MedEsthetics magazines offers business education and in-depth coverage of the latest noninvasive cosmetic procedures for physicians and practice managers working in the medical aesthetics industry.
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platform. The platform uti- lizes lasers that are actually contained in the handpieces enabling delivery of 1064nm and 532nm laser ener- gy. Switching wavelengths is as easy as connecting another handpiece," says Dr. Bern- stein. The device's long-pulse 755nm wavelength is viewed as a bonus as it allows practi- tioners to comfortably treat a greater variety of pigmented lesions without unwanted pigment changes." Alma Lasers (almalasers.com) Harmony offers a Q-switched Nd:YAG laser for treatment of darker skin types and darker ink colors, such as black and red. "The Medley laser platform (Ellman International, ell- man.com) combines a Q-switched Nd:YAG laser with an Er:YAG laser and an IPL," says Dr. Bernstein. "This system offers a variety of treatment options in a single unit. And the Q Plus C laser (Quanta Aesthetic Lasers, qantausa.com) is the only laser system on the market offering the combination of a Q-switched ruby and Nd:YAG laser in one box." According to Dr. Chasin, "Q-switched lasers remain the best and most versatile technology for removing tat- toos. They are reliable, powerful and have a large spot size that allows the energy to penetrate to a greater depth, making for safer and more effective treatment. The picosecond laser is emerging, and it certainly shows promise, but the big price tag and small spot size still make Q-switched lasers the smarter choice." Dr. Chasin uses three different lasers for tattoo re- moval; the Alex TriVantage, the RevLite (Cynosure/ ConBio, cynosure.com) and the Sinon Ruby (Quan- tel Derma, quantel-derma.com). "Each offers unique wavelengths that are better at treating different colors of ink and skin types. Having a selection of lasers allows us to treat just about any tattoo safely and effectively," he says. "We also use ablative and non-ablative lasers, like the Fraxel re:pair and the Fraxel re:store Dual (Solta Medical, solta.com), to enhance ink clearance and increase the threshold for scarring, allowing us to treat more aggressively with the Q-switched lasers. It's a great combination." Minneapolis dermatologist Brian Zelickson, MD, also utilizes several different tattoo removal systems in his practice. "In order to treat multiple colors of ink, you need several wavelengths: Nd:YAG—1064nm and 532nm—and either an alexandrite 755nm or Ruby 695nm. I am currently using nanosecond lasers, the Revlite Nd:YAG and the Alex TriVantage for the alexan- drite 755nm wavelength," he says. Ellman International recently introduced the Ruby 694nm Q-switched laser. According to Florida Derma- tologist James M. Spencer, MD, "Of the Q-switched tattoo lasers, the Ruby is the fastest and works the best. The Ellman 694nm Ruby is very reliable and quicker, and we have been happy with it. It is capable of remov- ing multiple colors with the exception of red ink. Typi- cally, we do six to 10 treatments spaced two months apart for professional tattoos, but we can get amateur tattoos to come off in about three treatments because there is not that much ink there." THE PICO PROMISE AND OTHER INNOVATIONS Recent developments have advanced the spectrum of tattoo-removal options, with the goal of making the process faster, more predictable and with fewer treat- ment sessions required. These include the application of perfl uorodecalin, performing multiple treatments in the same offi ce visit (called the R20 method), applying fractional lasers to complement Q-switched lasers, and the advent of picosecond lasers. Cynosure's Picosure picosecond pulse duration alexandrite laser launched in 2013, and is a game changer that has been 25 years in the making. Before After Tina Alster, MD, used the Syneron-Candela TriVantage to remove this patient's tattoo. PHOTOS COURTESY OF TINA ALSTER, MD 44 MAY/JUNE 2014 | Med Esthetics The Picosure laser works better for almost all colors." ERASING THE PAST E r a s i n g t h e P a s t M E D 5 - 6 1 4 . i n d d 4 4 Erasing the Past MED5-614.indd 44 4 / 1 6 / 1 4 4 : 4 5 P M 4/16/14 4:45 PM