Latest / The Science of Skin / The Evolution of Fractionated Lasers: Fraxel, FTX & Clear + Brilliant with Dr. Rishi Chopra

Transcript

The Evolution of Fractionated Lasers: Fraxel, FTX & Clear + Brilliant with Dr. Rishi Chopra · The Science of Skin

• 0:00
  SPEAKER_02: This episode is sponsored by Stolta Medical, and Dr.
• 0:03
  SPEAKER_02: Chopra has been compensated by them for participating.
• 0:06
  SPEAKER_02: At Solta Medical, we provide a portfolio of aesthetic systems designed to support patients at every stage of their beauty journey.
• 0:14
  SPEAKER_02: From early intervention and ongoing maintenance to rejuvenation, skin tightening, and contouring, they're with you every step of the way.
• 0:22
  SPEAKER_02: Solta Medical is more than a technology provider.
• 0:25
  SPEAKER_02: They are an experienced, clinically validated partner committed to supporting your growth and your patients' outcomes.
• 0:40
  SPEAKER_00: Hi, I'm Dr.
• 0:41
  SPEAKER_00: Patty Ferris.
• 0:42
  SPEAKER_00: I'm a board-certified dermatologist, and I'm your host for this episode of the Science of Skin Podcast.
• 0:48
  SPEAKER_00: I have an incredible guest today that I'm super excited to speak to, Dr.
• 0:52
  SPEAKER_00: Rishi Chopra.
• 0:54
  SPEAKER_00: I'm going to talk about his accomplishments because they are many.
• 0:57
  SPEAKER_00: He's a fellowship-trained board-certified cosmetic dermatologist, practices at Union Durham in New York City.
• 1:04
  SPEAKER_00: He completed an advanced fellowship training in laser and dermatologic surgery at Harvard Medical and the Massachusetts General Hospital Wellman Center for Photomedicine, which is without a doubt one of the world's leading centers for laser medicine.
• 1:19
  SPEAKER_00: He's internationally known for his expertise in injectables, energy-based devices, and treating patients with skin of color.
• 1:25
  SPEAKER_00: He serves on the faculty at all of the same meetings I'm at, so I don't know why we're not seeing each other more.
• 1:30
  SPEAKER_00: American Academy of Dermatology, American Society for Derm Surgery, and Aslums.
• 1:35
  SPEAKER_00: He's authored 30 peer-reviewed publications and serves as an advisor to lots of companies in the aesthetic, skin care, and beauty industry.
• 1:43
  SPEAKER_00: I've also seen him quoted in the media where he's been featured in the New York Times, CNN, Times, Forbes, Cosmopolitan, and lots of other major outlets.
• 1:51
  SPEAKER_00: So welcome, Dr.
• 1:52
  SPEAKER_00: Shopra.
• 1:54
  SPEAKER_03: Thank you for having me, Dr.
• 1:55
  SPEAKER_03: Ferris.
• 1:56
  SPEAKER_03: That was that was way too amazing of an introduction.
• 1:58
  SPEAKER_03: And I appreciate you having me on to talk about one of my favorite subjects, uh, which I nerd out about every day.
• 2:06
  SPEAKER_03: And it's just an honor to be here.
• 2:07
  SPEAKER_00: Thank you.
• 2:08
  SPEAKER_00: Well, I'm going to sort of start at the basics because, you know, we have a pretty broad audience, and some of them, I'm sure, are super laser uh tech savvy, and probably many that are not as knowledgeable.
• 2:22
  SPEAKER_00: So talk about the innovation that really occurred with fractionated laser resurfacing and why this was such a game changer for us as dermatologists.
• 2:31
  SPEAKER_03: Yeah, so frack we you know, we have fractionated lasers all around us.
• 2:35
  SPEAKER_03: They exist kind of everywhere, the pervasive and you know, almost every aesthetic practice nowadays.
• 2:40
  SPEAKER_03: And it wasn't always that case, right?
• 2:42
  SPEAKER_03: So the way lasers developed is we never had these fractionated types of lasers.
