flightdoc

I have on my Profile system only the Nd YAG module + the BBL(+ST) so i haven't any experience with the Profractional on treating melasma with it or in combination with the BBL.Patients with melasma are responded very well with the BBL alone,but of cource it's a difficult situation to treat and sometimes the addition of an hydroquinone cream is usefull.
Here there is another phycisian (Dexter) who is working many months with Sciton's platform and he has on it the BBL + the Profractional so maybe he could answer to your questions for melasma treatment.I also don't have any experience with the Pro-V or ProLipo.....
Cheers

Charry,
Thanks for the your settings with ST. The BBL is great. I had a Syneron Gallaxy before and this is light years ahead. I'm getting Profractional XC in a few weeks. I demoed the Mixto. Results were good, but the control panel is confusing and the machine had to be turned off and on to reset if I got out of sequence in changing the settings. The list price is $79K. I don't think it is worth that much. Needs to be more user friendly.
RAY

RAY

What was for you the cost of upgrade (the total cost module+hanpiece) for the Profractional-XC in US $?Thank you!!

RAY

If you don't want to post the total price of Profractional-XC upgrade on your Profile,you could email me at charrychavel@gmail.com.

I love this blog! I've been a Sciton user for 2 years.
I would appreciate if someone would share some parameters for the treatment of Port wine stains, BBL? 1064?
Thanks
Gloria

Gloria

If you have the BBL + Nd YAG modules on your Profile try this:
1)For deep (blue color or purple color) PWS begin with 6mm and pulse width 10msec.After the 1st or 2nd session and as the color of PWS is becoming more red change the spot (3mm),keep the pulse width at 10msec and adjust the fluence up to level that you could see a little purpura.You can do a trial shot for adjustment the Fluence.
As the color is becoming more and more light (red or light red) you can use first the BBL with 560nm filter 11J/cm2 ,20msec for type III skin and then the Nd YAG (3mm spot, >150J/cm2 ,pulse width:10msec).
2)For superficial (red or light red color) PWS you can use the combination of BBL +Nd YAG as i said above.

Charry,
My sales rep told me the cost of the Profractional XC was going up after 6/30/08, so I signed a purchase agreement and put a deposit down in June. My system has Contour (ablate and coag) erbium single head. So, I don't know what the Erbium module would be. My cost for the Profractional XC upgrade was 49K including install. I don't know if the cost is increased now. It is more to get both Profractional and Profractional XC upgrade. I'm told I won't have the Profractional handpiece for a few more weeks. I think the ability to add coag is vital. I hope to be using it soon!

RAY

Thanks RAY!!

charry

with Profrational XC only allowing you densities of 5.5 and 11%, do you think you are sacrificing the ability to fine tune treatment for speed??? esp for type IV patients? also the XC beam size is almost double that of the Profractional?
I have heard that the XC did not add much to real results ...since Er is not very good with coagulation anyway..

nymd

I know about the densities of the Profractional-XC but i don't think that anyone would ever used at the original Profractional densities >20%.And if you think that the spot size of the XC is 430μm vs 250μm of the original Profractional you could estimate that the real density of 11% aproximates to this of 20% of the previous model.As regards to the type IV patients,i think that safety is a very important issue.For ErYAG with coag please ask Dexter(he has also working with the original Profractional) who has tried the XC with level II coag.At his post said that with XC there is no need to get a CO2 laser (fractional or no) because you could get similat to CO2 results with more safety at type IV patients.Ask him for the XC....

dexter

Well, charry put you on the spot... With level II coagulation, at say, do you think you are getting some coagulation?
or there is no observable difference between I /II and II/ III as someone has mentioned? Would you go to level III on type IV patients?

Has anyone ever tried Er:YAG with a Fitzpatrick V patient? I have come across many articles regarding treatment of Fitz IV patients with Er:YAG but never seen anything about Fitz V. I would expect that there would be a great deal of concern about PIH-- but it would be interesting to see if anyone has tried treating Fitz V patients. Thanks.

Sorry I have been out of the loop for awhile. To answer the question directly by NYMD, there is no doubt there is coagulation. As we add coag. healing times are prolonged. With that said, as the skin type gets darker there is a higher degree of hyperpigmentation when using coagulation. This has certainly proven to be true (unless your Mitch Goldman) when using CO2 fraxel. However, the incidence of PIH will be much lower than the 100% ablative options with CO2 with darker skin types. It would be my advice to go with no or minimal coag. on darker skin types. Skin tightening of lax areas when using coag. comes with a potential price as you add coag. It's a bigger wound. We're only using coag. in areas where there is laxity such as under the eyes and frankly, if we want tightening under the eyes we would use our Sciton in full ablative mode with coag. putting us into the CO2 arena. We would do this only on lighter skin types. On the darker skin types we either use no coag. or add just a moderate amount somewhere in between CO2 and erbium ala Cutera Pearl. On a side note, in an earlier post I was corrected in saying that Pearl is not in between CO2 and erbium. What I meant was Pearl was in between on the water curve. On the water curve Pearl does in fact sit in between CO2 and erbium. In other words it is more coagulative or less efficient in water than erbium, but more efficient than CO2.

Regarding my comment about not needing a CO2 or any other devices I want to be clear. I am not saying you can add the maximum amount of coagulation (like CO2) and get less healing time. If you use the laser like a CO2 laser you will get CO2 like effects and problems. The advantage of profractional XC is that you can add coag. somewhere in between CO2 and traditional erbium, like CO2 or no coag. as erbium. You can't do that with other systems. This is why I believe that there is no need for these other devices. We can do them all whether they are 100% ablative or fractional.

