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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FROM HAIR TO BARE New and Impro ed Features There's a good reason for the surge in laser hair removal popularity: With larger spot sizes, built-in cooling systems, better safety mechanisms and speedier treatment times, today's lasers are faster, more comfortable and have fewer potential complications than their predecessors, practitioners say. "The original technology was slow and hurt more. A back would take one and a half hours to treat," says Dr. Bonakdar, who calls the latest devices "a world of improvement." Today, she can treat a client's back in 20 minutes, with more comfort for the client, even without anesthetic cream. "Newer lasers treat very large areas of unwanted hair in a short amount of time," says Eric Bernstein, MD, owner of Main Line Center for Laser Surgery in Ardmore, Philadelphia. He has been offering laser hair removal procedures for 15 years, and it currently makes up about 20% of his practice. "My sore back can attest to the days when I used a slower laser with a small spot size and spent hours [bent over] during a single session," he says. comfortable for the patients and also allows practitioners to treat a wider range of skin types, says Dr. Martin. Laser platforms that include multiple handpieces in one unit—each with a specific wavelength or range of wavelengths—are available. For some practices, the ability to offer multiple treatment modalities with one device is attractive. Others prefer wavelength-specific devices. "For laser hair removal, very rarely do you need to use both units for a single client. We have separate units in individual rooms, so—staff permitting—we can book [more] appointments," says Chris Dryden, a certified laser operator/aesthetics, who owns Indy Laser, a cosmetic laser center in Indiana. Choosing Y Practitioners looking to purchase a professional laser hair removal device have several choices. Dryden, whose clients include the Indianapolis Colts, the Colts cheerleaders, and Miss Indiana contestants, says his "go-to machines" are the Syneron-Candela GentleLase and GentleYAG (syneron-candela.com). "[These devices] use the most effective wavelengths—755 nm for "When you use In-Motion, you're pulsing about 10 times per second and you're creating a cumulative heating effect." The most popular and effective devices for hair removal are intense pulsed light systems, 755nm, 810nm and 1064nm wavelengths. Two of the latest devices to come to the market are the Sciton Forever Bare BBL (sciton.com) and Alma Lasers' Soprano ICE (almalasers. com). They offer "continuous movement" or "In-Motion" technologies that allow for lower fluence pulses and a higher repetition rate. "With the older single pulse devices, you have to deliver more energy than you necessarily need to heat the hair to the appropriate temperature to damage the growth center—somewhere between 50 to 55 degrees C," says Stephen Martin, MD, of The Martin Center in Mobile, Alabama, who works with the Soprano ICE in his plastic surgery and laser center. "When you use Inmotion, you're pulsing about10 times/second and you're creating a cumulative heating effect that still gets you to the temperature target you want but in a gentler way, so when you have pigmentation in the skin, you're not blasting those melanocytes with such high levels of energy." The cumulative heating makes the treatment more 42 JANUARY/FEBRUARY 2014 | MedEsthetics lighter skin and 1064 nm for darker skin," he says. "They also have larger spot sizes and faster repetition rates for faster treatments times. Their built-in cooling system makes for a more comfortable treatment, without the need to cover the area with gel." Dryden also appreciates the device's adjustable settings, allowing for a customized treatment. Dr. Bonakdar, on the other hand, is a long-time fan of Lumenis devices (aesthetic.lumenis.com). She is also a speaker and physician trainer for Lumenis Aesthetic Lasers. "I was an early adopter of laser hair removal technology in early 2000 with a Lumenis Light Sheer," she says. In 2009, she upgraded to the Lumenis Light Sheer Duet. "It has two handpieces, allowing for fast, comfortable treatments of large body areas," she says. Dr. Bernstein, who uses several laser hair removal devices in his practice, likes both Syneron-Candela and Lumenis products. The Lumenis' LightSheer has been a mainstay in his practice for more than a decade. "I was an early LightSheer adopter. It's a wonderful device that we still use quite extensively," he says. "I started with