• 2:48
  SPEAKER_03: We had full surface ablative resurfacing, where you know essentially these lasers kind of removed the top layer of the skin completely, and it required you know, intense healing time.
• 2:59
  SPEAKER_03: Um, it was painful, there was often complications associated with it.
• 3:02
  SPEAKER_03: It wasn't a very practical way to um um do require to do minimally invasive or uh moderate downtime treatments, and you know, for a patient to go through with that, that was like once a year at most, right?
• 3:17
  SPEAKER_03: So, and we remember those days.
• 3:18
  SPEAKER_03: So that was kind of like the 1990s.
• 3:21
  SPEAKER_03: We, you know, that was like fully ablative resurfacing.
• 3:23
  SPEAKER_03: We had CO2, we had these Airbnb lasers, and then uh we had this really awesome um development, and it, you know, I love to talk about it because it was out of you know, my institution, Mass General, um, Dr.
• 3:37
  SPEAKER_03: Rox, Dr.
• 3:38
  SPEAKER_03: Rox Anderson and Dieter Manstein.
• 3:40
  SPEAKER_03: Um, they published an awesome paper in 2004.
• 3:42
  SPEAKER_03: It's called fractionated photothermalysisis.
• 3:45
  SPEAKER_03: And this concept was developed where we didn't have to completely blow up the top layer of the skin to cause rejuvenation of the skin or repair the skin, right?
• 3:52
  SPEAKER_03: So by instead treating a certain percentage of the skin and going deeper into the skin with either non-ablative or ablative resurfacing, um, we were able to not uh to remodel the tissue without vaporizing and removing the tissue and cause a almost a regenerative reaction underneath the surface of the skin.
• 4:10
  SPEAKER_03: So you had much less downtime, much less painful, much less tolerable for patients, um, you know, uh, and then still got significant improvement um over time as the skin started to regenerate.
• 4:20
  SPEAKER_03: So we see these lasers all around us and a lot of popular names of lasers that we we come to know and love.
• 4:27
  SPEAKER_03: And uh we've kind of moved away from that whole ablative resurfacing.
• 4:31
  SPEAKER_03: Now we still do it here and there, but it's definitely not the uh mode that we we we choose for most of my of our patients nowadays.
• 4:38
  SPEAKER_00: Yeah, and that's such a good explanation.
• 4:40
  SPEAKER_00: I knew you would be, you know, able to distill it down because that's exactly right.
• 4:45
  SPEAKER_00: And it also opened up, I think, our ability to treat more skin types, more Fitzpatrick photo skin types.
• 4:51
  SPEAKER_00: So that's a was another plus that we saw with that innovation.
• 4:55
  SPEAKER_00: Um, going into fraxal for a little bit, and this has certainly been one of the most popular and the most valued of the fractionated laser systems, let's say.
• 5:06
  SPEAKER_00: And I remember when the Restore first came out, and then they had the dual not too long after that, and now we have the FTX.
• 5:14
  SPEAKER_00: So kind of walk us through that uh that progression and what did they add as they moved along?
• 5:21
  SPEAKER_03: Yeah, so I I think that most of the developments in this field have come from an unmet need, right?
• 5:26
  SPEAKER_03: So when we had our ablative resurfacing, it was fantastic.
• 5:29
  SPEAKER_03: We wanted to repair tissue, but as we uh become more and more nuanced in this in this arena of lasers, energy-based devices, and aesthetics, we realized we can kind of do more and more without completely removing tissue, right?
• 5:43
  SPEAKER_03: And so non-ablative was developed to kind of you know remodel the skin without removing the surface of the skin, fractionated because we wanted less downtime with treatments, we want to be able to treat potentially skin of color, um, reduce complication risk.
• 5:56
  SPEAKER_03: And so um similarly, our devices have gone through um kind of this progression where they become uh more acceptable to use, less downtime overall, kind of um focusing on certain areas to become more targeted in the skin.
