unveil the latest research developments and clinical studies in laser medicine, as well as present promising devices poised to enhance disease detection and management.

    As the ASLMS Annual Conference is traditionally regarded as the premier forum for the introduction of the newest breakthroughs in laser diagnostics and technology, some of the research and techniques are only in the early stages of development. In addition to nearly 1,500 laser specialists in aesthetic surgery, otolaryngology, ophthalmology, oncology, dermatology, photobiomodulation and urology, about 130 industry exhibitors will be on hand to showcase their latest products.

    Scientific Highlights

    Pilot Study Finds Low-Level Laser Irradiation Significantly Reduces Cholesterol and Triglyceride Serum Levels – Recent studies of the ability of laser irradiation to alter the function of certain transcription (i.e., communication) factors involved in the expression of specific genes prompted researchers to evaluate the efficacy of laser therapy in the reduction of cholesterol and triglyceride serum levels. Early findings of a non-controlled, non-randomized pilot study showed that 75 percent of study participants experienced an overall reduction in cholesterol serum levels.
    A Light-Activated, Sutureless Technology For Bonding Corneal Tissue Transplants Offers Superior Wound Healing – Results of randomized testing of two techniques for repair of corneal defects in rabbits – one invasive using traditional sutures; the other using a newly developed laser-activated, sutureless technology called photochemical tissue bonding (PTB) that uses photochemical reactions to create a tight seal will be presented.
    Innovations in Laser Surgery Enhance Treatment of Benign and Malignant Laryngeal Disease – Recent advances in fiber-based laser and endoscopic technologies are moving laryngeal surgeries from the operating room to the doctor’s office using local anesthesia. Researchers expect this style of minimally invasive laser surgery will likely lead to enhanced treatment of a number of benign and malignant laryngeal diseases thanks to the clinical benefits of earlier surgical intervention, better conservation of normal tissue, and improved vocal function for patients.
    First Human Study of Non-Invasive Cryolipolysis Yields Promising Results in Patients with Love Handles and Back Fat – Findings from the first multi-center study of non-invasive cryolipolysis, a breakthrough technology that is based on the natural biologic vulnerability of fat cells to the effects of cold via controlled energy extraction, confirmed that the procedure is safe and provides fat layer reductions when performed in routine clinical settings. Data based on interim results from evaluations of 32 male and female study subjects will be presented.
    New In Vitro Research Shows Laser Therapy Increases Efficiency of Certain Nanoparticles to Target Cancer Cells – Researchers investigating new applications of nanoparticles known as single walled carbon nanohorns (SWNHs) found that when they are exposed to infrared radiation, they have the capability to conduct heat and create local chemical reactions – resulting in enhanced tumor destruction. Laboratory results demonstrating the anti-cancer efficiency of nanoparticles will be discussed.

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