Laser Technology Updates
Facial Rejuvenation Lasers
As your skin ages, it loses its smooth, homogeneous color and becomes wrinkled. Ultraviolet light (sun) exposure and environmental toxins (cigarette smoke) cause the skin to wrinkle and develop age spots (lentigenes) and broken capillaries (telangiectasias). To improve aging skin, lasers can be very effective in restoring a smooth and even color to the skin and can improve superficial lines and wrinkles.
QuantumTM Intense Pulsed LightTM device (IPLTM/FotofacialTM): This device is technically not a laser because it emits a broad spectrum of light and not a specific wavelength. The broad spectrum of light makes it very effective for improving the color and texture of the skin. It is very effective for red discoloration of the skin and has been proven to improve pore size. However, it is not very effective in improving wrinkles. The IPLTM treatments can be intensified by adding levulinic acid (Levulan®) in a process know as photodynamic therapy (PDT). The Levulan® makes the skin more receptive to the light source, which makes each treatment more effective, but there is increased redness with this approach.
Fraxel® (fractional photothermolysis): This laser spans the gap between nonablative (minimally effective with quick recovery) and ablative (maximally effective with a long recovery) lasers. It works by using an Erbium laser to make tiny holes in the skin (leaving untreated skin between the holes), so about 20% of the skin is resurfaced at a time. The benefit is that there is minimal recovery (1 to 3 days of redness and swelling) compared to more aggressive treatments such as deep chemical peels or ablative lasers (10 days to 2 weeks). Fraxel® will improve the color and consistency of the skin, especially brown discoloration. If used in a more aggressive fashion, and with an increased recovery period, it can improve fine lines and wrinkles. An added benefit of this laser is that it can be used in locations other than the face, including the neck, chest, and hands.
Vascular Lasers
Vascular lasers target the hemoglobin molecule in the blood, which makes them effective for the treatment of red or purple lesions, including leg veins (spider veins), broken blood vessels (telangiectasias), port wine stains, superficial red birthmarks including hemangiomas, venous malformations, and acne rosea. Most offices offer one single alternative for the treatment of vascular lesions: an Intense Pulsed LightTM device (IPLTM). While we also also offer IPLTM treatments for uneven facial pigment (dyschromia), our vascular lasers are much more specific and effective because their laser light (wavelength) is specifically designed for these lesions.
Cynosure V-StarTM (595 nm pulsed dye laser): This is one of the most powerful pulsed dye lasers available. This laser has a wavelenth specific for the hemoglobin molecule in the bloodstream, making it useful for the treatment of vascular lesions such as port wine stains, superficial hemangiomas, as well as red raised scars (hypertrophic scars).
Laserscope GeminiTM (532/1064 nm laser): This is a state-of-the-art laser designed to treat vascular (red) lesions including spider veins, leg veins, broken blood vessels (telangiectiasias), venous malformations, superficial hemangiomas, and port wine stains. For difficult-to-treat vascular lesions such as broken blood vessles around the nose and cheeks, this laser offers the most powerful and effective treatment.
Hair Removal Lasers
Permanent hair removal is often promised, but laser hair removal is NOT permanent and should be called "hair reduction." In a series of treatments, unwanted hair can be dramatically reduced to a fine pale color. After the series, patients will occasionally need to have maintenance treatments.
Many centers use an Intense Pulsed LightTM (IPLTM) device for laser hair reduction. However, IPLTM hair reduction is less effective than can be obtained using lasers with a light source (wavelength) specific for the melanin pigment in the hair. Because melanin is also present in tanned skin and in patients with darker skin types, many hair reduction lasers or devices cannot be used to treat these patients. We offer two very specific lasers for both light skin and darker skin or tanned patients which are maximally effective for hair reduction.
Cynosure Apogee® 9300 (755 nm Alexandrite): The Alexandrite laser is highly specific for melanin in the hair follicle, making it extremely effective for hair reduction on patients with lighter skin. Many scientific studies point to the fact that the Alexandrite laser is the most effective hair reduction laser available. However, it cannot be used on dark or tanned skin.
Altus(Cutera) CoolGlide® (1064nm YAG): This hair-reduction laser is essentially "color-blind," making it very effective for patients with darker skin or patients who are tan. This very effective approach to hair removal is popular in summer months, when sun exposure is difficult to avoid.
Tattoo Removal
Unwanted tattoos can be removed in a series of laser treatments. Many clinics will use the Intense Pulsed LightTM device (IPLTM) for this purpose, but it is less effective than our laser, which is very specifically designed for tattoo removal. Regardless of the type of laser used, darker tattoo pigments respond better than yellow or green pigments.
MedliteTM C6 (Q-switched YAG): This laser incorporates a special technology call "Q-switching," which allows the laser to deliver its energy in a very short burst. This fast and powerful burst of energy is absorbed by the pigment in the tattoo, which literally fragments the pigment into tiny particles that are then removed by the body’s immune system. While laser tattoo removal can be a long and difficult process, no other laser is as effective as the MedliteTM, because of its Q-switch technology.