• 6:11
  SPEAKER_03: And so, for example, for the restore, with this is a 15-50 nanometer wavelength, we're targeted, targeting water in the tissue, but we're targeting deeper into the tissue, right?
• 6:19
  SPEAKER_03: So we're getting into that mid-dermis, about you know, sometimes even get up to 1.4 millimeters into the skin.
• 6:26
  SPEAKER_03: And by creating these fractionated columns deeper in the skin, we're remodeling tissues and deeper wrinkles, acne scars.
• 6:33
  SPEAKER_03: Um, you know, we don't have to necessarily remove the top layer of the tissue to go deep.
• 6:36
  SPEAKER_03: And that was kind of an innovative concept with the fraxal restore.
• 6:40
  SPEAKER_03: Um the fraxal, the next fraxal, the fraxal dual that was developed, incorporated another wavelength, right?
• 6:45
  SPEAKER_03: The 1927 nanometer wavelength.
• 6:47
  SPEAKER_03: I think of the 1550 and 1927 kind of like, you know, they're they're two Ps in a pod, and you know, they both, with both, you can kind of do a lot.
• 6:55
  SPEAKER_03: Uh, one, the 1550 goes deeper, and 1927 goes way more superficial because it has much more um affinity for water.
• 7:03
  SPEAKER_03: And so we were between these two with different wavelengths, so with the dual, we were able to not just treat deep, but also treat superficially at that derboepidermal junction to help resurface the top layer of skin.
• 7:14
  SPEAKER_03: I almost call it almost like a sub-ablative laser because it's kind of popping up these little, you know, little, I call them little manhole covers of epidermis around the skin to help regenerate almost like you're sub, uh, almost like you're an ablative laser.
• 7:27
  SPEAKER_03: And for this laser, this focuses more on kind of pigment, photo damage, superficial qualities of the skin that we weren't necessarily targeting with our deeper lasers with the 1550, and almost kind of like we're doing an ablative resurfacing, but but not with the downtime and and the complication riffness associated with that.
• 7:44
  SPEAKER_03: Um, with the new development of the FTX, um remember these were these lasers were kind of developed in the in the 2000s.
• 7:51
  SPEAKER_03: Um, with the FTX, this was launched, I think, last year.
• 7:55
  SPEAKER_03: It's it's I I always say the Frax the Fraxel Duel was a workhorse of a practice, and it's been in our practice almost for 20 years, right?
• 8:02
  SPEAKER_03: We haven't switched that.
• 8:03
  SPEAKER_03: I was pretty sure it used to be a white laser, now it's kind of yellow, it's probably accumulated a little bit of the epidermis of some of my patients.
• 8:11
  SPEAKER_03: And so um we for me, I never even thought that an innovation was needed um for the fraxal duel because it works so well.
• 8:19
  SPEAKER_03: And so when when um Salta launched at Fraxel FTX, um, I was really kind of surprised at kind of you know how you know you don't really need to mess with a good thing.
• 8:28
  SPEAKER_03: They messed with it in a really good way.
• 8:30
  SPEAKER_03: What we found with the older Fraxel kind of unwieldy, harder to use.
• 8:34
  SPEAKER_03: It was for a different period of time.
• 8:35
  SPEAKER_03: Um the user interface wasn't as as um you know, as um you weren't able to interface with it as quickly and as efficiently as you are with the newer models like an iPad or an iPhone.
• 8:46
  SPEAKER_03: Um, and so they really kind of upgraded the technology, not just in the laser itself, but also kind of with the with the with the with the whole device.
• 8:54
  SPEAKER_03: And so the way that they've improved upon that is um we need cooling to kind of cool the epidermis and make sure that these treatments are tolerable and safe for patients, especially in skin of color.
• 9:03
  SPEAKER_03: They integrated cooling into the device, they improved the optical tracking.
• 9:07
  SPEAKER_03: Um, one of the issues, and I we call that issues.
• 9:09
  SPEAKER_03: It was such a great device that I am calling this an issue.
• 9:12
  SPEAKER_03: If you ran the fast device, uh the handpiece a little bit fast on the skin, it may not track the way that you wanted it.
