Considering the Possibilities
Looking forward, as always, to this September laser issue of Skin & Aging, the thought of possibilities leap into my mind: What do my current and prospective patients need or desire that I may be able to deliver? What new technologies or upgrades represent more hype than reality? How will I know? What does FDA approval of a medical device mean to me and my patients? More questions certainly follow, but success in evaluating new products and technologies starts with a patient-centered approach.
Risks and Issues Associated with New and Existing Treatments
It is with great anticipation that I await new technologies as well as refinements to existing equipment. Practicing cosmetic dermatology in this era of rapid innovation is exciting, but also challenging. A constant pressure exists to have the latest. Patients are kept abreast of new developments by manufacturers through popular media and marketing campaigns.
Always waiting for the next great thing, patients are often unaware of risks and the likelihood of inadequate results. Yet, if the latest XYZ product pending approval is not available in your office, will once-loyal patients go elsewhere? Often, existing procedures and products may offer more. So many issues and risks must be considered that a clear process of accepting and offering new treatment solutions can be elusive.
Considering the Possibilities
Looking forward, as always, to this September laser issue of Skin & Aging, the thought of possibilities leap into my mind: What do my current and prospective patients need or desire that I may be able to deliver? What new technologies or upgrades represent more hype than reality? How will I know? What does FDA approval of a medical device mean to me and my patients? More questions certainly follow, but success in evaluating new products and technologies starts with a patient-centered approach.
Risks and Issues Associated with New and Existing Treatments
It is with great anticipation that I await new technologies as well as refinements to existing equipment. Practicing cosmetic dermatology in this era of rapid innovation is exciting, but also challenging. A constant pressure exists to have the latest. Patients are kept abreast of new developments by manufacturers through popular media and marketing campaigns.
Always waiting for the next great thing, patients are often unaware of risks and the likelihood of inadequate results. Yet, if the latest XYZ product pending approval is not available in your office, will once-loyal patients go elsewhere? Often, existing procedures and products may offer more. So many issues and risks must be considered that a clear process of accepting and offering new treatment solutions can be elusive.
Assessing Patients’ Desires and Expectations
That’s why a back to basics approach serves my office well and may be valuable for your practice.
1. Consider first the cosmetic concerns that most interest your patient population. This may vary widely from one area of the country to another or among demographic groups. Are you mainly asked about photo-age related changes, management of the “reds” of rosacea, or tattoo removal, to name a few?
2. Next consider patient expectations concerning components including risks, treatment process, results, and costs. My patients expect minimally invasive and noninvasive procedures, little to no downtime, minimal risks, and moderate costs. Discomfort should truly be minimal with topical or local anesthetic, or I won’t see patients or their referrals again. This excludes a number of laser procedures. For mainly privacy reasons, my patients expect to personally drive home shortly after the procedure. This of course limits conscious sedation as an option.
3. A more complete understanding of what procedures will be successful in any given practice follows the assessment of patients’ desires and expectations. For example, while many area residents may have tattoos, few may be current patients, and fewer still may desire removal when informed of the number of likely treatments needed and reasonable cost expectations. Investment in tattoo removal lasers would then only be considered as a service and not as a positive revenue generator.
Many of my patients despise their solar lentigos above all else. We constantly hear that it reminds them of prematurely turning into their elderly parent or grandparent. I personally have great success with intense pulsed light (IPL), and it certainly is a “patient pleaser.” This is after all what our practice looks for in the cosmetic arena — reliable services with high patient satisfaction.
My Own Practice: UltraPulse Encore
We use the Lumenis UltraPulse Encore, an ablative carbon dioxide laser, to decrease facial lines and laxity while greatly improving texture and tone of the skin. It is especially effective in treating vertical lip and periocular lines. The Encore with the coolscan CPG (computer pattern generator), when compared with previous versions of the UltraPulse, has a much smaller spot size, allows for lower density and hertz settings (leaves bridges), and has non sequential scanning. The coolscan helps eliminate heat build up in areas and associated striping. “Hertz hurts” is a good way to remember the importance of pulses per second, with lower settings improving patient comfort greatly. ActivFX, a procedure using the UltraPulse Encore at a range of lower-energy settings, requires only topical anesthesia. A single pass technique is most often used and patient downtime is limited to 4 days. One brief (30-minute) treatment of the face is often enough to achieve visual results. The procedure has a high safety profile with none of our patients experiencing complications such as pigmentary change, which was common with older techniques of laser skin resurfacing (LSR).
