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Facial Lasers’ Future: Shorter Downtimes, Darker Skin Types

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Picosecond lasers and the combination of fractional ablative and nonablative modalities are allowing cosmetic surgery technology companies to reduce downtime and open up laser facials to a broader demographic.

JAMES SCHLETT, EDITOR, [email protected]

When Dr. Mark Schwartz started performing laser facial rejuvenation treatments, he had regularly advised his patients that they should expect a month of downtime, meaning they’d experience redness, crustiness and swelling from the full-field, ablative carbon dioxide (CO2) laser he used. That was 1997, and his patients back then seemed willing to tolerate such long periods of downtime for the sake of looking years younger. Not so much anymore. “People just seem very busy now. Even those who are retired. It’s just rare that people will give me that kind of time, for good reason,” said Schwartz, who has an office on the Upper East Side in New York City. Now Schwartz braces most of his patients for far shorter downtimes, thanks to a hybrid ablative and nonablative fractional laser called Halo, by Sciton in Palo Alto, Calif. The laser system uses a 1470-nm diode for the nonablative delivery of 100- to 700-µm of coagulation to the epidermis and dermis as well as a 2940-nm erbium-doped yttrium aluminum garnet (Er:YAG) laser for the ablation of up to 100 µm of the epidermis. “I’m seeing really nice results with little downtime,” said Schwartz. In the Milwaukee suburbs, Dr. Andrew Campbell, another plastic surgeon, started using the Halo in August 2014, a few months after its release. When he previously used Sciton’s ProFractional, a 2940-nm Er:YAG laser, he advised patients being treated for skin texture and wrinkles to expect four to five days of weeping, during which their face would bleed and makeup would be prohibited.

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Published: October 2016
Glossary
carbon dioxide laser
A gas laser in which the energy-state transitions between vibrational and rotational states of CO2 molecules give emission at long IR, about 10 µm, wavelengths. The laser can maintain continuous and very high levels of power.
halo
1. The faintly hued ring that is seen to surround a light source viewed through fog or light clouds. The size of scattering particles determines the size of the ring. 2. The ring surrounding a photographic image of a bright source and resulting from the scattering of light in random directions.
fractional photothermolysis
A laser skin-resurfacing method that creates microscopic thermal wounds referred to as microscopic treatment zones (MTZs), which are surrounded by uninjured tissue. The MTZs are usually arranged in a grid pattern and are invisible to the naked eye. This patterned approach is less intense than the nonfractional methods in which all of the skin surface is treated. The MTZs create smaller injuries and shorter migratory pathways of wound-filling keratinocytes, resulting in faster skin repair.
er:yag laser
An Er:YAG laser is a type of solid-state laser that uses a crystal made of erbium-doped yttrium aluminum garnet (Er:Y3Al5O12) as the gain medium. The erbium (Er) ions are introduced into the crystal lattice of yttrium aluminum garnet (YAG) to provide the lasing action. The Er:YAG laser is known for its ability to emit laser light at a specific wavelength in the infrared region, making it particularly well-suited for various medical and dental applications. Key points about Er:YAG lasers: ...
diode lasersfiber lasersLasersBiophotonicsAmericasJames Schlettcosmetic surgerylaser facialcarbon dioxide laserCO2 laserssolta medicalLutronicSyneronScitonfraxelhalopicosecond laserlaser diodesfractional microneedle radiofrequencyfmrfractional photothermolysismicroscopic treatment zonesMTZsEr:YAG laserNd:YAG laserlaser-induced optical breakdownLIOBfractionalfractionatednonfractionalnonfractionatedablativenonablativeFeatures

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