• 9:18
  SPEAKER_03: We want to make sure that those that tracking is very precise with the FTX, um, much better tracking overall.
• 9:24
  SPEAKER_03: My patients in my clinic find that it's a lot more tolerable, it's a faster treatment, it's more, it's less painful due to the cooling that's integrated as well.
• 9:32
  SPEAKER_03: And so overall, it's just been a great boost to my practice in being able to kind of treat efficiently as well as making treatments more tolerable for patients.
• 9:40
  SPEAKER_00: So they took a good thing and made it better.
• 9:42
  SPEAKER_00: Yeah, that's amazing.
• 9:44
  SPEAKER_03: That's not always the case, right?
• 9:45
  SPEAKER_03: No, you're 100% right.
• 9:47
  SPEAKER_03: That's not the case.
• 9:48
  SPEAKER_03: Uh um, it's salt has been around for a long time.
• 9:51
  SPEAKER_03: And I fraxel is probably the first laser that I ever learned in residency, and I think it's the first laser that I also really learned to how to use in in fellowship.
• 10:00
  SPEAKER_03: So, I mean, for it to kind of you know be around for so long and and make the improvements that are needed to kind of there was actually nothing else that you could really do to it now that I think about it.
• 10:09
  SPEAKER_03: If I had to think on top of my head, how would I improve the fraxal?
• 10:12
  SPEAKER_03: It was really just came down to ergonomics and just ease of use.
• 10:15
  SPEAKER_00: Yeah, which is exactly what they did with this reiteration.
• 10:17
  SPEAKER_00: It's amazing.
• 10:18
  SPEAKER_00: Yeah, I I had a dual as well and loved that thing.
• 10:22
  SPEAKER_00: It just was an incredible, incredible laser.
• 10:25
  SPEAKER_00: Um, share maybe a case or some particular patient type that you think is really been benefited by this FTX innovation.
• 10:35
  SPEAKER_03: Yeah, so Fraxel has been historically known not to be so fun of a treatment.
• 10:40
  SPEAKER_03: And so we've had to use certain ways to kind of get around that.
• 10:43
  SPEAKER_03: Um, but the FTX has been very tolerable.
• 10:45
  SPEAKER_03: I just had it on myself about two weeks ago because I can personally speak to the differences um firsthand compared to the dual.
• 10:52
  SPEAKER_03: But um when it comes to treating with the Fraxal Dual and now the FTX, um, where this really shines is the ability to eat treat both kind of the collagen deep within the skin, the dermis within the skin, as well as the superficial qualities of the skin, especially pigment, um, because if you have that dual wavelength.
• 11:09
  SPEAKER_03: And so uh I really love the device for um acne scars and skin of color, and that's actually a focus of mine in my clinic, both uh facial acne scars as well as body acne scars, which can be historically very difficult to treat, especially in skin of color, because you have a risk for hyperpigmentation, um, scarring.
• 11:27
  SPEAKER_03: Uh and so uh I have a patient that had gone through, I think, two courses of acne.
• 11:33
  SPEAKER_03: Um he was of uh Latin descent, I think about like 22, 23 years old, struggling with severe acne scarring on the chest, as well as just um, you know, just severe divots kind of on his chest.
• 11:45
  SPEAKER_03: And the this laser kind of enabled me to treat him in a way that I didn't even know was possible, to be honest.
• 11:51
  SPEAKER_03: I was I when he came in, um I I basically told him that you know there's maybe a 20% chance that we're gonna get him, you know, improved to any discernible degree just because of how severe the acne scars were.
• 12:03
  SPEAKER_03: Um and so we treated him, I think, six sessions over a period of nine or ten months, and he made almost a 100% improvement on all of his shoulder and and and and back acne scars.
• 12:16
  SPEAKER_03: And his chest, the pigment completely improved.
• 12:19
  SPEAKER_03: He has a few divots left over, but like looking at his chest and back now versus then, um, it's incredible what that laser was able to accomplish.
