I know phycisians who have owned each of the mfgs. listed and the MedSpas offer(ed) basically the same services. The one that went with Medsurge has been the most successful. I don't know if that speaks well for their equipment or their training. Candela has certainly been around for a long time, but I don't know if that speaks well for their equipment. Some of their technology is arguably outdated as you will see in other comment strings on this site. A friend of mine who owned a Sciton laser didn't really make an effort to properly market the business, and ultimately sold the laser. Hope that helps.

Careful, MedSurge is a distributor of tier two technology. Works ok, good support after, but pricey. Candela and Lumenis actually manufacture the products. Break the cost down and save, careful of the turnkey concept. Lot's of upfront dollars.

Candela was prob the most painful experience I have had with a laser so far... and I just had one pass in the auxiliary.

hi jeff: it's been almost an year since you asked about candela, sciton, and medsurge. What have you discovered? There is a 2 day medsurge course coming up- have you been to anything similar of medsurge and was it worth it? Would you go if someone else paid for you to go? What did you conclude regarding candela? I'm thinking about getting a gentlelase and gentleyag but even their "good price" is pricey.

Hello,

I am in AZ, and the surgeon that I am going to work for is looking in to lasers.
He is looking to start small, and see what kind of business can be generated. I am going to be a big part of the marketing for his office, and I would really like to get advice on the best lasers.
I have met with Candela, Accent XL, Alma, and the Soprano sales reps. For the procedures that we plan to offer, the Accent XL, Soprano, and Alma seemed to be the best, but I don't know if the good doc will spring for this right away. He is relying on me to bring him information, and I don't trust some of these sales reps
Any sugesstions...

Thank you

I am going to tell you to look at Scitan and Palomar. Others will say to look at Cutera but if you have read my previous posts I am not a big fan of Cutera.

Medesthetician: In my opinion, the first step is to decide what procedures the doctor wants to offer. THEN you start looking at equipment. If you survey the general population you will be surprised. Very few people have any idea what the difference is between skin rejuvenation and skin resurfacing, or IPL vs. laser, or even that lasers can do as good a job (or better) than sclero in making unwanted veins - 1 to 4 mm diameter-- disappear, etc. For my money the best value on the market is a good 1064 Nd:YAG laser. With a single box you can do 70% of the most popular med spa procedures safely and effectively.

I'll say this and will openly and upfront admit/declare/state that I'm a rep for a laser company. So therefore, don't believe me as a rep. Believe me as a technical engineer who has a degree in lasers/electro-optics.
How many other reps are out there that are former pillpushers that now sell this equipment, but ultimately know nothing (short of a 3 or 4 day in-company brainwashing... errr, I meant "training course") about their laser? Nearly every single one of them. Which is frustrating for a very technical person who really knows how these things work inside and out. I left the field of scientific lasers for research and gov't defense laser systems to sell medical lasers, thinking I'd be a rockstar. Then I found out how deceitful and unscrupulous the other reps are. Piss-poor integrity and antiquated technology.

Wanna' know how to make a laser rep disappear? Buy their laser, and you'll never see them again.

Cutera=multimilliondollar worldwide marketing and a crappy piece of equipment that will co$t thousands more over time
Palomar = been around and has a solid name with nearly identical equipment as Coterie... look into the patent infringement lawsuit
Sciton = a lot better technology... really my only true competitor, so I must admit my respect for them, but they still have catching up to do. Smart idea about no need for replacement handpieces
Lumenis = disposable handpieces... underpowered
LaserScope = pooooorly managed company that is nearly dead in the water, systems are underpowered and inefficient that overheat regularly
Alma = good luck getting service, and they have low lifetimes on their handpieces. low power results in weak treatments and lots of them resulting in pissed-off patients
Candela = see above re: Cutera and Palomar... they just lost a huge patent lawsuit stealing Palomar's idea like Cutera did, and they try to sell you a new box every step you need to take

But whatever you guys do... DO YOUR HOMEWORK!!!!!! Ask at least 10 other Dr's who own the box you're looking at and DON'T go by the provided paid reference list given to you by the rep!!! (and DON'T believe the rep... we make fat commissions and will sell you anything that you want to hear, as long as you get a laser along with it.)

Pssst - anybody wanna' buy a watch?

