Posts Tagged ‘Deep FX Denver’

Skin Tightening and Wrinkle Removal In Denver, Colorado

Monday, November 2nd, 2009

The most common questions asked in my office are about skin tightening and wrinkle removal.  Patients want to know which laser treatments work the best.  There are so many technologies out there that it is easy to get lost in technical jargon and marketing build up.  The good news is that there are some truly excellent lasers procedures out there for both wrinkle reduction and skin tightening.  The better news is that there are some easy ways to evaluate these technologies.

To truly reduce facial lines is a difficult task, especially wrinkles around the mouth and eyes.  These lines can extend over a millimeter deep into the skin.  It is the depth of the damage that makes them very difficult to treat.  Most procedures for treating wrinkles are very superficial and although they may improve fine lines, they never treat the base of deep wrinkles.  In order to really get improvement one must have a procedure that treated then entire area of damage.  This is why fractionated CO2 procedures like the Deep FX are so effective.  This laser can penetrate up to 2mm into the skin assuring that even deep wrinkles will show significant improvement.  Yes, there will be a few days of downtime but we spent several decades making these wrinkles and a few days is well worth it in order to make the skin look literally years younger. 

What about tightening the skin?  There are two options here depending on the desired amount of improvement and amount of downtime a patient is willing to undergo.  The first option is using an infrared light call the Titan to heat the dermal skin which shrinks the existing collagen (much like a piece of meat shrinks on the grill when heated) and will stimulate new collagen growth.  The dermis of the skin thickens giving modest results of about 10 – 20% tightening after three treatments.  Plan on spending about $600-$1000 per treatment for a face and the results will last about 18-24 months.  The best part about the Titan is that there is absolutely no downtime.  The skin is pink for about 30 minutes after the procedure and that is it. Use this in combination with Laser Genesis which is another no downtime laser treatment that helps decrease pores and fine lines.

The other option is using a combination of Deep FX and Active FX.  A surgical facelift removes approximately 10 to 20 square cm of tissue.  Using fractionated lasers we poke microscopic holes in skin much like aerating a lawn.  After poking these holes, we have removed anywhere from 5  to 10 square cm of tissue.  That means that we can get results that are on par with a facelift without the cost or downtime of a traditional surgery.  This is the reason that many patient are choosing this procedure instead of a facelift (Denver Magazine: Death of the Facelift).  In addition to being the best wrinkle treatment and skin tightening treatment, the combination of Active FX and Deep FX will also treat enlarged pores, sun damage spot and even decrease scars.

There is a ton of confusing marketing when it comes to devices for wrinkle treatment and skin tightening.  With so many products such as Fraxel, Pixel, Matrix, Profractional, Thermage, Lux IR and more being added daily it is hard to know which one is the best.  So how does a consumer rate the different laser procedures?  It is actually very simple, just look at the pictures.  Make sure these are not the generalized pictures from the manufacturer.  Patients should stand firm and request pictures from the provider that will be performing the service.  Ask the provider if these are average results or if they are just showing their “homerun” cases.   If they cannot provide you pictures it is time to find a new provider or look at a different procedure.  Check out examples of before and after photos of Active FX  and Deep FX here.  

It is important that you both trust your provider and the technology they are using.  It takes several hundred cases to optimize clinical outcomes with any devise so make sure to choose someone who can prove that they achieve excellent, safe and consistent results.

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Posted in Active FX, Active FX, Articles/Q&A, Articles/Q&A, Deep FX, Deep FX, Skin Care, Titan, Titan | 1 Comment »

Active FX and Deep FX: What Medication Will I Need?

Sunday, March 1st, 2009

I routinely give my patients a Vicodin and Prednisone (an oral steroid to help swelling)  immediately before their procedure and send them home with a prescription for 5 more of the Vicodin and 4 days worth of Prednisone. We use a highly effective combination of topical high dose Lidocaine and Tetracaine along with local nerve blocks and forced cold air for anesthesia during the procedure.  The skin may feel hot and uncomfortable for about 2-4 hours after the procedure. For this reason, I also send my patients home with two gel ice packs, which almost completely alleviates this discomfort.

Although swelling can be significant (especially with more aggressive treatments), there is only minor discomfort during the days following the procedure. Patient routinely tell me that they took a single Vicodin to sleep the night after their procedure and have not required anything stronger than ibuprofen after that.  Depending on the amount of swelling, oral steroids such a Prednisone are usually offered to the patients. Patients who have a history of cold sores should also be placed on antiviral medication such as Acyclovir or Valtrex.

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Posted in Active FX, Articles/Q&A, Deep FX | 2 Comments »

What should I expect from Active and Deep FX are Milia Common?