• 12:27
  SPEAKER_03: And it really comes down to the fact that it treats both deep and superficial great and ul skin types, which is really important.
• 12:34
  SPEAKER_03: We know this, especially on the body.
• 12:35
  SPEAKER_03: Very difficult to treat with a laser on the body without causing issues.
• 12:39
  SPEAKER_03: And, you know, I really pushed that laser um in this patient, and he did incredibly well.
• 12:44
  SPEAKER_02: This episode is sponsored by Sulta Medical.
• 12:47
  SPEAKER_02: At Salta Medical, we provide a portfolio of aesthetic systems designed to support patients at every stage of their beauty journey, from early intervention and ongoing maintenance to rejuvenation, skin tightening, and contouring, they're with you every step of the way.
• 13:03
  SPEAKER_02: Saltamical is more than a technology provider.
• 13:06
  SPEAKER_02: They are an experienced, clinically validated partner committed to supporting your growth and your patient's outcomes.
• 13:12
  SPEAKER_00: Kind of playing off the body treatment, which you were so successful with.
• 13:16
  SPEAKER_00: What about treating photo aging on the body?
• 13:19
  SPEAKER_00: You like the FTX for that as well?
• 13:22
  SPEAKER_03: I I love the 1927 for photo aging, face, arms, decolleté.
• 13:28
  SPEAKER_03: Everywhere.
• 13:28
  SPEAKER_03: Everywhere, right?
• 13:29
  SPEAKER_03: You could do it everywhere.
• 13:30
  SPEAKER_03: Yeah, if a patient can tolerate it, you can do it literally everywhere.
• 13:34
  SPEAKER_03: And it I you know, besides the beside, you know, I always get asked kind of um what the difference is between IPL and like a 1927 and the dual for kind of photo aging, because they both treat similarly.
• 13:48
  SPEAKER_03: I always say, like, one's a light, one's a laser, right?
• 13:50
  SPEAKER_03: The IPL is a light at the end of the day, and the laser is a laser at the end of the day.
• 13:54
  SPEAKER_03: And the 1927 not just improves the browns on the surface of the skin, but it goes deeper to remodel the tissue.
• 14:02
  SPEAKER_03: And so you see improvement in texture, not just the pigmentation, you see improvement in just the quality of the skin.
• 14:08
  SPEAKER_03: And that's a regenerative process that you don't really see with those like light, um, strictly light-based technologies.
• 14:14
  SPEAKER_03: So listen, I love it for photo aging not just in you know Caucasian skin.
• 14:18
  SPEAKER_03: Again, they're um uh patients of color also experiencing photoaging just in different ways.
• 14:24
  SPEAKER_03: And it's just a great way to kind of get that off with a very low downtime treatment.
• 14:28
  SPEAKER_03: Remember, we're not fully ablating the surface of the tissue.
• 14:31
  SPEAKER_03: So they have a little bit of bronzing for about you know two to three weeks, and then you see all that pigment.
• 14:35
  SPEAKER_03: It's actually really satisfying to see all that pigment and those years of sun damages kind of roll off.
• 14:40
  SPEAKER_03: I think patients also love it, they freak out for a bit because they're like, oh my god, it looks a little bit darker.
• 14:45
  SPEAKER_03: But again, it's just the process of those little men's coming off very cathartic.
• 14:48
  SPEAKER_00: That's incredible.
• 14:50
  SPEAKER_00: That's incredible.
• 14:51
  SPEAKER_00: Um, I know you also have the clear and brilliant.
• 14:55
  SPEAKER_00: And talk a little bit about this.
• 14:57
  SPEAKER_00: Is another one of our fractionated lasers.
• 15:00
  SPEAKER_00: It's a great device, which again, lots of aesthetic practices have.
• 15:04
  SPEAKER_00: So, how do you how talk about the clear and brilliant touch just a little bit and how you view it, especially as opposed to the FTX, the fraxal FTX?
• 15:14
  SPEAKER_03: Yeah, so uh clear and brilliant is kind of going through this.