Good luck out there.

p.s. - I do not work for any of the above stated companies, but know inside techs at several, and have a working knowledge of most. I will not reveal whom I work for and am not doing this to discredit any of the companies, but rather the poorly informed reps for them.

LaserEngineer

Don't stop there.

The problem is not just the reps but as you clearly state the MDs and DOs as well who are being paid by these companies and push the products but don't realy have an idea of the "happiness" of their patients. Make sure to ask for the PA or RN or esthetican who is running the machine. They will give you the real scoop.

LaserEngineer

Tell me your opinions of Syneron and Cynosure. do you know anything about the MIXTO fractional CO2 laser?

Thanks

Laser Engineer: By the process of elimination can I assume that you are a Cynosure rep? If you are can I tell you that my partner and I have invested over $500,000 in your equipment since 2003 and that it was trash? The resale value was ZERO after just two years, the service contracts were highway robbery and I have lost half a million dollars. I could not be any unhappier with a laser company.

Laser Engineer:
I would be be interested in knowing your opinion on Syneron and their equipment.
And p.s.
just out of curiosity, doesn't it seem like all laaer companies are HQ in Israel? why is that?

Sorry for the delay in getting back to your posts.

Nope, I'm not a rep for Cynosure. They too have disposable/replaceable handparts, meaning a higher cost over time. Have had reports from Dr's in ther offices that they wich they would have looked into a bit more. It's SOOO hard not say "NITWIT!!! I TOLD YOU SOOOO!!!!"
I also find that Doctors often distrust me because they got "taken" by some quick n' slick rep offering a laser that "does all the same things!!" for a lower price. So they buy it, it sucks and now they hate all reps for lasers. I'm SO close to getting off this ferris wheel because of that type of example. I do not want to be lumped in with the fast eddie sales reps of the world.

med spa guy, I'm sorry to hear about your experience. I hate to see this happen, but thanks for posting frequently to this site, becasue it can help the integrity of the industry, one blog at a time.

Betteroffnow,
There does seem to be a lot of laser co.'s headquartered in Isreal. One good guess for this is the low cost of operating from there. Plus, there are a LOT of investors over there that see this industry and its ever-nicreasing $40-50 billllllion per year (and growing) fugures and they want to get in on the game. So they throw down a few million to start a company and in order to keep a watchful eye on the investment dollars, they keep the operations close to home. So think long and hard about this... do you realllly want your weakend dollar to go to support Isreali investors who take their investment dollars and put it into sources you-don't-porbably-wanna'-know-where? But that's really getting into political stuff and the site creator surely wants us to keep it to medical stuff.
The majority of laser companies are in the U.S. in two other areas: Silicon Valley of Notrhern Californina (San Jose/Bay Area)(home of most of the big scientific players and whera allll other laser companies are in some sense, a spinoff of Spectra Physics, the very 1st commercial laser company in the world and of Coherent who used to own Star Medical lasers).
Included in the Bay Area roster are: Cutera, LaserScope, Sciton, Hoya ConBio (now in SoCal, I believe... known mostly only for tattoo laser stuff), Lumenis, Fraxel (made by Reliant Technologies) and a few others.
Most others hail from the East Coast, primarily Massachustes, including: Candela, Palomar, Alma, and several others that escape my breain at the moment. Many Israeli companies have U.S. Main Offices set up in MA or on the East Coast.

Eyelaser,

Yes!!! Everyone should be verrrry wary of any Dr. whos a speaker or presentr for a laser company. That means they are paid for their services. There's another defenition of a 'professional' who gets paid for their services of making oters foeel comfotrable and good. But to keep it cleanm I guess I souldn't go there.
I'll also say this - my company had a speaker that I went to the 2-day seminar and I thought the guy was great. He seemed to be open and not too biased (remember, when one is touting your product in front of others, it's hard to not salivate and be able to see the forest for the trees).
I was going to use him as a reference. That is, until I googled him. Upon further review of the play, he came up as a speaker for two other companies as well. (holding - 10-yard penalty, first down! damn.)
So you see... even *I* was duped!!! (albeit temporarily, mind you)

You've all GOT to do your homework!!!

How can so many doctors be so easily convinced by fluff glossy adslicks and brochures on a $100K+ decision!?!?!?!? ARRRRGH!!!!!
Make the company show you the difference between their equipment ant the others. And tell your friends!!!!!

