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    Skin rejuvenation

    Technology combo shown to improve skin with less risk

    Waikoloa, Hawaii - The Galaxy, a new machine from Syneron, achieves optimal skin rejuvenation by combining high fluence radio frequency energy with optical light and laser, according to R. Stephen Mulholland, MD.

    "The combination of intense pulsed light, high energy radio frequency (RF), and laser diode has greatly enhanced my ability to rejuvenate the skin," said Dr. Mulholland, a plastic surgeon at SpaMedica in Toronto who co-developed the popular FotoFacial RF procedure and helped originate the protocol for using the Galaxy machine.

    The Galaxy has two ports: One combines laser and RF energy in the same pulse profile. The other combines intense pulsed light and RF. The basic attachment to the laser port is a wrinkle reduction head that emits pulse diode laser (910 nm, 50 J/cm2) and high energy bipolar RF (100 J/cm3). The basic attachment to the optical light port is a skin rejuvenation head that emits intense pulsed light (45 J/cm2) and bipolar RF (25 J/cm3).

    In a trial of the Galaxy for skin rejuvenation, Dr. Mulholland treated 40 patients using the FotoFacial RF protocol. (FotoFacial RF is a brand name registered by Dr. Mulholland and Patrick Bitter Jr., M.D., dermatologist, Los Gatos, Calif.)

    Choosing candidatesCandidates for the treatment included patients with chromatic concerns, such as rosacea, telangiectasia, dyschromia, and hyperpigmentation, as well as those with textural concerns such as large pores, acne scars or wrinkles, skin laxity or ptosis.

    Patients underwent a series of five treatments, one every three weeks for 15 weeks. On each visit, the patients received one or two passes with the skin rejuvenation head [IPL and RF] to improve color and texture, then several passes with the wrinkle reduction head [laser diode and RF] to improve wrinkles and laxity of the brow, cheeks, and neck. Each treatment lasted about 30 minutes.

    The patients experienced an 80 percent reduction in vascular and dyschromia and a 40 percent improvement in moderate wrinkles, Dr. Mulholland said. Eighty-five percent reported a significant tightening of the cheeks and neck, with some lift effect on the brow. Ninety percent said they were happy with the procedure.

    The only complications were two superficial burns, after stacking pulses [early on in the study] which resolved with subsequent FotoFacial RF treatments using the same apparatus. To maintain results, patients require an additional treatment every three months.

    Combining radiofrequency with laser and or intense pulsed light is better than using one alone because you can use less light, reducing the risk of complications, Dr. Mulholland said. "When you use a combined modality the risks are diminished and the outcomes optimized. Each supplements the other."

    Dr. Mulholland said the Galaxy worked so much better, he no longer uses older machines.

    Syneron, of Richmond Hills, Canada, is the first company to combine RF and laser or optical energy in the same pulse. "RF is clearly the new kid on the block and this company has very cleverly taken the existing technologies and combined them," Dr. Mulholland said.

    Package costThe basic model, with the wrinkle reduction and skin rejuvenation heads, sells for an estimated $104,900, according to Syneron President Domenic Serafino. Three other heads are available at additional cost: A leg vein head that attaches to the laser port; and hair removal and acne heads, which attach to the optical light port.

    Heads monitor progress The heads are water-cooled and include monitors that give the user feedback on the drop in impedance with each pulse (the drop in impedance is inversely proportional to the rise in skin temperature). "This makes it safer to delegate into the hands of nurses, technicians, or PAs," Dr. Mulholland said.

    Dr. Mulholland is a consultant for and receives honoraria from Syneron.

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