• 15:17
  SPEAKER_03: Uh it's crazy on the social media just because I think that a lot of the younger population is learning about lasers and fractionated technologies.
• 15:25
  SPEAKER_03: And you know, this is a low downtime treatment that they can do, even at, you know, a lot of patients maybe you know at younger ages may be kind of anxious about pursuing a more aggressive treatment.
• 15:35
  SPEAKER_03: And so clear and brilliant kind of gives patients that option.
• 15:38
  SPEAKER_03: Um, I when clear and brilliant was first introduced, I really I personally didn't understand.
• 15:44
  SPEAKER_03: I'm like, oh, I'm a laser guy.
• 15:45
  SPEAKER_03: Why would I ever want to reduce the energy or the density on a laser?
• 15:49
  SPEAKER_03: Why wouldn't I want to go full max?
• 15:51
  SPEAKER_03: Um, and what I found is that uh patients, patients want that.
• 15:55
  SPEAKER_03: Patients are looking for a treatment that they can do um routinely for maintenance.
• 16:01
  SPEAKER_03: And listen, with the fraxal FTX, you're able to do that to a certain degree, but it involves uh, you know, a per, I call it more of a procedure, more downtime.
• 16:11
  SPEAKER_03: Um, it's not something that you can just easily kind of work into your workday if you decide on the spot that you want to get some type of resurfacing done.
• 16:18
  SPEAKER_03: And so what the what the what the touch does is it kind of it addressed an unmet need.
• 16:23
  SPEAKER_03: Um younger patients, patients that maybe don't want to address or repair a cosmetic concern, but want to do something a little bit lighter, more rejuvenative, but it it's it's lighter in terms of what it costs them to kind of invest in terms of downtime.
• 16:37
  SPEAKER_03: So it's it's 1927 and a 1440 instead of a 1550 nanometer wavelength.
• 16:42
  SPEAKER_03: It's just powered a little bit differently, so you're putting a little bit less energy, you're not going as deep.
• 16:46
  SPEAKER_03: But then again, that means it's less painful, less downtime.
• 16:49
  SPEAKER_03: And patients were able to incorporate that into their schedule.
• 16:52
  SPEAKER_03: And so I really love that for treating, um, kind of just resurfacing the top layer of the skin.
• 16:57
  SPEAKER_03: Um, it serves similar purposes uh as the fraxal FTX.
• 17:02
  SPEAKER_03: Just think about as something that you know maybe a younger patient or patient with not too many cosmetics concerns would select.
• 17:07
  SPEAKER_03: And it opened up a whole new um avenue to treat skin of color much more safely.
• 17:13
  SPEAKER_03: Let's say the patients were either reluctant or the practitioners are reluctant.
• 17:16
  SPEAKER_03: Um, clear and brilliant touch is uh pretty safe to treat in that patient population.
• 17:20
  SPEAKER_00: So, from a business and sort of a patient care perspective, what advantage do you see in offering both of these resurfacing options?
• 17:30
  SPEAKER_00: Um I think from a business perspective, you kind of hit it.
• 17:34
  SPEAKER_00: And from a uh patient satisfaction, I think it you're right.
• 17:39
  SPEAKER_00: They can bop in, they can get a clear and brilliant, and there's not the downtime.
• 17:46
  SPEAKER_00: So you've got you've got sort of uh what do we we used to call them lunchtime procedures.
• 17:50
  SPEAKER_03: I don't know what they call them anymore, but yeah, lunchtime facials, lunchtime process.
• 17:55
  SPEAKER_00: Yeah, lunchtime facial, yeah.
• 17:57
  SPEAKER_03: Yeah, it it's a it's a great way to bring patients that may be reluctant to do your practice, younger patients.
• 18:03
  SPEAKER_03: It also is a great way to kind of keep patients on a maintenance regimen.
• 18:07
  SPEAKER_03: Let's say they come in for a fractional FTX.
• 18:09
  SPEAKER_03: That next time they want a little bit of brightening or oversurfacing, what are they gonna do?