Fraxel? Read the other prior posts on this site. My opinion? I don't like it. It's a partial treatment that is painful, goes unnecesarily deep into the skin (1.2mm !!! OUCH!!) takes many sessions with moderate results, and costs the patiens lots of collective downtime, tons of money (and your office too, due to many return visits and patient maintenance/handholding).
Compare the before and afters of the Fraxel treatments vs. CO2 peels and Erbium peels. No comparison.
CO2 fractional and Er:YAG fractional treatments (now offered by Sciton) are also overrated. Sciton (most very very likely) added this to their platform in forder to compete in the market. They have far better results with their Er peels.
Cutera offers an Erbium head that is as someone esle posted "...a toycompared to Scitons' Erbium..."
Fotona also offers ErbuimYAG in their laser which is almost a twin of Sciton's.
Everyone's crazy about fraxel and I can't wait for it to just be revealed for what it really is (or isn't) and just go away.

p.s. - I don't offer frectional treatments with the lasers I rep, but that is by NO means whey I do not like fractional lasers. I have a very close friend who got fraxel performed on her face for mild acne pitted scarring. $7K and 8 treatments over 11 months later - NO noticable results. Dissapointment was/is an understatement.
Again, I say - go look at some before/after pics of both from the companies and see for yourself.

LaserEngineer,

Sciton, 6-7 treatments over a one week period - What do you think about that?

Most other Doc's recommend 2-3 treatments with 4-6 wks between ech treatment for my condition and use other machines like the Candela V Beam Pulsed Dye Laser.

Thanks

Lost,

6-7 treatments over a 1 week period for what treatment? Regardless of the treatment, that sounds excessive... the body does not regenerate skin/hair/collogen/etc. that fast.

More parameters to the equation, please.

p.s. - I aplogize for my spelling as well as my rant in the prior message... spellcheck didn't catch ANY of that when cut n' pasted into word to check it, and I was quite surly at the time of the posting.

Sciton machine with YAG 1064, BLU LIGHT & IPL heads

6-7 treatments over 1 week period

Lost,

What are they treating?

These posts are ridiculous. It's very obvious to me that most of these comments are from laser sales reps or physicians who are bought and sold by laser companies. I won all of the Alm products: the Soprano, Accent XL and the Harmony. Alma's service is excellent. They have depot service and respond timely. Their handpieces don't have a short lifetime as someone suggested. Their systems are safe, effective and not over priced. I went to a MedSurge course in the past and investigated their equipment. It is all underpowered. MedSurge prays on non-core physicians who don't know any better and are trying to get into aesthetics.

Dr. P.
I am glad you are happy with your lasers. The best are best. Mercedes are Mercedes and Hyndai's are Hyndai's. These are nonpaid, nonbiased poll across the country .

