dexter,

Thanks for the input. I had heard he had the prototype. I do not own the profractional but have done 5 cases. I have been told that I will be one of the first to get access to the new Profractional with coag. Can't wait should be fun.

LH, Dexter and Charry: I have always been curious about the BBL system. Does it allow you to actually use the system "like a laser" in the sense that you want to use high energy with short pulse durations for fine hair and lower energy over longer pulse durations for thick, dark hair? Earlier models of IPL did not allow this type of operation due to more rudimentary electronics I guess. I also believe that BBL also uses single pulses only rather than pulse trains like the pioneering IPL models from Lumenis/ESC? Do you have any thoughts about the pulse train and "rest periods" used by some systems to (theoretically anyway) capitalize on the different TRTs of different-sized chromophores, etc.?

medspaguy,

Yes, you can independently change the pulsewidth and fluence. Changing the pulsewidth is the key, especially when going after hair and vascular. Smaller structures get shorter PW's and larger structures get longer PW's. Just with lasers, delivering the fluence in the appropriate time is essential. You can have the correct fluence but if it's not delivered over the appropriate amount of time it's not effective. We see this commonly. In fact, I often argue that it (PW) is the most misunderstood and misused parameter with lasers or light. Too often I hear people using PW's that either too long or too short and wondering why they don't get results. In my opinion, the reason why earlier models didn't have the ability to deliver single pulses in tied into overall power (peak power specifically). You actually have the ability with BBL to single, double, or triple pulse but there really is no benefit. It's a low power solution to extending pulse width.

The other variable that I think is overlooked is the ability to independently change the cooling temp. We find that for more superficial vascular structures we use a higher chilling temp. You have to be careful not to overcool the vasculature. It is sitting in the upper papillary dermis. With most contact cooling, within 1 second the entire epidermis is the temp. of the chilling sapphire. That means the papillary dermis has also changed temp. (away from body). The goal is to heat the vasculature. If it's colder, then you have to use more fluence to get it heated. In fact, if it's very superficail we actually float the handpiece in gel. One for temp. control, but mainly because if you place the crystal in contact with the skin it flushes out your target. No target, no absorption. However, when we treat hair we can move the temp. down because we're not worried about cooling the deeper follicle. Having the ability to independently change fluence, PW, and cooling temp is valuable if you understand their role. It's also important to have multiple filters to choose from. I don't think a lot of systems give you this. I wouldn't usually go so overboard with the Sciton hype, but we are in the Sciton forum so I think it's okay.

med spa guy,

You can control absorption using filters. You do not have to change heads so it is very easy. You can control Jcm2 and I have never run out of energy. You can control pulse width and even temperature of the head from 5 to 25 degrees. They also give you 3 clip on heads to control the size of the head. You get a 15x15 square a 7mm round and a 14mm round (I think these are the correct sizes). The head itself is 15x45. My only complaint about the BBL is that it is a little slow when you are trying to cool to 5 to 10 degrees. In general these are the temps you use with hair removal. So it slows you down when you are doing large surface areas for hair removal. We have had fairly good results with lighter hair. The question is always is it permanent?

med spa guy

I have the BBL almost three years now and i agree with dexter and LH.In my opinion is the best IPL in the market as it gives you the the ability to independently change the filters(absorption),the fluence,the pulse width and the cooling temperature.It also has four spot sizes(15x45mm ,15x15mm ,7mm round and 11mm round).
LH
Why it is slow when you are using 5-10C for cooling?I am usually working in hair removal at 8C and at 1shot/2sec as you can't move faster the spot if you want to cool the skin in an effective way.I am finishing the hair removal of both legs after 40-45 min.The result is permanent.I can say it after three years of BBL hair removal.You know LH that the hair folicle doesn't recognize the photons if they have been delivered from a laser or an IPL source.

LH
I have also been informed today that the new Profractional with coag.mode is coming soon.

Charry,

My BBL is slower than 1 pulse every 2 seconds at 8 degrees. Maybe I need to call Sciton to ask about it. I have the BBLs which is the self contained unit.

I was just saying that I have not had the system long enough (1 year) to be 100% on permanence. I agree that hair does not care where the photon comes from. It is just getting enough to the shaft.

LH
How your BBL slows down at 8C?What happens?It raises the temperature of cooling system?Which temperature(cooling) you are using for hair removal?

It just will not fire.

It is strange.Maybe the specifications are different for the portable BBL,I don't know...

Anyone knows how often can you repeat the sessions of BBL treatment(420nm) for acne?I am doing 4 sessions(without ALA or Metvix),1 every week,with very goods results even in mild cystic acne,but i am wondering for the duration of this improvement and for the repetition of the treatment course in one's year time.

I am also looking into this. It seems to be to get them in about every 4 to 6 weeks.