• 18:13
  SPEAKER_03: They're not gonna necessarily always do another fractional FTX.
• 18:16
  SPEAKER_03: They can now just kind of either maintain the results with the with the clear and brilliant or add to their results over time.
• 18:22
  SPEAKER_03: Um, I found that a lot of my patients, especially, because I remember I treat a lot of skin and color, were like, I've heard lasers cause this, that, and that.
• 18:31
  SPEAKER_03: Very, very concerned that they're gonna have issues.
• 18:33
  SPEAKER_03: Uh the clear and brilliant has been great to help patients kind of get over the hump, be like, hey, let's trust the pro even patients that may need a fraxal um FDX.
• 18:42
  SPEAKER_03: It's a great way for patients to kind of like trial what a laser would feel like and kind of what the treatment would look like the recovery would look like, what the results would look like, and help them kind of trust, build um a rapport with the physician prior to pursuing a more aggressive treatment.
• 18:57
  SPEAKER_03: That's actually been um a very um I it was an unexpected boost uh in terms of kind of how I would use this with this particular device compared to the other devices.
• 19:07
  SPEAKER_03: And so I have a lot of patients that just come in kind of like, hey, I want to try laser, you know, I want to try it.
• 19:12
  SPEAKER_00: Something scary about the first time someone turns a laser on and puts it on your face.
• 19:18
  SPEAKER_00: There's no doubt about it.
• 19:19
  SPEAKER_03: Especially after the horror stories you see on social media sometimes, because you'll see all the bad cases, but like the you know, the good ones are the ones that you don't necessarily that you can't even recognize because their skin looks great.
• 19:29
  SPEAKER_03: You know, you never knew they had a laser.
• 19:31
  SPEAKER_03: I said the best work is that you can't detect, right?
• 19:34
  SPEAKER_00: Yes, it's so true.
• 19:36
  SPEAKER_00: Well, this has been so knowledgeable.
• 19:38
  SPEAKER_00: I love this discussion.
• 19:40
  SPEAKER_00: Very practical, great practical advice.
• 19:42
  SPEAKER_00: Hopefully, clinicians will understand that both of these devices have got a place in the clinical practice.
• 19:50
  SPEAKER_00: I love the point you make about keeping the patients engaged, giving them an entry point, which is really important.
• 19:56
  SPEAKER_00: But then you can keep them engaged, you know, with touch-up treatments and and the like with uh using the clear and brilliant.
• 20:03
  SPEAKER_00: Just uh, you know, again, uh thank you so much for such great clinical information and things that I think are relevant.
• 20:09
  SPEAKER_00: So I hope everybody's enjoyed this episode.
• 20:11
  SPEAKER_00: I want to thank Salta for bringing this incredible guest to my podcast episode today.
• 20:18
  SPEAKER_00: And for those of you who are out there listening, I hope you enjoyed it and tune in again to the Science of Skin podcast.
• 20:24
  SPEAKER_00: Dr.
• 20:24
  SPEAKER_00: Schofer, thank you so very much.
• 20:26
  SPEAKER_03: Thank you so much for having me, Dr.
• 20:28
  SPEAKER_03: Ferris.
• 20:38
  SPEAKER_02: This episode was sponsored by Sulta Medical.
• 20:42
  SPEAKER_02: At Sulta Medical, we provide a portfolio of aesthetic systems designed to support patients at every stage of their beauty journey.
• 20:49
  SPEAKER_02: From early intervention and ongoing maintenance to rejuvenation, skin tightening, and contouring, they're with you every step of the way.
• 20:57
  SPEAKER_02: Solta Medical is more than a technology provider.
• 21:00
  SPEAKER_02: They are an experienced, clinically validated partner committed to supporting your growth and your patient's outcomes.
• 21:07
  SPEAKER_01: The Fraxal FTX laser system is indicated for Fraxal 1550 nanometer wavelength is indicated for dermatological procedures requiring the coagulation of soft tissue, skin resurfacing procedures, treatment of dyschromia and cutaneous lesions, such as, but not limited to, lentigose, solar lentigose, actinic keratosis, and melasma, and the treatment of periorbital wrinkles, acne scars, and surgical scars.