www.aesthetictrendsandtechnologies.com

2006 Laser & Light Technology Choice Awards™
Recipients & Honorable Mentions - Final Poll
Category Award Company Device
Most Diverse Hair Removal Laser Recipient Cynosure Apogee Elite
All Skin Types Honorable Mention Candela GentleMax
Best Hair Removal Laser Recipient Cutera CoolGlide Excel
Dark Skin Types tie Honorable Mention Candela GentleYAG
tie Honorable Mention Cynosure Acclaim 7000
Best Hair Removal Laser Recipient Candela GentleLase Family
Light Skin Types Honorable Mention Cynosure Apogee 5500
Best Laser for Superficial Recipient Cutera CoolGlide Excel
Leg Veins tie Honorable Mention Candela GentleYAG
tie Honorable Mention Cynosure Acclaim 7000
Best Laser for Facial Recipient Iridex Diolite 532
Telangectasias Honorable Mention Candela Vbeam Aesthetica
Best IPL for Photo Facial Recipient Palomar StarLux
Treatments Honorable Mention Lumenis Quantum SR
Best Laser for Vascular Recipient Cynosure Cynergy III
Malformations Honorable Mention Candela Vbeam
Best Laser for Acne Recipient Sciton Profile
Honorable Mention CoolTouch CT3
Best Non-Laser Device for Acne Recipient Photo Therapeutics OmniLux
Honorable Mention CureLight MultiClear
Best Non-Ablative Laser Recipient CoolTouch CT3
Collagen Remodeling Honorable Mention Cutera Vantage
Best Device for Skin Laxity Recipient Thermage ThermaCool
Honorable Mention Cutera Titan
Best Fractional Technology Recipient Cynosure Affirm
Honorable Mention Reliant Fraxel SR
Best Laser Resurfacing: Er:YAG Recipient Focus Medical NaturaLase Er:YAG
Honorable Mention Sciton Contour
Best Laser Resurfacing CO2 Recipient Lumenis UltraPulse Encore
Most Promising New Aesthetic Recipient Alma Accent XL
Technology Honorable Mention Cynosure SmartLipo
Best IPL Technology for Hair Recipient Palomar StarLux
Removal Honorable Mention Lumenis Quantum HR
Most Affordable IPL Device Recipient Novalis Solaris
Honorable Mention Aesthera Aesthera PPx
Best Tattoo Removal Laser Recipient HOYA ConBio MedLite C6
Honorable Mention Focus Medical NaturaLase QS
Most Diverse Aesthetic Device Recipient Cutera XEO w/ Option Pkg E
Honorable Mention Alma Harmony
Best Customer Service / Support Recipient Syneron
Honorable Mention Candela
Best Stand-Alone Epidermal Recipient Zimmer Cryo 6
Cooling Device Elektromedizin
2006 Laser & Light Technology Choice Awards™
Awards Criteria
Awards Criteria
1 Efficacy
Includes substantial, scientific clinical evidence, and technical specifications.
2 Training
Includes clinical, technical, and marketing.
3 Cost
Incorporates average selling price, value of average warranty provided,
weighted average of disposables, average repair costs not under warranty.
4 Support
Includes clinical, technical, and marketing.
5 Reliability
Includes annual average service incidences, average required
troubleshooting, average downtime of unit.
6 Patient Comfort
Pain Score Range: 1 = Painless 10 = Severe
7 Ease of Use
Includes user interface, ergonomics, portablitiy, and weighted average
treatment(s) speed.
8 Warranty
Includes coverage, length of time, and value.
Aesthetic Trends & Technologies
11622 El Camino Real, Suite 100
San Diego, CA 92130 USA
858.605.0470 telephone
858.605.0469 facsimile
The Laser & Light Technology Choice Awards is a trademark of Aesthetic Trends & Technologies, Inc. www.AestheticTrends.com

One last comment/opinion which IS biased..... smaller companies may have a harder time dealing with lawsuits and patent infringements. ie - alma and their entire line are currently being sued by Lumenis which may put them out. this may not be such a big issue for other larger companies like palamor, cutera, candela, sciton,.... etc.

Dr. P,

I am not sure what posts you are calling ridiculous. I am a physician and have not been bought or so;d by a laser clinic. We are all a product of our experiences. Some have more than others. Some have experience with multiple laser systems and some do not. Some have purchased a single system and are completely invested in that product but do not know all of what is out there. Some of the physicians on here are very knowledgeable about lasers and IPL systems and like some better than others.

I am glad you are happy with your Alma system but it would not work for me. It can not do what I need it to do such as deep resurfacing. I need to be able to do more aggressive treatments than those offered by Alma. So before calling all of the posts ridiculous think about what is stated and learn from others mistakes and insight. And yes, watch out for those glowing posts planted by sales reps.

LH,

They are treating Seb Derm, Rosacea/Dermatitis, Mild Acne Scaring

And eventually treat a surgical scar Candela Fraxel

Been awhile since I posted but I couldn't resist this one. Dr. P should know that his post on "non-paid, non-bias" information is not exactly correct. I thought this is well known but if not you need to know that anything in Aesthetic Trends or Medical Laser Insight etc. are exactly what you say they aren't. If you advertise you get written up in them. The more you advertise the more you get written up. Those awards are based on advertising enticements and advertising dollars. There is a reason that those who "win" the awards happen to have advertisements in that issue or many issues. You can't use these magazines as unbiased references. They are rags and nothing more. Almost all of the write-ups are steered in a company friendly way. You have never seen them talk ill of any technology. Why? Because they want to ruin an advertising opportunity.

Dexter

My reference to Dr. P was incorrect. I was actually addressing mdman's comments. Sorry Dr. P.

