To all - thanks for this great forum! It's nice to see a place online where people can support each other in this area.

I am coming very close to buying my first laser - actually a used IPL. I have to go used, just can't even begin to think about adding the stress of a large risk / expense to my practice. Unlike a lot of folks here (and bear with my way of thinking even if you don't agree) price is the major factor - beyond the system working and making people happy. I'm very conservative and like to pay for things fully and not owe money that is not mine. I'm not a big sales person - I don't know how many of my patients will even end up using my laser! I have a part time practice where I do 95% botox and fillers, and have great word of mouth and happy patients.

I'm looking at a few used models, one is a Palomar StarLux IPL for $20,000 and the other a Luminis Quantum IPL (older) for $10,000. To me, unless the former does double what the other does, and they both are good, it's a no brainer. The Quantum comes with $10,000 attached, relatively. I know it's old and there are new amazing things out there, but can anyone tell me if I can expect good results with the Quantum for what it does (photofacials, spider veins, brown spots)? I realize that it requires a cooling gel on the face and maybe a Zimmer cooler.

To me, paying more now to get a "platform" that I can add to later is like throwing money into a lottery ticket. If I do well with this I'll be able to later afford selling this (hopefully i'll have made my money back) and buying something new that does more.

I'd love any and all advice! Thanks!

Hello Dr K. I would love to offer some advice physician to physician. First please get adequate training there are many courses for doctors some are the ASLMS conf and IPAM. If possible see if you could spend some time at as a " preceptor" learning form another doctor. The class from the laser companies is not adequate. Its important to know tissue interaction, fluences, beam size and its effect on the fluence and the contraindications.

Second the used market is a slippery slope. Laser companies frown on this unless you but from them as a referb unit but it has a year warranty so that's a nice option. The laser companies make it very difficult to repair second hand systems bought outside the co. by not allowing for secondary repairers to buy parts etc so maintaining these systems gest dicey.
There are good aftermarket repairers out there ask some local doctors who they use.

Be careful with " old" equipment, these systems have a life expectancy, one may think oh its IPL it lasts and lasts but no hand pieces go , flash lamps go and they can cost 10-20K when they do so check the pulses on your systems and find out the life expectancy remaining. I have seen lasers offered on ebay that are going to require a 10k repair in the next few patients. IE ( the handpiece fires 10 times and there is 8k on the unit)

As a doctor if you have a complication and believe me the IPL sounds safer than a " laser" but it is very easy to over power tissue creating a burn that you may not notice until 30 min after completing the treatment. Its important to know that your system is up to date, reliable and accurate in its output. It would be a real raking if you end up in a court room and they bring up the fact that the laser was 10 or 12 years of age. They may be fine but it leads to a degree of suspicion.

The palomar is a fantastic system, reliable but $$$ to repair, you can add to that which at this point dosent mean a lot to you but will once you get more involved. Remember every laser is another box to maintain and repair, some maintence contracts are 8-20K a year! So having one box with add ons can be a savings but the add on handpieces often have the guts in them so dropping one can be a catastrophe.

Lumenis is good as well, in my opinion not a good as the other but if very old may break down

The treatment of a used system in imperative, ie: you find that some OB/GYN added laser hair to the practice, it never took off, he couldn't resell the laser so its barely used but in his garage. If this is in the north east the freezing weather could freeze the liquid cooler causing a disaster when you later turn on the system due to bottle rupture and spraying the innards so knowing how the system was treated is important.

All in all you may be better biting the bullet getting a relatively new refurb from the manuf and taking a 3 year loan. If you do get some patients it will begin to pay for itself.

There are times to buy a new system, shows are great the ASLMS has one coming in April they often discount the lasers then, the best time of all is December when they want to close out the year with a bang so you may find a laser they have been pushing at 90-110k go for 65K . If you want to wait a few months it may be worth it, you can even get deals on demos they carry the full warranty as new.

Well I hope this diatribe was of help. Best of luck

GM - Thank you so much for your input. It is so nice to be able to communicate with others who have been through the same decision making process.

I will look at other training then. The company I am buying from (Sentient) is charging me $2,500 for a day of training including didactic, slides, laser info, machine training and sample cases on my patients. I thought that sounded like enough, but more training is always a good thing. :} If anyone here has used them for that training, let me know if it's all it's cracked up to be!

I will definitly check the pulses left on the machine - thank you for the suggestion! If that seems okay I may dip my toe in these waters with the Luminis Quantum. It's a 9 year old laser that they say wasn't used much as was working well when it was sold. The previous doc had 15 lasers so didn't use this one much. If I find that I have a laser practice that grows I very well might go the route you suggest soon, sell this model and upgrade to a newer unit. I'm all for having something great, but I still have a fear that whatever I buy may sit untouched. When I get over that I'll move up!