• 21:51
  SPEAKER_01: Specifically lantigose, solar lantigose, and affiliates.
• 22:00
  SPEAKER_01: Contraindications Do not use on any patient who is ineligible for general surgery.
• 22:06
  SPEAKER_01: Pre screening should include but not be limited to predisposition to keloid formation or excessive scarring, changes following surgery, skin indentations and textural changes following surgery, systemic steroids, prednisome, dexamethasone, which should be rigorously avoided prior to and throughout the course of treatment, and patients undergoing isotrentinoid acne treatment or with drugs in a similar class.
• 22:38
  SPEAKER_01: Medical judgment should be used when treating patients with a predisposition to postinflammatory hyperpigmentation.
• 22:46
  SPEAKER_01: Warnings and cautions.
• 22:47
  SPEAKER_01: Protective eyewear or goggles should be worn by any patient, operator, and assistant.
• 22:53
  SPEAKER_01: Medical judgment should be used when treating patients with certain medical conditions.
• 22:58
  SPEAKER_01: Improper use of fraxal may cause personal injury or damage to the system.
• 23:04
  SPEAKER_01: Adverse events.
• 23:05
  SPEAKER_01: The following may be associated with fraxyl laser treatment blistering and burns, temporary or permanent skin discoloration, eye injury, infection, keloid formation, prolonged resinus, scarring, delayed wound healing, skin textural changes, and temporary bruising.
• 23:26
  SPEAKER_01: The Fraxal FTX laser system is prescription only.
• 23:31
  SPEAKER_01: See the operator manual for detailed directions, proper use, and full risk and safety information.
• 23:38
  SPEAKER_01: For additional product information see www.fraxel.com forward slash HCP.
• 23:50
  SPEAKER_01: Indication Clear and Brilliant Laser System 1440 nanometer and 1927 nanometer hand pieces is indicated for dermatological procedures requiring the coagulation of soft tissue and general skin resurfacing.
• 24:05
  SPEAKER_01: Important safety information.
• 24:08
  SPEAKER_01: The following contraindications are routine for many laser treatments and may also be associated with non-ablative, clear and brilliant laser system treatments.
• 24:18
  SPEAKER_01: Pre-screening should include, but not be limited to, diagnosis, possibility of actinic keratosis, melasma, rosacea, or other significant skin conditions.
• 24:29
  SPEAKER_01: Examples skin cancer, active infections, cold sores, open wounds, rashes, burns, inflammation, eczema, psoriasis, predisposition to keloid formation or excessive scarring, diagnosis of a condition that may compromise the immune system, such as HIV, lupus, scleroderma, or systemic infections.
• 24:55
  SPEAKER_01: Known sensitivity to light or if photosensitizing agents or medications are being taken.
• 25:12
  SPEAKER_01: Use of retinoids which should be avoided for at least two weeks prior to and during treatment.
• 25:18
  SPEAKER_01: Patients undergoing isotretinoid acne treatment or with drugs in a similar class.
• 25:25
  SPEAKER_01: Whether skin is still recovering from a cosmetic procedure, such as chemical or mechanical peel or laser resurfacing, and whether botulinum toxin injections or derma fillers such as collagen have occurred within the past two weeks.
• 25:42
  SPEAKER_01: Expected responses to treatment include erythema, edema, itching or dryness, increased skin sensitivity, pain or discomfort, and paticia.
• 25:57
  SPEAKER_01: Improper use of clear and brilliant may cause personal injury or damage to the system.
• 26:03
  SPEAKER_01: See the operator manual for detailed directions, proper use and full risk and safety information.
• 26:10
  SPEAKER_01: For additional product information, visit www.clearandbrilliant.com forward slash HCP.
• 26:19
  SPEAKER_01: Caution Federal USA law restricts this device to the sale by or on the order of a physician.