Other Devices
Zimmer air cooler: Our air cooler is designed both for comfort and safely. Cooling the skin during a laser treatment protects the outer layer of the skin (epidermis) from potential damage while making the treatments more comfortable for the patient. Because cooling the skin protects it from damage, the laser power can be increased to more effective levels, making each treatment maximally beneficial.
Sciton Erbium: This laser is used only by our experienced surgeons for laser resurfacing of the face. The Erbium laser is very specifically tuned for water in the skin and precisely removes skin down to a deep layer, which heals over 10 days. The resultant new skin is dramatically improved both in terms of color and wrinkles. The Erbium laser is much more specific for water in the skin than the CO2 laser. With the Erbium laser, there is dramatically less heating of the skin, making it a more "gentle" laser. This results in fewer problems with pigment changes in the skin after laser treatment, and the redness of the skin resolves much sooner than with CO2.
Future Devices
UltraShape: EpiCentre-Dallas was chosen as one of two locations in the United States to test the UltraShape device. This device uses focused ultrasound energy to destroy fat cells, making it the first noninvasive alternative to liposuction. With each treatment, one to two centimeters of fat can be removed. While it can never achieve the results of traditional liposuction, it can improve body contours without surgery. This device is currently undergoing an FDA review and when it is approved it will be available at EpiCentre-Dallas.
Lasers and Devices Not Available at EpiCenter-Dallas
At EpiCentre-Dallas, we feel it is our obligation to offer only those lasers and devices that are both safe and effective. We carefully evaluate each new technology and determine if it can meet our highest standard. Many of the newer devices can achieve excellent results, but in an inconsistent fashion. We believe that a device or laser should be both safe and consistently able to produce an excellent outcome. We also feel it is our duty as a specialized laser center to inform you of those devices we do not offer so that you can have all the information you need to make an educated decision.
Portrait (Plasma Thermolysis): This device is not a laser and uses nitrogen plasma to heat (burn) the skin on a superficial level. Most offices offer this treatment in two forms. The first alternative is a superficial treatment usually done by a nurse. Three superficial treatments are necessary to achieve the desired result. The second alternative is a single, deeper, more aggressive treatment done by a physician, usually requiring some form of sedation for pain control. After treatment, the dead skin forms a protective layer over new skin (similar to a scab). This dead skin falls off in several days, leaving the new skin underneath. While this technology can improve the color and texture of the skin, its effect on wrinkles is minimal. At EpiCentre-Dallas, we prefer to use our Fraxel® (fractional photothermolysis) because it requires less recovery time. More importantly, with Fraxel® treatments, the laser light penetrates to a deeper level than Portrait, which theoretically allows it to better treat wrinkles.
Thermage® (Radiofrequency device): This device is not a laser and uses radiofrequency to affect the skin. The radiofrequency acts to "damage" the skin and elicit a healing phenomenon know as "collagen remodeling." After a Thermage® treatment, the skin remodels itself, theoretically getting rid of wrinkles. Proponents of this device claim that it tightens skin and improves facial contour. It has been marketed as a means to a "nonsurgical facelift." However, patients do not always respond to this treatment and the results are highly inconsistent. In some instances, Thermage® treatments can and will tighten the skin, but careful photographic analysis reveals that this is inconsistently produced. Furthermore, even the best Thermage® results cannot compare with a surgical facelift. For our patients who desire tightening of facial skin, there is no reasonable alternative to a facelift.
VelaSmooth: This device is not a laser and is designed to improve cellulite. It works through a combination of infrared light, suction, and radiofrequency. VelaSmooth treatment causes transient swelling of the area being treated, giving the illusion of cellulite reduction. (In other words, the swelling causes the skin to look smoother). The real question is whether VelaSmooth can improve cellulite after the swelling goes away. At this time, there is no good scientific evidence to support that VelaSmooth treatments will improve cellulite on a long-term basis.
Mesotherapy: Mesotherapy refers to a technique where caustic substances are injected into the skin, causing internal scarring. The belief is that fat can be dissolved and cellulite improved with repeat injections. The problem is that these injections can also kill body tissue, resulting in tissue loss or necrosis. This can cause scars which will not go away. In addition, mesotherapy injections can cause contour irregularities in the skin, which can be worse than the cellulite they are designed to treat. The results of mesotherapy are highly variable and therefore inconsistent. Currently, there is no good and consistent device for fat reduction or cellulite treatment. For our patients desiring a fat reduction procedure, we recommend traditional liposuction. The only alternative is the UltraShape device (see above), which is not currently available.
TitanTM: This device is the first light-based solution for heating the deeper skin (dermis) with the goal of skin tightening. The concept is similar to Thermage® in that the treatments stimulate collagen remodeling, which in theory tightens the skin and improves contour. However, like Thermage®, these treatments have variable effectiveness and do not provide consistent results.
Polaris: This device combines a diode laser (900 nm) with radiofrequency to significantly heat the dermis. Like TitanTM and Thermage®, Polaris tightens skin by heating and subsequent collagen remodeling. However, the results are also inconsistent and not highly reproducible, making it an unreliable device.