We are behind the times and have not jumped on the "fractional" band wagon. I think we are ready but there are too many out there to choose from! We don't need a multi-platform device as we have most other technologies. Of course, price matters but so do results, safety, etc. Although we've purchased all of our lasers, I'm thinking leasing might be better. I'd love some recommendations!

We have the Palomar Lux1540 handpiece for our StarLux 500 series and LOVE it for stretch marks, scars and facial resurfacing for those patients who want a gradual process. The Lux2940 handpiece also provides great results for 1 step resurfacing.

If you don't have a Palomar base unit and want fractional technology, definitely talk with others in the group like LH who is very experienced and versed in this subject! He helped us tremendously! We ended up adding the Lumenis ActiveFX / DeepFX / TotalFX basically for speed of procedure and tailoring of depth.

I've heard great things about Dot Matrix which is about $30,000. You might want to demo this before spending big bucks on Palomar who will not give you the time of day after they have your money. I have a Pearl Fractionated which does an O.K. job.

It depends on your patient demographics and cosmetic needs. If they are mostly FST I and II, then CO2 is your best bet. If FST III or higher then it is safer to go with Er glass (1500, 1400nm). For Co2 laser, Lutronic eCo2 is good and not too expensive. For Er glass, Lutronic eMatrix, Sells 1500 are reasonable. Fraxel Dual are great for pigmentation and deep scars.

I agree with KDO

Fractional CO2 produces a lot of heat and tend to induce Post inflammatory Hyperpigmentation in Type III and Type IV skin.
Erbium based fractionated laser does not generate heat and is better suited for Type III and Type IV patients. In this economy, I would only consider laser platforms without consumable disposable tips. Fraxel lasers are a tough sale given their pay per use sales scheme. I favor the Sciton profractional over other platforms for all the reasons above

I agree with Kenneth about the Sciton's Er YAG laser.One more think you have to consider is that with the Profractional you can work as if you had a CO2 fractional device or an Er YAG fractional or a 2790nm fractional.You have GREAT flexibility with this platform and without consumables,disposable tips.

SD MD,

The first thing I want to know is what you plan to use it for? Also, what are the primary skin types that you will be treating.

Lornell E. Hansen II, M.D.
www.LazaDerm.com

Is Venus fractional? Can't find the info on their site. If it is, does it have coagulation features on top of its cold ablation?

I am a fan of the Palomar Starlux and the 1540 fractional and have used it for 4 years. I have tried a CO2 fractional system recently called Equinox CO2 fractional laser. And it is a great value for a fractional ablative device. I don't believe the Venus from Iridex is fractional.

I've used the Sciton ProFractional and was not impressed with the results even at aggresive settings. The new ProFractional XC is faster, however I still think Fractional CO2 yields better results. I own the Mixto and am thrilled with it. Treat fitz IV or V with a post hyperpigmentation protocol to reduce risks of hyperpigmentation. The trainer for mixto was great and no consumerables.

I am a fan of the Palomar Starlux....when all is working well. Not when it breaks and trying to find service parts etc. I think Cutera is equally horrible in the category in finding parts and service from 3rd party service organizations. I had a Cutera Xeo platform that broke down 3 times in 2 years and was a challenge to get parts and service.

We mosty are interested in treating scarring, wrinkles and loose crepey skin. Our patient population is a mix - lots of type II but also enough III and IV to want something flexible. We have tested the Sciton Profractional and both Fraxels (repair and restore). I love the Sciton platform but it's very pricey and one profractional tx didn't do much for our test populaiton. According to the rep, a series of treatments needs to be done for optimal results. I was not impressed with the Fraxel restore but the repair gave decent results. Still not sure we want the risk and post-procedure care of fractionated CO2 and while the company was willing to sell us a used Fraxel repair for $60K, the consumables remain an issue.

Any one tried the Mosaic ?

SMARTXIDE LASER ANY ONE GOT ANY INFO ON SETTING FOR SKINTYPE 1/2 TO TREAT WRINKLES ON LIP AREAS OR CAN SOMEONE RECOMMEND DEPTH AND PASSES ,FOUND BASIC BOOK SETTING DO NOT DO ALOT.

WOULD LIKE INFO ON SMARTXIDE DOT LASER ,I WOULD LIKE TO GET A MACHINE THAT WILL HELP ALOT OF LADIES WHO WANT TO IMPROVE THE WRINKLES AND SUN DAMAGE.I HAVE HEARD THIS LASER IS VERY GOOD .CAN ANYONE HELP WITH REGARDS TO A COUPLE OF MACHINES .
ALSO THE RESULTS YOU MIGHT SEE FROM THE SMARTXIDE DOT LLASER .
SKIN 1 AND 2 I BELIEVE ARE GOOD ,WHAT ARE THE DIFFRENT SETTING /DEPTHPASSES TO GET GOOD RESULTS FOR EYE AREA AND SMOKERS LINES

I have used this laser for two years, and it is by far the best lasers that i have used. It gives much better result that some non ablative lasers. It works very well on skin resurfacing , polishing the skin textures and reduce pore sizes. It also works well on some acne scars. I am extremely happy with this laser, but do ask for extended warranty if you decides to buy this laser. The laser seems to drop in power after extended period of time.

The DERMEO MEDIFLASH3 is at the top of the European market for a aesthetic and dermatologic treatments and has been FDA approved for the US. This may be a good introductory IPL for you. Under freedom pricing one has the option to buy the machine under a pay-per-flash option. The only consumable is housed in a small interchangqble carteridge eliminating the need to call in outside service for maintenance. Our warrenty is transferable and DERMEO has no re-certification fees so performs well on the second hand market if need be. See our site at http://www.dermeo.com/EN/produits.html or contact me at leanne.martin@dermeo.com

PLEASE CAN SOMEONE GIVE ME INFOR ON THE SMARTXIDE DOT LASER ,WANTING TO GRT PEOPLES VEIWS ON SETTING OTHER THAN THOSE GIVEN WITH THE MACHINE .SKIN TYPE 1/2.

I also offer fractional laser skin resurfacing with Palomar Lux 1540. This provides minimal epidermal damage and it causes good dermal heating and collagen re-modelling. I've been using this to treat acne scars and wrinkles.

I partially agree with the comments about erbium over CO2; the erbium has less thermal migration so it will cause less unintended damage and a lower chance of PIH. However, that problem has been reduced with the invention of superpulsing the CO2 wavelength. The problem you will encounter with the low priced CO2 fractional lasers is that they are CW (continuous wave) which cannot reach a desirable peak energy in a short period of time, so the energy exposure time must be increased to reach that level, thereby increasing thermal migration and potential for PIH. A superpulsed CO2 delivers higher peak energy in a far shorter period of time, reducing thermal migration. Also, most of the low priced CO2 fractional lasers use glass tubes from China which tend to fail rather quickly; these are usually DC excited and lose their peak energy early on. A superpulsed system with a metal tube that is RF excited is the best technology in terms of a clean beam and longevity. The Venus could be useful if you could find a scanner handset that is convenient to use and easy to adapt to the Venus device. There are "stamp" types of fractional handsets available that will work on the Venus, but the energy output is low on that system so a stamp handset may not deliver the desired results in all situations.