CHMD -
It's a great idea to focus the random vent's in one post, they are fun to read and write but hard to find among the rest of the posts!

A few thoughts/vents/rants - when a laser vendor sells you a new machine, wouldn't it be great if they actually had some useful guidelines published? case in point - Titan by Cutera (hereafter known as 'Cuterrible). How many studies were shown with different techniques all contradicting the last, and all using protocols far from the companies published guidelines. I would like an objective source of protocols that can be used on whatever skin types we feel comfortable treating and not have to experiment on patients just so the laser manufacturer can say 'hey, that was outside our guidelines, we aren't responsible, even if our suggestions were completely ineffective!"

While on the subject of Cuterrible products; what is wrong with actually providing an affordable warranty? $20+K for a year of warranty on 3 machines? and that doesn't include the handpieces! Are they expecing them to fail that often that they think it is worth the equivalent of 2-3 service calls per year for each machine?

If I can share a frustration of my patients: every Tom, Dick and Dr Harry are getting into esthetics these days because of the cash potential (potential, not probability). What does a local opthalmologist doing laser procedures in his office do if he blisters a patient - he sends them to the emergency room! One of the first questions most of our callers and consultations ask is whether we use doctors or techs to do procedures. And the second is 'is the doctor licensed?'

That feels better, thanks CHMD.

I spend 2 hours listening to a Webinar. The Questions and Answers are the best part, but they never have enough time to complete the questions and the answers and then they have no follow up. My suggestion is to have the Q&A continue in an online forum. We need information clarified so we can use the information to treat patients effectively without complications.

It really pisses me off that Allergan only gives 0.8 cc per syringe and then they bug me about using more Juvederm.
And not only that, because I don't use Juvederm, I can't become a Diamond Provider.
My rant is to Allergan: Give us 1.3 cc per syringe or just shut up and get out of my office!

You want better results and more patient satisfaction? Give us more VOLUME!!!

What is with this 0.8 cc??? Where did that come from. What a bunch of idiots at Allergan. Yes they are IDIOTS !!!

Here's a vent.

Some of the posts here, especially the IPL area sound like they were written by reps. Would it be possible to get a clinicians only area or 'Out' the reps.

Dr. Mitch Goldman’s Webinar on Deep and ActiveFx Summary:
October 29, 2008

According to Dr. Goldman:
The Deep and Active Fx work all the time.
The is no bruising or bleeding or oozing even when doing 17.5 j energy.
There is no pain, not enough to need percocet or valium.
There is no PIH even on Asians and dark Latinos.
There are no disposables.

Everything is just great. The perfect laser (but don’t use it on the DA’s wife! You have to know when to hold them and when to fold them).

Fraxel Sucks. It doesn’t work and is very painful and has an expensive disposable.
Cynosure’s 1440 MultiPlex is good (probably because they paid him or gave him a free laser).

Conclusion: Dr. Goldman is a laser whore. He is not reliable or believable. Lumenus should be ashamed to invite their current users to waste their time with this embarrassing, misleading marketing BS. The information contained in this webinar is DANGEROUS because it may lead an inexperienced Lumenis user to underestimate the power and side effect potential of the Deep and ActiveFx. Shame Shame Shame. Dr. Goldman has different protocols than Dr. Weisse, Dr. Dover and other experts. Why is there this difference? Why isn’t Lumenis getting all these experts together to give us some guidance? I am not ready to say LUMENIS SUCKS, but I am getting close!

I am coordinating a fractional C02 laser power point presentation along with the hands on demonstrations to show the versatillity of the laser. I live in Great Falls Montana. The date is set for the evening of Nov 3, 4 and part of the 5th to make it convenient for docs to show up. Unfortunately I am without doc's confirmation as yet....!!!!! The$ 76,000 laser has arrived at my medical massage clinic and the reps are flying in in just three days to host this thing. HELP!!!!

This is the problem . . . the marketing webinars should be completely seperate from the training webinars. When you tune into a marketing webinar to get trained, you get F - -ked because you don't get the truth. You get marketing spin which is half the truth (only the good half).

Lumenis is negligent in not having seperate training webinars and inviting its users to watch the marketing webinar and thinking they are getting trained. We are getting FALSELY reassured that there are no problems when in fact the laser causes lots of bleeding, lots of downtime and there is a significant risk of PIH and other side effects.

By suggesting the road is smooth, wide and easy, Lumenis does us a great disservice when the road is dark and windy and bumpy. We need to know the truth. We need to understand the risks and the dips and the turns. Lumenis is negligent and in my opinion they should be held liable if any doctor has any problems with their treatments.

Lumenis, don't tell me it is going to be easy when it is going to be hard. Don't encourage me to let my guard down and don't let me be "ambushed" by side effects and compilcations. You need to start TRAINING WEBINARS where we can all learn from the Lumenaries (who all have different techniques).

I am done venting, but I will continue THIS VENT until Lumenis gets their act together and stops acting like arrogant a--holes!

It takes me 45 minutes to do a deepfx followed by an activefx! How does Dr. Goldman do it in 15 minutes? I also get LOTS of BLEEDING and OOZING at 17.5 j. How does Dr. Goldman get almost no bleeding at 17.5 j? Is he just hovering over the skin rather than pushing down?

It really pisses me off that I don't have the opportunity to clarify these discrepencies and these Lumenaries are not available to us after they give their webinars.

Lumenis, you are creating a dangerous enviroment for your providers and their patients. Mark my words, if you continue to ignore this type of feedback and ignore the best interests of your users and their patients, your company will pay big time in the end. MARK MY WORDS. You had better get your act together and "do the right thing". Do the smart thing and stop being arrogant and uncaring.

From the Lumenis webinar:
Question: Are you seeing any pin point bleeding wtih the Deep Fx ? "

Dr. Mitch GOLDMAN: "I I donly see pin point bleeding when I am doing a 20 mj . My usual standard ....I am usually doing 17 mj but when I go to 20 mj I see SOMETIMES see with people with rocecea ......."

We have been using Deep and Active prior to the office launch and this statment in my personal experience is completely false. There is quite a bit of pin point bleeding occasionally starting at arount 15 mj. I thought this whole entire "informercial" by the "expert" sounded like all the other laser salepeople out there.

Give me a break..

I dont think he is actually doing the procedures. Medical students , resident students and fellows at UCSD ?