I think the problem with blue light, without ALA, is that it has a shallow depth of penetration. It is just treating the P.acne bacteria which is a an effect not the cause. For cystic acne you probably need to heat up the sebaceous gland which lies in the dermis. that is why we would include the 1319 (probably could use ST as well) for treating the SG. This is what the cooltouch, aramis, smoothbeam etc. do. We do both the blue light and 1319 (trying ST) in combination.

dexter,LH

Thanks you.I am using recently this combination treatment(first 420nm,then 2 passes of ST at 35J/cm),and i am seeing even better results,but my certain question remains.How often and in which rythm you could repeat the treatment course in 1 year for the same pt?

I don't think there is an absolute answer. We would do the treatments once a week for six weeks and tell them to come for in for maintenance every 3-6 months.

I would agree with dexter if you are doing the ST also. I would see tham back at 3 months.

Thanks LH,dexter...Thank you very much.

Anyone who knows what is the price of ProLipo (only the 1064 module)without the 1319(endovascular) and the BBL modules?Anyone who knows if Sciton has technicaly the ability to transform an articulated arm Profile system into a fiber unit (ProLipo)?

LH

You said that with Contour "I tend to go 50 to 100 microns depending on the area and make multiple passes. Total 300 to 500 perioral and 150 to 250 periocular. I usually add 50 microns of ablation to the last pass."...With these settings what is the improvement that you are getting for lower eyelids?The total result is about similar to the eyelid plastic surgery?

Charry,

I am seeing great results but I am waiting to see how long it lasts. Some studies have shown that the tightening from laser resurfacing with a CO2 can relax 12 to 18 months after the procedure. I have had my erbium for about a year now. I did not start going deep immediately so I am waiting to see if we have better longevity of results around the eyes.

Thanks LH.

Hi Charry,

I too have noticed that the BBL slows down during hair removal when the tip temperature is 8-10 degrees. You have to remember that the BBL is one of the very few IPL's that actually regulate the tip temp (+/- 2 deg from setting) and the Quad-Thermo Electric Coolers attached to the sapphire tip do have a maximum heat transfer capacity. If you exceed this capacity, the system will force you to stop until the temp comes back into range. There are two ways around this, increase the tip temp to 13-15 degrees and maybe decrease the fluence, or just slow down during HR. Just leaving the chilled tip on the skin for a second after firing makes for a very comfortable treatment - effective hair removal should not be a race. There is another solution that I have not mentioned here - do you have the water chiller that comes with the Sciton ClearScan Nd:YAG?

Hi Charry

Regarding the SkinTyte, the Sciton protocol requires you to do 3-5 passes over an area at ~40Jcm2 for 5 seconds. The problem with this is that if the strip you are working on is too long, ie chin to clavicle, by the time you have finished one pass and return to the beginning, the skin has cooled. For better results you should try treating three adjacent spots and repeat over this area 4 times before moving on to the next three spots. This will ensure that the temp increases with each successive pass. Try 45Jcm2 for 5 seconds and ask the patient to notify you when the treatment becomes uncomfortable. At this point , treat for one more second then lift your foot from the pedal while maintaining tip contact with the skin for two more seconds, then move to the next spot. Eventhough Sciton claim ST should be painless, I have seen better results when the patient winces.

ServiceTech

I too have noticed all these you mentioned about the BBL hair removal.If you go too fast the system will force you to stop until the temp comes back into range.I have always used high fluence up to 15 J/cm (640filter) for FitzIII with low cooling temp 7-8 degrees and frequence 1shot/2sec and i have noticed all these above.I have recently used a little lower fluence 12-13 J/cm (640filter) for FitIII with a little higher temp (9-10 degrees) and frq 1shot/3sec and this phainomenon has stopped.Maybe i would use a little higher temp (as you mentioned 13-15 degrees),i'll see...Anyway the absorption of skin melanin is determined by this rule μa=1,70 X 10^12 X L^ -3,48...Where L is the wavelength in nm...By this rule the skin melanin absorption is for every wavelength the following:
640nm=290 cm
695nm=220 cm
755nm=164 cm
800nm=134 cm
1064nm=49 cm
By these results the 755(Alex) has 25,45% less absorption in melanin in comparison to 695nm and 43,44% less absorption in comparison to 640nm.So,if someone is working at an average 21J/cm with 755(Alex) this fluence is "roughly" equal for the BBL hair removal to 15,5J/cm for 695nm or 12J/cm for 640nm or for 71J/cm for 1064nm(Nd YAG) always for the same pulse width...

ServiceTech

Thanks for all you mentioned about the SkinTyte.I have used in the past very high settings up to 55J/cm,7sec and frq 1shot/4sec and 4-5 passes but maybe i would try to treat with lower settings (as you said 45J/cm,5 seconds) three adjacent spots and repeat over this area 4 times (total 4 passes for every area) before moving on to the next three spots.I too have noticed that when the patient winces a little the results are even better that ever.