Medical Laser Blog - Fotona Straight Talk for the Physician

Acne Laser Treatment System…Because Acne is More Than Skin Deep.

Acne is a common problem not just of teens but of adults as well.  Acne scars the skin but often leaves lasting emotional scars as well.  Many companies sell laser acne treatment systems that require 8 to 10 treatments with what I would consider marginal results.  In my office we treat acne in a single session with NO down time.  Unlike photodynamic therapy or IPL that leave the acne sufferer red, swollen and in pain, our patients leave our office with no sign of treatment and in just a few hours they see results.

How can this be?   Our acne laser treatment equipment is a Variable Square pulse Nd:YAG laser with flat top optics and a computer controlled scanner.  The inflamed tissue of the acne is a great target for the Nd:YAG energy.  It heats the tissue and sterilizes the follicles and pores.  This results in the clearing of acne bacteria and reduction of the inflammation and edema common in acne.  The result is improved skin in hours to a few days.

There is no perfect treatment for acne and we have our failures with the laser.  In those cases we look at hormonal triggers and food sensitivities.  It is rare that the laser is not helpful.  It is common that it is a great value.  If we do not see results in one or two scans we will look into other confounding factors such as those noted above.  Once those are addressed the laser will generally clear the acne quickly.  See for yourself the life-changing results.

Nd:YAG Laser Equipment and the Pepperoni Pizza

There is an idea in Aesthetic medicine that an Nd:YAG is an Nd:YAG.  That is about as true as saying all pepperoni pizzas are the same.  Sure the pepperoni may be the same, but what about the crust? Is it thin or pan…what about the cheese…the sauce, etc. You get the idea.

The wavelength is an important part of the Nd:YAG laser equipment selection process, but the truth is there are several wavelengths that can generally accomplish a single goal.  Many companies will use a second or third harmonic of a laser, shifting its wavelength a few nm and create a new story about this new unique proprietary laser.  Don’t be fooled, that is just marketing.  Take a look at any absorption curve.  The curves are continuous and generally smooth.  A few nm is not the clinical difference. Control of the laser technology is.

I have already posted on Calibration.  Another differentiating issue is how the Nd:YAG laser energy is turned on and off.  The technical term is attack and decay.  The natural attack and decay of a laser discharge is a bell shaped curved, known as Gaussian.  This results in the peak power being significantly different than the average power.  This can mean that if you choose 60 Flu on your control panel, that will be the average power, but your peak may be 100 Flu or more.  Another issue is flat top optics.  Remember as a kid using a magnifying glass to burn paper?  The center of the spot was hot and the edges cooler.  If the optics of your laser are like that, as many are, the center of the spot will be hot.

Fotona uses VSP technology to create square pulses, not Gaussian.  The square pulse makes the peak and average power nearly the same.  The Fotona optics result in a flat beam…without hot spots.

So why should you care?  The more precisely the beam is delivered, the more aggressive you can be with your treatments without concern for side effects from suboptimal beam profile.  This translates into outcomes and comfort.  Not just comfort for your patients but comfortable sleep for you.  Don’t just trust me, look at what other users have to say: Fotona Doctor Testimonials.

Aesthetic Laser Equipment and Calibration: It Will Make or Break You.

What is calibration and why is it important?  Calibration is simply making sure that the parameters you select on your laser is what comes out of the end of the laser.  That seems like a no brainer…and with Fotona it is.  Our aesthetic lasers are calibrated with each pulse - automatically.  Most aesthetic laser equipment systems require that you manually calibrate them.  This means it may or may not get done, depending on the technician. Generally, manual calibration requires the technician or operator to set up the device and aim the handpiece into a special calibration port.  That is all fine, but it only happens at the beginning of the day or perhaps at the beginning of a treatment.  The problem is that lasers and IPL’s get hot.  When they get hot the parameters of the device change, requiring a recalibration.  So 10 min into a procedure you need to recalibrate.  Are you really going to stop and recalibrate? I didn’t think so….
 
Not only are Fotona lasers automatically calibrated with each pulse, but three separate sensors do the checking.  These sensors must all agree, or you get an error message.  I have been told that there is an error message but have not seen it, because Fotona lasers are among the most reliable on the planet.
 
What do you want in a cosmetic laser system?  Well I want one that turns on when I throw the switch, puts out the power and parameters I ask for and is safe and effective to use.  All without me having to think about it.  That is the perfect description of a Fotona laser. Choose Fotona and you choose perfection.

Laser Medicine Training - From Novice to Laser Expert

We routinely train Physicians and their staff to give expert level laser treatments in a single day.  Our initial laser medicine training may not qualify them as laser experts, that will take a little more reading, study and experience.  But the delivery of expert level treatments, that we certainly can teach in a single day.  Also in that training day, physicians and staff are given the tools to truly become an expert.  Our training is top of the line, provided by operators in clinical practice.  Generally the training is in your office.  The reasons for that are many, but the main reason is so you that are comfortable with your laser equipment, in your laser room and with your stuff.

It may seem like a tall order to have you providing expert level treatments in a single day, but it really is not.  First, how one determines a treatment parameter is really simple and logical, plus we write it down for you.  Next, we don’t start with the “settings” we start with basic laser physics.  Don’t get frightened; it is basic and common sense type stuff.  Once you understand the basics, the selection of treatment protocols will be second nature.  By the end of any training day, our trainers are sitting in the corner of the treatment room and observing while the trainees are excitedly selecting the correct treatment settings.

That is the beauty of high laser technology.  When the technology is right, it is transparent to the operator.  Our computer controlled interface is easy to operate and intuitive in design… for expert level treatments in a single day.

If ever in doubt, we provide ongoing phone support.  You are never alone with Fotona.