My Own Practice: Lumenis One & Quantum SR
There are many clinical applications for intense pulsed light (IPL) and many delivery devices from multiple manufacturers. Our office uses the Lumenis One and Quantum SR devices for two of our most common patient complaints, the reds of rosacea and solar lentigos. These two devices come from a long lineage of IPL equipment from Lumenis dating back to the Vasculight and Photoderm. Both the day-to-day redness and flushing that often accompany rosacea are addressed by IPL. Photoaging related changes such as poor tone, coarsened texture, and solar lentigos can be corrected in many skin types. While the face is the most frequently treated area, we often treat other areas including the dorsal hands, forearms, neck, and chest. Treatments are well tolerated by patients without any anesthesia and there is little to no down time. Since no expensive consumables are used, costs can be minimized for the patient. Our use of IPL technology helps us meet defined patient needs and their expectations.
Caveats in Considering New Procedures
On the road to discovering patient-pleasing procedures there are many potential pitfalls, such as disregarding “older technology” such as IPL in favor of the latest marvel. Better disregarded are proforma statements.
1. Communicate with colleagues and rely on your knowledge base. Didn’t we all learn years ago that carbon dioxide laser resurfacing yielded more tightening than erbium? Should we be surprised in the future to realize that fractional CO2 resurfacing with the Ultrapulse Encore (Lumenis) tightens more than fractional erbium resurfacing? Will other competitors now bring out their own fractional CO2 devices? I sure hope they do.
2. Don’t get lost in the semantics … focus on results… As an example, patients don’t care about what equipment delivers truly
fractional ablation or any other construct we in the field need to understand. They care about their experiences and results.
3. Being swayed by glossy marketing images. You need to determine whether the underlying technology fills a void in your armamentarium. Will it yield more predictable results, be better tolerated, have less adverse effects, have limited downtime, and fill the need of your patients?
Rise to the Challenge
The challenge and excitement of laser medicine for me is the hunt for great technology and delivering effective treatments to the right patients. Thankfully, there is much to hunt through given the staggering depth of innovation. As you read, learn, and discover all that awaits us in the field of cosmetic dermatology, keep your mind centered on your patients. It will make all the difference.
Considering the Possibilities
Looking forward, as always, to this September laser issue of Skin & Aging, the thought of possibilities leap into my mind: What do my current and prospective patients need or desire that I may be able to deliver? What new technologies or upgrades represent more hype than reality? How will I know? What does FDA approval of a medical device mean to me and my patients? More questions certainly follow, but success in evaluating new products and technologies starts with a patient-centered approach.
Risks and Issues Associated with New and Existing Treatments
It is with great anticipation that I await new technologies as well as refinements to existing equipment. Practicing cosmetic dermatology in this era of rapid innovation is exciting, but also challenging. A constant pressure exists to have the latest. Patients are kept abreast of new developments by manufacturers through popular media and marketing campaigns.
Always waiting for the next great thing, patients are often unaware of risks and the likelihood of inadequate results. Yet, if the latest XYZ product pending approval is not available in your office, will once-loyal patients go elsewhere? Often, existing procedures and products may offer more. So many issues and risks must be considered that a clear process of accepting and offering new treatment solutions can be elusive.
Considering the Possibilities
Looking forward, as always, to this September laser issue of Skin & Aging, the thought of possibilities leap into my mind: What do my current and prospective patients need or desire that I may be able to deliver? What new technologies or upgrades represent more hype than reality? How will I know? What does FDA approval of a medical device mean to me and my patients? More questions certainly follow, but success in evaluating new products and technologies starts with a patient-centered approach.