Gloria,

Wanted to chime in on PWS. I think Charry has described the process well, but I would only change one thing. When beginning I like the use of the 6 mm spot as does Charry (larger spots penetrate deeper), but I would extend the pulsewidth to accommodate the larger vessels that probably exist in the deeper bed of vessels that is feeding the PWS.

dexter
using your theories, does it mean that one should stay away from Profractional XC for skin type IV?? esp for resurfacing deep acne scars and wrinkles???

nymd

NYMD,

You don't have to stay away from XC, but I would use it with minimal or no coag.

medspamd,

We have used erbium profractional on type V. There is also another doctor in Hawaii (Todd Bessinger) whom I have seem some great photos on type IV and V using profx. for acne scars.

Hi,

I would like to ask the following questions as im considering purchasing the Sciton -

-My main application is Acne Scars treatment. Would you recommend the Sciton with the Profractional XC Module ?
-Can results be seen with the profractional xc at every sitting and what would be the downtime for the same.
-Has anyone reported/experienced cases of PIH following the treatment ? My patients would be asian Type IV and Type V . I have used the Palomar 1540 with very good results and am considering mainly between the 2 systems. If anyone has used these 2 systems , I would really appreciate their feedback comparision on the same.

I have a Cutera Xeo with Pearl , Vantage and Titan along with the Medlite C6. I need a solution for maximum results on acne scars.

Thanks for your feedback.

AVK209,

Consider the Fraxel Re:store 1550 Glass Erbium.

This works well in patients of color, it goes deep (1.4 mm). It is nonablative (like the Palomar 1440).

I am not sure how the Palomar and the Fraxel compare (which is better). You might get better support from Reliant (because Thermage just bought them).

Check out "Fraxel Limitations" blog for more detailed information about Fraxel and Reliant.

Lumenis DeepFx is probably best for acne scars, but you can't use it on skin type 5 & 6 and you have to be careful with PIH on skin type 4 (see DeepFx Forum Blog for more info).

Hope this helps.

I agree with MDR. Fraxel re:store works on Asians of darker types. Acne scars are deep, you may have to be aggressive to treat them effectively ( depth and surface area). This may lead to transient PIH. Tell the pt this may happen, if the scars are bad enough the trade off for a few months of pigment may be worth it to them.

The Palomar fractional is the same in theory, but different in practical application. This is due to differences in depth penetration and surface area coverage settings.

Thought I would really like to use the Nd:YAG portion of Sciton for veins/teles but everytime I turned the articulated arm the spot size totally diffused/defocused ergo useless. And the foot plate totally fogged. I do like the MLP and Pro Frax side of box but the "cook" time, set-up, external chiller, external smoke evacuator (plus heart beating body to manage same) just a pain. Am I missing something?

Laser92045,

I would call my Sciton Rep to have the unit checked. This does not sound right. I think your unit is not functioning properly.

MDR , Florida PA

Thanks a lot for your input. I don't like the consumable aspect of the Fraxel, Im based in India, and the consumable makes it unaffordable for most clients. ( though there are a few Fraxels here, they cater to a very elite audience ). Anything making the skin darker is not accepted by asians, if you can make them fairer nothing like it, they will love it.... One problem with a CO2 is the possibility of depigmented spots, thats a taboo and no one would take a risk with anything associated with even one spot of depigmentation. Still, Im also trying the Alma Pixel CO2, haven't had any problem so far, looking foward to the results.I am aware a few docs here are using a CO2 fractional without problems so far even on darker skin.I would love to hear from someone was has used Fractional CO2 on darker skin types.

You are right of the limitations of the Palomar 1540, but then I was doing a second demo on the palomar today and have treated around 25 patients in the first demo without any problems. Hence I was looking at the Sciton Fractional 2940 since it has additional features like a scanner and more adjustable settings. Im also aware Palomar is ( or has ) introduced the Fractional 2940 handpiece, but am not sure how it compares to the 1540 in practical results. Any suggestions on this would be appreciated.

What would you consider a better fractional wavelength for Acne scars 1540 / 1550 or 2940 ?

To further add on, since this a Sciton forum, I would really like some feedback on the Sciton Profractional XC on Acne Scars specifically, downtime following the procedure. At lower settings can a person put make up and go to work the next day ? Is there any blackening of the skin like the Alma 2940 pixel or flaking with 3 days social downtime like the Pearl. Are patients tolerable of the Profractional XC in combination with the ZImmer or do you also suggest some topical anaesthetic ? Would you see some difference on the superficial and deep scars at every sitting of the profractional xc ? Multiple sittings is not an issue generally with clients, but results are of importance .

I would also like to know of the Sciton ND Yag. Can it be used for rejuvenation like the Cutera Genesis. i.e. settings like 18J / 5mm Spot Size and 8 Hz Speed with 0.3 msec pulse width continuously for 5000 -6000 pulses ? Is there any user who has used both the Cutera and the Sciton ND Yag for hair removal on Type IV and V patients and can compare results ?

AVK209,

Cutera ND:YAG 1064 is worthless for skin rejuvenation (Laser Genesis). It works well for veins and hair in African-Americans (dark, thick hair). In my opinion, the best laser for hair removal in Indians is the Lumenis LightSheer. Check this laser out if you are in India.