This is a copied post from LH. Not sure what year it was posted:

I currently have the Titan, skin tyte as well as thermage. I originally got the Titan cutera and just added it to the platform. I have had trouble with my staff selling the Titan as they do not feel it works that great so we have been somewhat inconsistant with it. We have seen some fairly good results but nothing great.

I just got the BBLs and the ST was part of the package deal. We hope to see results from it. I also just bought the Thermage unit and hope it works. I will be able to compare these. I wish I could get someone to fund a splitface study as I have the technology. It would be fun to have the head to head comparisons.
05.6 | LH

I am not sure who re-posted my above post but it fits well. I will try to answer some of CHMD's questions.

Part 1: I do not use the Titan any more although I do have about 3000 pulses left on the head. I did do some for free for 1 patient recently. I have tried all of the tricks given to me by Cutera and also some from this site and I feel that the results are minimal at best. About the most you can get the patients to agree with is that they saw an improvement in the skin quality but they did not feel that they have had much tightening.

Comparing the Titan and the Skintyte is easy. The Skintyte wins hands down. It gets a little more difficult once you add Thermage to the picture.

Cost: the Titan costs about 30 to 33 cents per pulse and the Skintyte is 0 cents per pulse. Cutera wants $40,000 for the Titan upgrade. Sciton charges about $15,000 to upgrade your BBL with the Skintyte. If you talk nice to them you can do better than the 15k. Thermage you will pay about $42,000 for the machine and then all of the consumables. Thermage has the biggest cost per treatment.

Pain: the Titan has a very small head and this focuses the pain. The Skintyte has a much larger head and is less uncomfortable even at higher energy settings. That is one advantage to a larger treatment head. Thermage is the most uncomfortable and we pretreat with Hydrocodone and valium.

Charge: Titan I have to charge more to recoup my costs due to the 33 cents per pulse. I do more pulses with the Skintyte and charge about the same. We charge $500 per treatment for a full face. Thermage full face we charge $2150. The patients cost is about the same as we tell the patients that they should plan 3 to 5 treatments with the Titan or the Skintyte. Many patients prefer the one time treatment as we have a lot of patients that travel fairly long distances.

Expectations: I tell absolutely every patient that they may show no results at all. I tell them that the biggest risk is to their pocketbook. Do NOT promise the results of face lift as you will disappoint every single one of them.

Use: Which do I use the most? I had previously focused on the Thermage and now I am doing a little more Skintyte. I have seen pretty good results on the face with Thermage but have not seen the greatest results with the body treatments. My personal feeling is that none of them work that great. They are a good choice for the patient that is starting to get a little laxity and is in her late thirties to her early fifties. The patients that just want to maintain or improve without surgical intervention.

Part 2: No matter which piece of equipment you have you must cause enough thermal damage to the dermis to get results. We always focus on a small are and do multiple passes. You do not want to much time between passes as the goal is to denature some of the proteins in the dermis. This will cause the body to "repair" the area. The body then lays down new collagen etc. I am always looking for visible changes at the time of the treatment. You should see some redness, swelling in the skin and also some visible tightening.

Part 3: I can not help with any of the other equipment.

I have not heard much from pmdoc lately and I hope to visit his clinic when I get to California. He feels he has very nice results with Thermage and from his posts he has some very interesting theories and protocols.

I too have the BBLs and feel the skin tyte is the most cost effective tightening on the market. From my experience we can get about a Thermage -level tightening in 3 good skin-tyte sessions; we also have thermage. Thermage pricing for us has decreased due to competition ($2k-full face) and the occassional discount tip purchase from the manufacturer; we usually throw in a site of Botox to enhance the results.

I use the CoolBreeze 1320 nm painless laser. Without any downtime, it will gradually help with fine lines, thus skin tightening. It works slightly better than an IPL, but without the pain, which is a huge benefit. My patients DO NOT WANT ANY PAIN.

I am hoping a Dr. can advise me, as I am considering skin tightening treatments, however it is my understanding that certain medications could prevent me from having this procedure, due to photosensitivity. I am 55 years old, taking Norvasc for high blood pressure and also Paxil for minor depression. Will I be a good candidate for this treatment?

Does someone have experience with NIR handpiece from alma lasers?

Will you recommend Alma Lasers? Checked their site and found out that they have over 18 different heads to choose from to treat various skin conditions. Not to mention, they also have an option for facial and body contouring/tightening.

Short-pulsed Q-switched lasers "explode" the pigment rather than depending on heating the pigment like long-pulsed lasers or flashlamps. This minimizes scarring and occasional temporary nasty-looking wounds that get patients upset.

I have been using 1550nm laser to tighten skin and remove wrinkles. A beam size of around 50 um from single mode cw 1550nm laser (around 20W) after focusing and then was scanned via steering device (scanner) on the surface of the skin. My patients are extremely pleased with the outcomes.

What does the 10 in 55/50/10 stand for? Do you set the spot size at 10 but use the 12mm guage?