I agree with Dexter. You always have to watch what you are reading. In another post I talked about reading the Aesthetic Buyers Guide. I like it because it talks about some of the new technologies coming out but I always read it knowing what the articles are. Everyone of the articles is basically written by the company and is what we call an advertorial. So it is an advertisement acting as an article.

Remember just because it is written in some "magazine" or "journal" does not make it fact. In this industry you have to always take things with a grain of salt.

Has anyone had any experience with an Energist Ultra VPL?

I had all but decided on a Sciton BBL and was recently told about this unit. Any feedback would be appreciated.

What is the best laser to treat Rosacea?

Seb Derm?

Rosacea/Dermatitis?

The best laser to treat Rosacea is the BBL(IPL) by Sciton and even better with combination with 1064nm in the same session.

Lost:
Depending on which skin types you are dealing with. The Candela Smoothbeam is one of the best in treating rosecea. It is a pulsed dye laser

Lost,

The pulsed dye laser is the gold standard for treatment of rosacea but has the difficulty of leaving you with 1 to 2 weeks of purpura (round spots that are purplish). The advantage to what Charry said is that it should work as well but will not have the associated purpura if done correctly.

LH:
you are absolutely correct about that. I treat mostly skin type III and IV. In pulse dye laser, it is very important you understand it well and the machine allows you the ability to adjust the fluency and pulse duration and spot size. O/W you can do much harm to the patients.

pmdoc,

I was thinking about purchasing a used smoothbeam, how well do you think it works for acne?

I have seen multiple videos of people getting laser treatments on the web and most were being treated with the Reliant Fraxel. Does anyone think this suggests Reliant to be superior to other laser equipment? There doesn't seem to be much coverage like there is with Reliant.

My doc is using the Candela V beam 595 in their office and suggested that I be treated with this for acne scaring and the pulse dye for rosacea.

Any comments welcome

lost,

Personally, I think there are better choices for acne scarring than the V beam. They of course are more invasive.

LH,

What do you think is better?

"lost,

Personally, I think there are better choices for acne scarring than the V beam. They of course are more invasive."

I like the Fraxel for younger populations so that you do not have to worry about the hypopigmentation and deep resurfacing using erbium would be my choice in an older patient with wrinkle concerns along with the acne scars.

Can the Pro Fractional cause hypopigmentation? If so, how long before one might see it. Are Er peels as effective?

LH:
Pulse Dye Laser as in Candela VBeam has been known to be very effective in acne treatment, besides rosecea, telangectasia and postop scars

pmdoc,

I was talking about acne scarring. I agree with your comments though. I just think there are better options for acne scars.

LH:
Acne scars are always such tough issue to deal with, especially the shallow type. What is your take on Fraxel??? I only recently used the new second generation Fraxel 1500. For scars, I use about 12-15 J. The machine adjust for the MTZ. I also have the option of selecting for the % treated area, the more % of coverage, the less of MTZ

pmdoc,

I have seen fairly nice results generally 50% plus improvement. I always treat at 20 to 24 joules and 1000 to 1500 mtz per cm2. I tell patients 4 to 6 treatments. I still have the Fraxel 750 and do not see any great advantage to the 1500. I do know of some going 40j with the 1500.

I do 8 passes. How many do you do with that fluency range??

pmdoc,

There is a difference between the Fraxel 750 and the 1500. One difference is that as you stated the 1500 decreases your mtz/cm2 as you increase your joules. With the 750, I only have a choice of 125 or 250mtz/cm2 per pass. So passes with the 1500 are dfferent than with the 750. I generally shoot for 1000 to 1500 mtz/cm2 to get best results. You will have to figure out the equivalent with the Fraxel 1500 as I do not have experience with it.

It sounds the top 3 are the C's Candela, Cutera and Cynasure. I have heard that Cynasure is a "break off of Candela" Anybody know if that's true. Personally, I hate Cutera. I dislike Palomar (ok, the ipl is good), but just not good at hair removal.

MWRN,

I also would add Sciton to that list.

I am considering some type of treatment to even out my skin. At the age of 44 I have sun damage and mild acne scaring, nothing deep. I'm trying to research my best options. I have never had any procedure's done and am fearful of spending a chunk of money and seeing no results or gettin a poor result. I'm looking at Fraxel, but am wondering if I'm shooting a canary with a canon. I would so appreciate any imput from those of you who are far more informed than I.