It sounds like the Quantum still does good things for people, and if I learn to finesse its capabilities I'll still be able to help people with it. For now I think I'm okay with that - as long as it doesn't immediately break after its 30 day warranty. I'll definitly post in the future with my resutls, good or bad, so people can learn from my experience!

One more question - I hear that this is a "self-calibrating" unit and doesn't need to be calibrated when it arrives. That sounds odd to me - does anyone know if this is the case? What if the self-calibrating sensors are off? Is this standard with IPLs instead of lasers?

Thanks again for your help!!

2500 is steep normal about 1500
A lot of us do not realize what is involved in laser or IPL therapy and its very important to really grasp what is happening at the tissue level. There are tolerances and measures of heat dispersal that must be understood to avoid complications such as burns and later scar formation. I recommend you buy the goldman series books of laser and lights its very comprehensive and found on amazon there are several laser and lights, laser therapy, pigment therapy etc. They are packed with information that will definitely get you up to speed.
Ask the reseller if they had the IPL evaluated , calibrated and tested. If not forget it, too much of a crap shoot and BTW I have yet to meet the salesperson who says oh yes this laser is beat to shit, they are all " rarely used" or " bank repo" you must really know. In fact if you find out the serial # call Lumenis they can may give you some numbers that were on the unit the last time it was serviced. Its likely its self calibrated but you sill should have a service q 6 mo with active use. IPL is a much less sophisticated device compared to lasers. Also see what new IPL's go for you may be surprised to find you are paying 20k for a 9 year old one and a new may not be outrageously more and you have new system with a full warranty. If you ae already doing botox the photofacials etc should fit right in.

GM,

Lol, that's pretty funny. It's true, I'm sure there aren't many 100% honest reps out there. Thanks again so much for your advice. I am happiest reading books as they are far more detailed than most lectures, and am ordering the Goldman Lasers and Energy Devices for the Skin now. I tend to be cautious and conservative, so hopefully all will go okay.

This laser addition will be interesting. One nice thing about Botox, fillers and sclerotherapy is that there is no huge investment up front! At least I'm not going to be stuck with a $100,000 machine, but it will remain to be seen how this will play out. The rep told me that if the shot count on each of the 4 handpieces is over 10,000 they replace the bulb and reset it. Oh well. I got very excited about the machine details and pressed the "buy" button, so it will soon be mine, for better or worse. I will definitely send updates and let you all know.

On the bright side, the laser was $9,950. plus $1500 shipping / insurance I could fit it on one credit card payment.

Okay, another question for GM or anyone else out there -

I live in Ohio and have been poring through Ohio and other websites to find specific regualtions for rooms with lasers, eyewear, etc. Obviously I will do the usual postings, eyewear, etc, but I'd love to find state specific guidelines to make sure I'm not leaving anything else out that is required for IPL use. I can't find anything! OSHA doesn't have much either that I can find. I'm assuming there are requirements for annual calibrations and record keeping.

I love this site with definitive requirements, but it's British!
file:///C:/Users/Jon/Downloads/COP_Laser_IPL_Conditions.pdf

I can't even find if there needs to be an appointed "Laser Protection Supervisor" in Ohio. If so it would be me.

Anyone know how to get these details??

Thanks!

Oops - ignore that link in my last post. I realized it was a download, so it's not a valid link.

Yes you can be the supervisor. As I said earlier see if you can get to the ASLMS basics course this April it will cover laser safety.
The IPL is a class II device and thus so technically does not require protective eyewear since its figured that the burst of light will elicit a blink reflex cutting out light to the retina. However this is you sight so I would have good quality lenses specific for the wavelengths your IPL is emitting. Even better there are shields that blink for you with the flash .

Its best to use a room no smaller than 10x10 to avoid overheating the room and in turn shutting down the laser or IPL
Its important to have signage stating what class of instrument you are using and a locking door is nice as well.

Windows are not a big factor in IPL but its best to use windowless rooms, should you go to lasers then make sure you have the windows either covered or a laser blocking coating applied to the glass.

Thanks. It's all very interesting - I just spoke to the Ohio State Medical Board and they have no requirements at all regarding medical lasers! I know they have extensive regulations regarding radiology equipment. Oh well. It's not a problem following what courses say to do for safety, I just am amazed that there is one thing our Medical Board hasn't got its teeth into yet.

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