Risks and Issues Associated with New and Existing Treatments
It is with great anticipation that I await new technologies as well as refinements to existing equipment. Practicing cosmetic dermatology in this era of rapid innovation is exciting, but also challenging. A constant pressure exists to have the latest. Patients are kept abreast of new developments by manufacturers through popular media and marketing campaigns.
Always waiting for the next great thing, patients are often unaware of risks and the likelihood of inadequate results. Yet, if the latest XYZ product pending approval is not available in your office, will once-loyal patients go elsewhere? Often, existing procedures and products may offer more. So many issues and risks must be considered that a clear process of accepting and offering new treatment solutions can be elusive.
Assessing Patients’ Desires and Expectations
That’s why a back to basics approach serves my office well and may be valuable for your practice.
1. Consider first the cosmetic concerns that most interest your patient population. This may vary widely from one area of the country to another or among demographic groups. Are you mainly asked about photo-age related changes, management of the “reds” of rosacea, or tattoo removal, to name a few?
2. Next consider patient expectations concerning components including risks, treatment process, results, and costs. My patients expect minimally invasive and noninvasive procedures, little to no downtime, minimal risks, and moderate costs. Discomfort should truly be minimal with topical or local anesthetic, or I won’t see patients or their referrals again. This excludes a number of laser procedures. For mainly privacy reasons, my patients expect to personally drive home shortly after the procedure. This of course limits conscious sedation as an option.
3. A more complete understanding of what procedures will be successful in any given practice follows the assessment of patients’ desires and expectations. For example, while many area residents may have tattoos, few may be current patients, and fewer still may desire removal when informed of the number of likely treatments needed and reasonable cost expectations. Investment in tattoo removal lasers would then only be considered as a service and not as a positive revenue generator.
Many of my patients despise their solar lentigos above all else. We constantly hear that it reminds them of prematurely turning into their elderly parent or grandparent. I personally have great success with intense pulsed light (IPL), and it certainly is a “patient pleaser.” This is after all what our practice looks for in the cosmetic arena — reliable services with high patient satisfaction.
My Own Practice: UltraPulse Encore
We use the Lumenis UltraPulse Encore, an ablative carbon dioxide laser, to decrease facial lines and laxity while greatly improving texture and tone of the skin. It is especially effective in treating vertical lip and periocular lines. The Encore with the coolscan CPG (computer pattern generator), when compared with previous versions of the UltraPulse, has a much smaller spot size, allows for lower density and hertz settings (leaves bridges), and has non sequential scanning. The coolscan helps eliminate heat build up in areas and associated striping. “Hertz hurts” is a good way to remember the importance of pulses per second, with lower settings improving patient comfort greatly. ActivFX, a procedure using the UltraPulse Encore at a range of lower-energy settings, requires only topical anesthesia. A single pass technique is most often used and patient downtime is limited to 4 days. One brief (30-minute) treatment of the face is often enough to achieve visual results. The procedure has a high safety profile with none of our patients experiencing complications such as pigmentary change, which was common with older techniques of laser skin resurfacing (LSR).
My Own Practice: Lumenis One & Quantum SR
There are many clinical applications for intense pulsed light (IPL) and many delivery devices from multiple manufacturers. Our office uses the Lumenis One and Quantum SR devices for two of our most common patient complaints, the reds of rosacea and solar lentigos. These two devices come from a long lineage of IPL equipment from Lumenis dating back to the Vasculight and Photoderm. Both the day-to-day redness and flushing that often accompany rosacea are addressed by IPL. Photoaging related changes such as poor tone, coarsened texture, and solar lentigos can be corrected in many skin types. While the face is the most frequently treated area, we often treat other areas including the dorsal hands, forearms, neck, and chest. Treatments are well tolerated by patients without any anesthesia and there is little to no down time. Since no expensive consumables are used, costs can be minimized for the patient. Our use of IPL technology helps us meet defined patient needs and their expectations.