Thanks

I am an RN with 15 years operating room experience looking to go in to the laser hair removal etc business..I have done alot of reading and I am presently investigating my laser options...this is where the confusion comes in!! Everone says their laser is better than the others and are all quite convincing!!
Can anyone that is practicing out there just tell me (truthfully) what the best laser is out there for hair removal and skin rejuvination?? I would appreciate any and all advice!!!
Thanks.

MTB:
What is your ethnic skin type?? It also depends on how much downtime you can tolerate. For acne scar, you definitely need something strong and ablative which requires some downtime

Cathy:
If you are new to this, I would strongly recommend against hair removal. The financial math won't work out for you. But if you still want to do this (LHR), for Fitz I-III, go with 755nm, for IV-VI: 1064 Nd-YAG. For skin rejuvenation, it depends on the QUALITATIVE and QUANTITATIVE aspects to put it figuratively. The gold standard is full ablative CO2 laser. However this is highly limited by the 2 week downtime, risk of hyperpigmentation in darker skin people, pain and postop wound care. In between that and micky mouse dermabrasion are:
1) IPL: no downtime, good for mostly pigmented spots, rosacea. Good for global treatment not for local treatment due to large handpiece and wide spectrum range of wavelength on emission (polychromatic)
2) Pulse Dye (595nm):very good postop scar reduction, rosacea,telangectasia stria, fine wrinkles and inflammatory acne
3) 1064 Nd-YAG: skin tightening, laser peel with Carbon powder, telangectasia, LHR. This is one the MOST diverse platforms
4) 1320nm: skin tightening, acne scars
5) skin resurfacing: The most effective and efficient skin rejuvenation category but limited by side effects and operator's experiences (short of full ablative CO2):
Erbium 2900's: close to CO2 in clinical effects but no skin tightening effect
Plasma+ RF (Rhytec): very effective but highly operator's dependence due to emission of N2 gas
Fractional 1540, 1550: safe, no downtime. Requires 4-6 treatments, results are decent, no skin tightening
I intentionally left out the skin tightening specific platform since it is another different animal altogether. Did I confuse you more??? Hope not, LOL. It is paramount to learn from someone very experienced in this field.

Please help! I have had Refirm tx's for tightening, but a) they're very painful, and b) they did not cover periorbital area or my nose where I have huge pores now that I'm 56. I am considering the Sciton or Pearl for laser peel and firming. Please...someone tell me which has the most "bang for my buck?" I'm a single mother with two kids in college; I'm already broke! Many thanks for any valuable input. LDH

I need some advice, please.

I had these pale port-wine stain-like marks on my legs. Purplish-pinkish. They were theere when I was born, but they got darker later on - still not as dark as typical port-wine stains, but still, they were visible.

Then I decided to go to a doctor and make them disappear. The first doctor I went to told me that they were a mild case of port-wine stains, so he recommended me to get VPL (A kind of IPL laser). After 5 months and 5 sessions, they did look slightly better, but I moved to Cyprus, so I had to look for another doctor to keep the sessions going.

I went to this doctor, and she told me that they werent port-wine stains, but cofe au lait. So she recommeded this CO2 laser!... And, surprise surprise, my skin was bleeding, weeping, got scabby later on - never picked them!.. They were infected too... And finally, they stopped healing and left me with these even darker red marks on my leg...

Now it has been 2 years since the CO2 laser treatment, and they are still there... I went to another doctor, where she told me that they are not scars, but broken blood vessels... So, again, she recommeded that I go through 6 VPL sessions and Id be fine....

As you can guess, still nothing has happened after 6 months.

So now, after 2 years and a half, I am still suffering from these red port-wine-stain-scarred-red-broken-blood-vessels problem...

Do you have any suggestions?

Thanks in advance...

M.Y

I am helping the doctor i work for look into laser treatment options.
We are looking for something that can do:
striae removal, hair removal, rosacea treatments, and acne treatments.
We want a machine that is reliable, effective, and reasonably priced (I know, it does everything, works perfectly, and is cheap).
Anyway, I was wondering what any recommendations would be for a machine that could cover those procedures in a cost-effective way.
Thanks,
JR