Transcript Diapositiva 1

Michael J. Tomcik, M.D.
MiXto sx®
Microfractional CO2 Laser
at the Advanced Laser and
Skin Care Center
Michael J. Tomcik, MD
William Ting, MD
WHY CO2
• Gold standard for smoothing, tightening and
resurfacing.
• Ablative > Non-Ablative
• CO2 > Erbium > Near Infrared
• Heats the dermis greater than all other
wavelengths.
Laser
Feature
Mixto SX®
Lasering
Encore®
Lumenis
Pixel®
Alma Laser
Lux 1540
Palomar
Affirm®
Cynosure
Fraxel®
Reliant
Wavelength
10.600 nm
10.600 nm
2940 nm
1540 nm
1440 nm
1550nm
Type of Emission
Continuous\Pulsed
Pulse
Pulse
Pulse
Pulse
Continuous
Beam Spot size
0.3 mm
1.3 mm
0.7 mm
0.2-0.3mm
N.A.
N.A.
Scanned area
20x20 mm
14x14 mm
11x11 mm
10-15 mm
10 mm
N/A
Scanner
Yes
Yes
No
Yes
No
Yes
Mode
Ablative
Ablative
Ablative
Nonablative
Nonablative
Nonablative
1540
1540
1540
CO2
CO2
CO2
Necrosis
Coagulation
Why MiXto sx® Microfractional CO2
• Innovative Computerized Pattern Generator
– Microspot - 300u
– Covers 20% of the surface on each pass
– Algorythm avoids heat build-up
MiXto sx® after 24 hours
Why MiXto sx® Microfractional CO2
• Innovative Computerized Pattern Generator
– Microspot - 300u
– Covers 20% of the surface on each pass
– Algorythm avoids heat build-up
Video
Why MiXto sx® Microfractional CO2
• Price
• Two Year Warranty
• Results
Two Controls
• Depth of heating (sx)
• Tissue ablation (power)
Choosing your settings
• Baseline*- 8 sx, 8 power
• Face* - may do multiple passes
– Acne/Chicken Pox - 6 sx, 11 power
– Tightening - 5 sx, 10 power
• Neck, Décolletage, Hands and Arms* - generally one
pass
– 6 sx, 10 power
*These are only recommended as guidelines, each patient
needs to be evaluated individually.
Benefits of MiXto sx®
• Versatile (Face, Neck, Décolletage, Hands and Arms)
• Easy and fast
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Face (20 – 40 minutes)
Neck (15 - 30 minutes)
Chest (20 – 30 minutes)
Each Hand (10-15 minutes)
• Topical anesthetic
– BLT (20%, 6%, 4%)
• TLC Pharmacy, Hermosa Beach - 310-798-5400
• All skin types
Benefits of MiXto sx® (cont.)
• Minimal Discomfort
– Moderate Sunburn sensation – 30 minutes – 3 hours
– Erythema and Edema – 1 – 3 days
– Tightening and Itching – 7 days
• Minimal Risks for:
– Hypo/Hyper Pigmentation
– Scarring
• Minimal downtime
– Face – 3-6 days
– Neck and Hands – 7-10 Days
– Chest – 10 – 21 Days
Progression Photo’s
Before
Post Op - Day 2
Post Op - Day 3
Post Op - Day 9
Progression #1
BEFORE
DAY 2
DAY 3
DAY 9
Before
Post Op - Day 3
Post Op - Day 6
Post Op - Day 12
Progression #2
BEFORE
DAY 3
DAY 6
DAY12
Before
Post Op – 10 Minutes
Post Op - 24 Hours
Post Op - 3 Days
Post Op - 8 Days
Progression #3
Progression #4
Type III – 52 Yrs – Face 2 Passes (Sx 6/Pwr 10)
Neck 1 Pass (Sx 6/Pwr 10)
6 Days – Post Op
30 Days – Post Op
Before/After Photo’s
Before/After Photo’s
Type II – 2 passes
Sx 6/Pwr 10
Before/After Photo’s
Type II – 36 Yrs. – 2 passes
Sx 6/Pwr 10
Before/After Photo’s
Type IV – 44 Yrs – 3 Passes
Sx 6/Pwr 10
Before/After Photo’s
Type I – 56 Yrs. – 2 Passes
Sx 6/Pwr 10
Before/After Photo’s
Type IV – 58 Yrs. – 3-4 Passes
Sx 6/Pwr 10
Patient Selection
1. Realistic Expectations
2. Medical History
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Herpes Simplex
Keloids
Pregnant/Breast Feeding
Accutane within 12 months
Committed to Sunscreen – 45 or higher
Pre-Operative
• No Asprin or Anti-Inflamatory Drugs – 3 days
prior/post
• Famvir – 500 mg – T.I.D. – 10 days
• Keflex – 500 mg – T.I.D. – 7 days
• TriLuma Cream – 4 weeks prior to treatment
every second to third day for skin types II, III, IV.
Post-Op
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Immediate
– Hydrating Gel (Cicalfate - Avene, Aloe Vera Gel, etc.)
– Sunscreen - SPF 45 or higher
– Fan
7 Days
– Hydrate – Luke Warm Shower – 5 X a day
– Lubricate
• Elta M.D.
• Aquaphor
– Sunscreen - SPF 45 or higher
General
– No financial decisions for 24 hours
– Avoid Sun Exposure
• Sunscreen, Broad Brim Hat, Scarf
– Avoid Strenuous Exercise 3 – 7 days
– Call office for any pain greater than a mild sunburn
Physician Recommendations
• Proceed cautiously
• Use Eye Protection
• Be less aggressive on neck, chest, hands,
arms
• Gradually increase power
• Gradually decrease SX
• Remember – Ablative lasers CAN scar