Caveats in Considering New Procedures
On the road to discovering patient-pleasing procedures there are many potential pitfalls, such as disregarding “older technology” such as IPL in favor of the latest marvel. Better disregarded are proforma statements.
1. Communicate with colleagues and rely on your knowledge base. Didn’t we all learn years ago that carbon dioxide laser resurfacing yielded more tightening than erbium? Should we be surprised in the future to realize that fractional CO2 resurfacing with the Ultrapulse Encore (Lumenis) tightens more than fractional erbium resurfacing? Will other competitors now bring out their own fractional CO2 devices? I sure hope they do.
2. Don’t get lost in the semantics … focus on results… As an example, patients don’t care about what equipment delivers truly
fractional ablation or any other construct we in the field need to understand. They care about their experiences and results.
3. Being swayed by glossy marketing images. You need to determine whether the underlying technology fills a void in your armamentarium. Will it yield more predictable results, be better tolerated, have less adverse effects, have limited downtime, and fill the need of your patients?
Rise to the Challenge
The challenge and excitement of laser medicine for me is the hunt for great technology and delivering effective treatments to the right patients. Thankfully, there is much to hunt through given the staggering depth of innovation. As you read, learn, and discover all that awaits us in the field of cosmetic dermatology, keep your mind centered on your patients. It will make all the difference.
Considering the Possibilities
Looking forward, as always, to this September laser issue of Skin & Aging, the thought of possibilities leap into my mind: What do my current and prospective patients need or desire that I may be able to deliver? What new technologies or upgrades represent more hype than reality? How will I know? What does FDA approval of a medical device mean to me and my patients? More questions certainly follow, but success in evaluating new products and technologies starts with a patient-centered approach.
Risks and Issues Associated with New and Existing Treatments
It is with great anticipation that I await new technologies as well as refinements to existing equipment. Practicing cosmetic dermatology in this era of rapid innovation is exciting, but also challenging. A constant pressure exists to have the latest. Patients are kept abreast of new developments by manufacturers through popular media and marketing campaigns.
Always waiting for the next great thing, patients are often unaware of risks and the likelihood of inadequate results. Yet, if the latest XYZ product pending approval is not available in your office, will once-loyal patients go elsewhere? Often, existing procedures and products may offer more. So many issues and risks must be considered that a clear process of accepting and offering new treatment solutions can be elusive.
Considering the Possibilities
Looking forward, as always, to this September laser issue of Skin & Aging, the thought of possibilities leap into my mind: What do my current and prospective patients need or desire that I may be able to deliver? What new technologies or upgrades represent more hype than reality? How will I know? What does FDA approval of a medical device mean to me and my patients? More questions certainly follow, but success in evaluating new products and technologies starts with a patient-centered approach.
Risks and Issues Associated with New and Existing Treatments
It is with great anticipation that I await new technologies as well as refinements to existing equipment. Practicing cosmetic dermatology in this era of rapid innovation is exciting, but also challenging. A constant pressure exists to have the latest. Patients are kept abreast of new developments by manufacturers through popular media and marketing campaigns.
Always waiting for the next great thing, patients are often unaware of risks and the likelihood of inadequate results. Yet, if the latest XYZ product pending approval is not available in your office, will once-loyal patients go elsewhere? Often, existing procedures and products may offer more. So many issues and risks must be considered that a clear process of accepting and offering new treatment solutions can be elusive.
Assessing Patients’ Desires and Expectations
That’s why a back to basics approach serves my office well and may be valuable for your practice.
1. Consider first the cosmetic concerns that most interest your patient population. This may vary widely from one area of the country to another or among demographic groups. Are you mainly asked about photo-age related changes, management of the “reds” of rosacea, or tattoo removal, to name a few?
2. Next consider patient expectations concerning components including risks, treatment process, results, and costs. My patients expect minimally invasive and noninvasive procedures, little to no downtime, minimal risks, and moderate costs. Discomfort should truly be minimal with topical or local anesthetic, or I won’t see patients or their referrals again. This excludes a number of laser procedures. For mainly privacy reasons, my patients expect to personally drive home shortly after the procedure. This of course limits conscious sedation as an option.