Sunday, March 1st, 2009

We were one of the first offices in the country to use the Active and Deep FX lasers and milia are fairly rare if you use the right post care ointment.  Immediately after the procedure the skin will be very hot for about 2-4 hours.  The skin may ooze for about 24 to 48 in any areas that have been treated with the Deep FX. 

You should cover the treated area with an occlusive ointment like Silkses (less milia and acne) or Auqaphor.  You may notice mild to significant swelling, especially around the eyes.  The more aggressive the treatment, the greater the swelling is likely to be.  In many cases we put our patients on prednisone (oral steroids) to help decrease this swelling.  Most swelling starts to significantly improve by about day 3. During this time you can wash your face with Aquanil (cuts the grease of the ointment well) and/or one tbsp plain white vinegar to 1-2 cups cold water.  The water/vinegar combination is weak ascetic acid and will act as an antibiotic and sooth the skin. 

You may also notice some minor itching, if itching is more than mild and not controlled with Benadryl, Claritin or Zyrtec call you doctor as this can be a sign of dermatitis or infections.  If you have a history of cold sores you should be taking an antiviral such as Valtrex or Acyclovir.  Some patients do get breakouts after a few days of having the occlusive ointment on their skin.  This is also were the milia can come into play.
Somewhere between day 5 and 7 you should be able to start back with mineral make-up and stop the topical ointment. After a week or so the Active FX areas will look pretty normal but you will likely be pink in the areas of the Deep FX for at least two or three more weeks depending on how aggressive your provider does the procedure.

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Posted in Active FX, Articles/Q&A, Deep FX | No Comments »

Active FX vs. Fraxel vs. Pixel vs. Profractional What's the Difference

Thursday, December 18th, 2008

There are quite a few fractionated resurfacing lasers out there.  So exactly what is resurfacing and what are fractionated lasers.  What makes one fractionated laser different from other? 

Resurfacing is a procedure where layers of damaged skin are removed usually by vaporization from a laser.  It can be used to get rid of brown pigment caused by sun damage, decrease wrinkles, shrink pores and tighten skin.  Vaporization is the process of using heat to instantly evaporate water out of the exposed tissue.  Resurfacing not only removes the tissue on top but also heats the tissue below the level of vaporization causing collagen contraction and stimulation.

So then what is fractional resurfacing?  If resurfacing is like mowing a lawn where every blade of grass is cut to a somewhat shallow depth then fractional resurfacing is more like aerating a lawn.  Fractional resurfacing pokes small but deep holes in the skin, but leaves a certain amount of the skin completely untouched.  Because these patch of undamaged skin patient heal much faster with minimal side effects. Fractional resurfacing was developed at The Wellman Center of Photomedicine at Harvard around 2001.  The original fractional laser did not destroy any tissue (non-ablative), it simply applied heat in order to stimulate new collagen formation.  This non-ablative (non-vaporizing) procedure required multiple treatments and has some significant limitations on efficacy.  Around 2005 we started testing fractionated ablative (tissue vaporization) CO2 lasers (Active FX, Deep FX, Fraxel Re:pair) and found that in a single treatment we could achieve results that were not attainable after 5 or 6 treatments with the non ablative fractionated lasers. The downtime of about 5-7 day was a huge improvement over traditional CO2 resurfacing (think mowing the law) that can take several months to heel. 

Now the market is saturated with fractionated products and it is hard for the patients to figure out which one is the best for them.  The first thing that separates these devices is the actual type of laser.  There are two main lasers used for resurfacing CO2 and erbium.  The Active FX, Deep FX and Fraxel Re:pair are CO2 lasers.  The Pixel and Profractional are erbium lasers.  The CO2 lasers heat tissue much better causing more skin contraction and more collagen stimulation.  They also cause much less bleeding than erbium lasers.  The clinical results speak for themselves as much more skin damage can be removed with by a CO2.

Between the CO2 platforms FX (made by Lumenis) and the Fraxel (made by Reliant), the FX is much preferred by patients.  In 2007 Dr. Robert Weiss performed a split face study at Johns Hopkins using the Active FX on one side and the Fraxel Re:pair on the other.  Nine out of ten patients preferred both the comfort of the procedure and the results of the Active FX.

Ok so the Lumenis FX gives the best results and the most patient preferred procedure. So then what is the difference between Active FX, Deep FX and Total FX?  The Active and Deep FX are different heads that can be attached to the laser.  The Active FX is more shallow (about 1/3 mm) and wide which is better for skin tightening, decreasing pore size and removing pigmented sun damage.  The Deep FX is a narrow beam that goes deep (up to about 2mm) into the skin in order to treat wrinkles and scars.  The Total FX is more a marketing term that describes using both heads during the same treatment (which is how the procedure is normal done).

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Posted in Active FX, Articles/Q&A, Deep FX | No Comments »