The Aesthetic Guide November/December 2010 : Page 48

Cutera Devices Prove Successful for Scar Correction and Improving Skin Quality By Sean McKinney, Contributing Editor Ally-Khan Somani, M.D., Ph.D. Assistant Professor and Director Dermatologic Surgery and Cutaneous Oncology Division Department of Dermatology Indiana University School of Medicine Indianapolis, IN As Ally-Khan Somani, M.D., Ph.D., assistant professor and director of the dermatologic surgery and cutaneous oncology division, department of der-matology at Indiana University School of Medicine (Indianapolis, Ind.) discov-ered, the Laser Genesis and Pearl from Cutera, Inc. (Brisbane, Calif.), success-fully treat scars and improve skin qual-ity associated with head and neck cancer surgery, acne, chicken pox and pre-existing injuries. Dr. Somani explained that as a Mohs micrographic surgeon, he creates scars from head and neck cancer surgery that affect cosmetically sensitive areas. “Scars that develop after reconstructive surgery may exhibit increased fibrosis and vascularity, resulting in a more ob-vious red and raised scar,” he pointed out. “Oftentimes, younger patients heal more robustly, contributing to a more prominent scar. Although many of these scars improve over 6 to 18 months time, treatment with Laser Genesis greatly ac-celerates scar remodeling, improves er-ythema and enhances cosmesis.” Laser Genesis’s 1064 nm wavelength, combined with high peak power micro-second technology, protects the epi-dermis, targets microvasculature and stimulates collagen production. The flu-ence used to treat the scars ranges from 13 J/cm 2 to 16 J/cm 2 , using a 5 mm spot size and a 300 µs pulse width. calibration, enabling desired and re-producible results without compromis-ing patient safety. “Laser Genesis can be used on all skin types – Fitzpatrick I to VI.” A treatment lasts no more than 15 minutes. “Typically, I use a minimum of 400 to 600 shots and a maximum of 1,500 shots over the scar site,” Dr. Somani noted. “I see positive effects in four weeks. New collagen takes three to six months to fully form.” “I typically use the Laser Genesis be-cause it works so well. This treatment is Cutera’s best kept secret,” said Dr. Somani. “The bulk heating targets the microvasculature and stimulates colla-gen production – both important factors in scar correction and remodeling.” New collagen formation after Laser Genesis occurs more evenly below the scar and in the surrounding skin, creat-ing a less obvious scar. “Treating adja-cent tissue is also important because scar tissue has no nerve endings. Dr. Somani also uses Cutera’s Pearl instead of dermabrasion for skin resur-facing. The Pearl, offers a 2790 nm wavelength, a spot size of 6 mm with a scanning system, and a fluence of 1.5 J/ cm 2 to 3.5 J/cm 2 , providing ablation and coagulation to maximize thermal effects while minimizing patient downtime, num-ber of treatments and amount of pain. “I numb the skin as I would for derm-abrasion,” said Dr. Somani. “The Pearl literally vaporizes a thin layer of skin. I wipe away the skin with wet gauze and repeat this process until I have achieved the desired depth. Subsequently, I leave the final zone of thermal coagulation as a biologic dressing to aid with healing and wound care.” After five to seven days the surface of the skin re-epithelializes. Furthermore, “if combination treatment is needed, I can use the Laser Genesis within three weeks,” Dr. Somani added. “Patients are very pleased.” Patient after Mohs surgery Patient five months after two Laser Genesis treatments Photos courtesy of Ally-Khan Somani, M.D., Ph.D. Patient after Mohs surgery Patient one month after one Laser Genesis Tx Photos courtesy of Ally-Khan Somani, M.D., Ph.D. Dr. Somani performs one to three Laser Genesis treatments, spaced four weeks apart, as early as six weeks af-ter reconstructive surgery. “The patient’s report of heat sensation and the physi-cian’s assessment of erythema and der-mal heating should guide treatment intensity,” Dr. Somani advised. “Numbing is not required or recommended. There is no downtime except for post treatment erythema of one to two hours.” According to Dr. Somani, the Cutera platform features unique, real-time 48 THE Aesthetic Guide November/December 2010 www.miinews.com