3. A more complete understanding of what procedures will be successful in any given practice follows the assessment of patients’ desires and expectations. For example, while many area residents may have tattoos, few may be current patients, and fewer still may desire removal when informed of the number of likely treatments needed and reasonable cost expectations. Investment in tattoo removal lasers would then only be considered as a service and not as a positive revenue generator.
Many of my patients despise their solar lentigos above all else. We constantly hear that it reminds them of prematurely turning into their elderly parent or grandparent. I personally have great success with intense pulsed light (IPL), and it certainly is a “patient pleaser.” This is after all what our practice looks for in the cosmetic arena — reliable services with high patient satisfaction.
My Own Practice: UltraPulse Encore
We use the Lumenis UltraPulse Encore, an ablative carbon dioxide laser, to decrease facial lines and laxity while greatly improving texture and tone of the skin. It is especially effective in treating vertical lip and periocular lines. The Encore with the coolscan CPG (computer pattern generator), when compared with previous versions of the UltraPulse, has a much smaller spot size, allows for lower density and hertz settings (leaves bridges), and has non sequential scanning. The coolscan helps eliminate heat build up in areas and associated striping. “Hertz hurts” is a good way to remember the importance of pulses per second, with lower settings improving patient comfort greatly. ActivFX, a procedure using the UltraPulse Encore at a range of lower-energy settings, requires only topical anesthesia. A single pass technique is most often used and patient downtime is limited to 4 days. One brief (30-minute) treatment of the face is often enough to achieve visual results. The procedure has a high safety profile with none of our patients experiencing complications such as pigmentary change, which was common with older techniques of laser skin resurfacing (LSR).
My Own Practice: Lumenis One & Quantum SR
There are many clinical applications for intense pulsed light (IPL) and many delivery devices from multiple manufacturers. Our office uses the Lumenis One and Quantum SR devices for two of our most common patient complaints, the reds of rosacea and solar lentigos. These two devices come from a long lineage of IPL equipment from Lumenis dating back to the Vasculight and Photoderm. Both the day-to-day redness and flushing that often accompany rosacea are addressed by IPL. Photoaging related changes such as poor tone, coarsened texture, and solar lentigos can be corrected in many skin types. While the face is the most frequently treated area, we often treat other areas including the dorsal hands, forearms, neck, and chest. Treatments are well tolerated by patients without any anesthesia and there is little to no down time. Since no expensive consumables are used, costs can be minimized for the patient. Our use of IPL technology helps us meet defined patient needs and their expectations.
Caveats in Considering New Procedures
On the road to discovering patient-pleasing procedures there are many potential pitfalls, such as disregarding “older technology” such as IPL in favor of the latest marvel. Better disregarded are proforma statements.
1. Communicate with colleagues and rely on your knowledge base. Didn’t we all learn years ago that carbon dioxide laser resurfacing yielded more tightening than erbium? Should we be surprised in the future to realize that fractional CO2 resurfacing with the Ultrapulse Encore (Lumenis) tightens more than fractional erbium resurfacing? Will other competitors now bring out their own fractional CO2 devices? I sure hope they do.
2. Don’t get lost in the semantics … focus on results… As an example, patients don’t care about what equipment delivers truly
fractional ablation or any other construct we in the field need to understand. They care about their experiences and results.
3. Being swayed by glossy marketing images. You need to determine whether the underlying technology fills a void in your armamentarium. Will it yield more predictable results, be better tolerated, have less adverse effects, have limited downtime, and fill the need of your patients?
Rise to the Challenge
The challenge and excitement of laser medicine for me is the hunt for great technology and delivering effective treatments to the right patients. Thankfully, there is much to hunt through given the staggering depth of innovation. As you read, learn, and discover all that awaits us in the field of cosmetic dermatology, keep your mind centered on your patients. It will make all the difference.