Fractional Laser System - Not a One Trick Pony

Our aesthetic laser practice is in a small town 90 west of the Twin Cities (that’s Minneapolis and St Paul, MN).  You need to understand, for 80 of those miles you will see nothing but farmland.  To give you a better picture, this is how small our town is.  One day at the local dinner the special was a Philly sandwich.  I ordered it and ask if they could bring some Au jus. The answer was "yes."  Great, we are up town, I thought.  When lunch arrived I got a Philly and a glass of orange juice!  That’s a small town!
 
Despite the 80 miles of farmlands and the lack of culinary acumen, we routinely get people from the Twin Cities at our clinic.  You can find lots of those fractional systems in the cities, so why are they coming to our clinic?  We don’t have a one trick pony. 

We have a Fotona Er:YAG laser.  With our laser we can do everything from laser microdermabration to papillary dermis peels with or without fractionation.  We can also do Smooth mode, a more precise plasma like treatment, also with or without fractionation… and everything in between.  So rather than fitting the patient to the treatment we have, we fit the treatment to the needs of the  patient.
 
When a new patient comes to our office they get a complete consult for free.  They will understand the option and the various levels of outcome.  If they need a no down time treatment, we can arrange it.  If they want the 10 years younger in 10 days we can do that also.  Most importantly, we fit the treatment to the patient not the other way around.
 
 
“If the only tool you have is a hammer, you tend to see every problem as a nail.”
Abraham Maslow

For a Medical Laser Company - Wouldn't You Choose Perfection?

Choose Perfection

This is the tag line of the medical laser company, Fotona.  "Choose Perfection."  Further they state: “Best Made Laser Systems in the World.”  I have occasion to speak with laser repair techs all over the US.  They are factory trained on Fotona systems and they tell me that Fotona lasers require less maintenance than any other laser they service.  In fact, one told me Fotona lasers are great but that “I would not want to rely on them for my income as I rarely get calls on them.”

Why is that?  Just back from the Fotona factory in Europe and I can tell you that they live in a culture of excellence.  Every place you turn there is a PhD or Engineer working on an R&D project.  They have grad students (PhD candidates) working under the guidance of the Fotona staff and professors from the local universities using their labs for data collection.  Many areas more closely resemble a university research lab than a manufacturing plant.

Over on the manufacturing side they have state-of-the-art C&C machines.  These are computer-controlled robots that make parts to extremely fine tolerances.  The lasers themselves are not built on an assembly line but rather, are hand-crafted by skilled workers, each taking personal responsibility and more importantly, pride in their product.

So what is my experience as a Fotona owner and user?  Well, I have broken a few fibers over the years.  That was my fault.  I have burned a few protective windows and have replaced flash lamps.  All of these are consumable products.  The handpieces are not disposable - in fact most are made of titanium or stainless steel, not plastic.  Generally we are told, “everything is in spec.”  Of course Fotona lasers are just machines and so they do occasionally have problems, but we are told by our techs that the rate is very low compared to the other companies.

Fotona.  Choose Perfection.

Spider vein treatments - why provide them in your office

Spider veins are a common concern.  Almost everyone over 50 has them.  Many people are embarrassed by them.  Some even alter their behavior because of them.  And yet they are simple, safe and fun to treat.  People often tell me they no longer wear shorts or go to the pool or beach due to their spider veins.
 
Spider veins, also called telangiectasia, are small dilated blood vessels near the surface of the skin or mucous membranes.  They are generally 0.1 to 1mm in diameter.  Women are affected about 4 to 1 over men. Pregnancy is a key factor contributing to the formation of spider veins. The most important factor is circulating hormones that weaken vein walls. There's also a significant increase in the blood volume during pregnancy, which tends to distend veins. Moreover, later in pregnancy, the enlarged uterus can compress veins, causing higher vein pressure leading to dilated veins.
 
With the right technology, spider veins on the face, legs or other part of the body can be effectively treated with laser.  Generally spider veins are treated in just one or two sessions with excellent results.
 
So why should you be treating them?  Because they are common in the patients already in your practice.  Your patients want them gone, and are going elsewhere to have that done. Treatment is easy with the right technology. In addition this is generally not “one more thing” for you to do.  This is a procedure you can delegate to a staff member.  So while you are doing your regular clinic, a nurse is doing these cash procedures.  How much cash? In my practice it is about $800 per hour.

 

 

 

Aesthetic Laser Equipment for Sale

All next week Robin and I (that's us below) will be in Slovenia at the Fotona plant where they manufacture our aesthetic laser equipment.  We will be working with R & D as well as the Sales departments to bring the next generation of Aesthetic Lasers to market.  Fotona's tag line is Choose Perfection.  Fotona is not a market driven company, it is a physics and engineering driven company.  Fotona has one of the largest technical staffs of any laser company and has been in business since 1964.  The laser was invented in 1960!  Fotona is a wild place.  They have grad students from the local university working in the Fotona R&D facility looking into the next great thing.  The most interesting thing to me is that they investigate most every thing that you may have seen or heard about in the laser world... Everything.  You may notice that Fotona does not come out with all of the gadgets and gizmos that other companies have.  Because they are physics and engineering centered, if it isn't real, they don't market it... Makes you wonder doesn't it? 

Once, in a meeting with a number of engineers and physicists they broke into Slovene to discus a technical point I was raising.  They kept saying "bolje, bolje."  The discussion was rather energetic and I thought they were saying bull sh**.  I asked what the bull sh** was about and they laughed.  Bolje means better.  Since that time I have realized that Fotona is the No Bull Sh**, only Bolje (better) company.

Stay tuned for more from the Fotona plant in Ljubljana, Slovenia.