Cutera Devices Prove Successful for Scar Correction and Improving Skin Quality

Sean McKinney,

As Ally-Khan Somani, M.D., Ph.D., assistant professor and director of the dermatologic surgery and cutaneous oncology division, department of dermatology at Indiana University School of Medicine (Indianapolis, Ind.) Discovered, the Laser Genesis and Pearl from Cutera, Inc. (Brisbane, Calif.), successfully treat scars and improve skin quality associated with head and neck cancer surgery, acne, chicken pox and pre-existing injuries.<br /> <br /> Dr. Somani explained that as a Mohs micro graphic surgeon, he creates scars from head and neck cancer surgery that affect cosmetically sensitive areas.“Scars that develop after reconstructive surgery may exhibit increased fibrosis and vascularity, resulting in a more obvious red and raised scar,” he pointed out. “Oftentimes, younger patients heal more robustly, contributing to a more prominent scar. Although many of these scars improve over 6 to 18 months time, treatment with Laser Genesis greatly accelerates scar remodeling, improves erythema and enhances cosmesis.”<br /> <br /> Laser Genesis’s 1064 nm wavelength, combined with high peak power microsecond technology, protects the epidermis, targets micro vas culature and stimulates collagen production. The fluence used to treat the scars ranges from 13 J/cm2 to 16 J/cm2, using a 5 mm spot size and a 300 ìs pulse width.<br /> <br /> Dr. Somani performs one to three Laser Genesis treatments, spaced four weeks apart, as early as six weeks after reconstructive surgery. “The patient’s report of heat sensation and the physician’s assessment of erythema and dermal heating should guide treatment intensity,” Dr. Somani advised. “Numbing is not required or recommended. There is no downtime except for post treatment erythema of one to two hours.”<br /> <br /> According to Dr. Somani, the Cutera platform features unique, real-time Calibration, enabling desired and reproducible results without compromising patient safety. “Laser Genesis can be used on all skin types – Fitzpatrick I to VI.” A treatment lasts no more than 15 minutes. “Typically, I use a minimum of 400 to 600 shots and a maximum of 1,500 shots over the scar site,” Dr. Somani noted. “I see positive effects in four weeks. New collagen takes three to six months to fully form.”<br /> <br /> “I typically use the Laser Genesis because it works so well. This treatment is Cutera’s best kept secret,” said Dr. Somani. “The bulk heating targets the micro vasculature and stimulates collagen production – both important factors in scar correction and remodeling.” New collagen formation after Laser Genesis occurs more evenly below the scar and in the surrounding skin, creating a less obvious scar. “Treating adjacent tissue is also important because scar tissue has no nerve endings.<br /> <br /> Dr. Somani also uses Cutera’s Pearl instead of dermabrasion for skin resurfacing.The Pearl, offers a 2790 nm wavelength, a spot size of 6 mm with a scanning system, and a fluence of 1.5 J/ cm2 to 3.5 J/cm2, providing ablation and coagulation to maximize thermal effects while minimizing patient downtime, number of treatments and amount of pain.<br /> <br /> “I numb the skin as I would for dermabrasion,” said Dr. Somani. “The Pearl literally vaporizes a thin layer of skin. I wipe away the skin with wet gauze and repeat this process until I have achieved the desired depth. Subsequently, I leave the final zone of thermal coagulation as a biologic dressing to aid with healing and wound care.”<br /> <br /> After five to seven days the surface of the skin re-epithelializes. Furthermore, “if combination treatment is needed, I can use the Laser Genesis within three weeks,” Dr. Somani added. “Patients are very pleased.”<br /> <br />

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