5598 replies to this topic

[birch]

Thanks lightgirl,

Your posts have been really great. Glad you're seeing improvement.

No I don't think Fraxel can offer any guarantees. Dr. Rohksar expanded on his 50% quote by saying that's how people respond when asked on average. Some do better, some not as well. But it is genuinely hopeful because they predict (like all the other lasers) that there will still be a cumulative improvement over months and maybe even up to a year.

Does your doctor have a zimmer cooling machine? My first treatment he didn't turn it on and the second pass was pretty brutal. But in my second treatment he used it and I almost didn't feel any pain at all even at 20.

[lightgirl]

[quote=birch,Oct 6 2005, 05:48 PM]
[quote=kooky,Oct 6 2005, 06:53 PM]
Hi birch,
That's great to hear...I've heard great things about Dr. Rokshar and he's one of the first doctors to use the Fraxel. He's a bit expensive but I guess office space isn't exactly cheap in Manhattan. My doctor also likes to go at 20/1250 too for acne scarring. Are you waiting a month between treatments?

Did he provide you with any before and after photos of patients with acne scarring and if so, what was your impression of the level of improvement?
Thanks,
kook



Hey kooky,

Yeah it seems the 20/1250 is becoming the standard for acne scars.

Yes Dr. Rohksar was one of the first along with Dr. Fitspatrick in CA and they really targeted it at acne scars doing I think the only clinical study where the average result of 50% improvement for scars came from. He told me he will not go over 20/1250 because you can run into trouble. It still delivers a lot of heat and can blister over that setting which could mean more scarring.

I'm only waiting 10 days between treatments which is the minimum at that setting, but I guess people with just discoloration can do them even quicker.
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Yikes. After my experience today, I think I could not handle level 20 unless I was sedated.

[lightgirl]

Thanks lightgirl,

Your posts have been really great. Glad you're seeing improvement.

No I don't think Fraxel can offer any guarantees. Dr. Rohksar expanded on his 50% quote by saying that's how people respond when asked on average. Some do better, some not as well. But it is genuinely hopeful because they predict (like all the other lasers) that there will still be a cumulative improvement over months and maybe even up to a year.

Does your doctor have a zimmer cooling machine? My first treatment he didn't turn it on and the second pass was pretty brutal. But in my second treatment he used it and I almost didn't feel any pain at all even at 20.

Yes, she does use the Zimmer cooling machine, which is why I was suprised that it hurt so bad today because I haven't felt pain at all with these treatments. I actually had the same level done last treatment, but not nearly as painful. Who knows!

I am so glad we have another person on board to give feedback because it is so interesting to see how everyone responds to such a new procedure. I actually called your doctor's office when I was researching Fraxel bec I saw the article on the study--the only article I think out there. He was on vacation the day before my first fraxel, but his assistant who answered the phone said that generally Docs were intially scared and inexperienced with this type of laser and did not go to the higher levels so a lot of people were not getting great results on their scars. I was glad to hear that my doctor was not only comfortable with higher levels, she was in contact with other doctors and was in agreement that for the best results, the levels should not be under 15 and a max of 20 for scarring.

[WishUallBest]

hmm lightgirl have u seen any improvements as of now? and what kind of scars do u have? I'm thinkin bout takin this step also.

[JennyL]

Hi, everyone,

Just got a price quote from Dr. Fiztpatrick in San Diego: "Ballpark fee for Full Face 6900.00 ( usually 4 treatments about 1-2 weeks apart. Recovery time is mild swelling for 1-3 days you may have spots of blue dye for 24 hours."

Wow, that's $1725 per treatment. Is this a new record?

Still seeking a doc in LA who is experienced treating acne scared patients with Fraxel Laser and charges a lot less.


Kooky,

Thanks for the info. Maybe I should contact Dr. White in NYC? Hate to fly across the continenet just to remove the overly injected filler.

JennyL

[lightgirl]

hmm lightgirl have u seen any improvements as of now? and what kind of scars do u have? I'm thinkin bout takin this step also.

After 4 treatments: 40% improvement on one moderate rolling scar that has been on my face forever. 30% on another moderate rolling scar, which is two scars combined and I can barely see my shallow scar. Skin color is great, but did not see that improvement until after the 4th treatment. Definate softening of my scars. I usually wait about a month after each treatment to really assess the situation so since I just got the 5th treatment done today---I'll have to fill you in later on any further improvements. First three were at level 15 and last two at level 17 with my treatments being a month apart.

Hope you see improvements and find a doctor who won't over charge you!

[WishUallBest]

hmm only 40% yield of improvement? it does gradually improve overtime right? and for my treatment here, the cost is $2000 for 5 treatments, just on my cheeks though, spaced 2 weeks apart.. and by the way I'm in Thailand..so costs here are much lower..and by the way, do u have before and after shots? how many treatments are u gettin? what's your age too? and where did you find the articles regarding to this? thanks..hollla

[lightgirl]

hmm only 40% yield of improvement? it does gradually improve overtime right? and for my treatment here, the cost is $2000 for 5 treatments, just on my cheeks though, spaced 2 weeks apart.. and by the way I'm in Thailand..so costs here are much lower..and by the way, do u have before and after shots? what's your age too? and where did you find the articles regarding to this?

In my book, 40% is a fantastic improvement for scar revision!! Throughout the last ten or so years, I have had dermabrasion, 4 Erbium laser treatments, fat transfer, n-lite treatments, micro-dermabrasion-- ALL with no or very little results and worsening of my condition. I understand your reaction though because it is a tough percentage of improvement for some to take when they are having to pay sooo much for this treatment!

I didn't think to take a before photo myself so I will have to ask my doctor for one and I will take a photo after this treatment and my last one so people can compare. My last treatment will be either November or December depending on if I decide to go for a 7th one.

I am 33 years old (34 in a few weeks).

I am pasting the article for your review--hope it helps. If you want to find it yourself, you can search on the Internet for "New York Study of Fraxel on Scars."

Here it is:

NYC Laser Surgeon Presents First Report on Correction of Acne Scars with Breakthrough Laser Treatment
Latest Generation FRAXEL™ Laser Treatment Gently Repairs Acne Scars Like Photoshop® Software – Pixel by Pixel, Spot by Spot


New York, NY - May 9, 2005 -- Cameron Rokhsar, MD, presented the first report of the treatment of acne scars using the FRAXELâ„¢ Laser, the newest generation of noninvasive fractional resurfacing technology. Acne scars are an all too common sequel to acne. In the past, the most effective procedure for acne scars was carbon dioxide resurfacing known as CO2 resurfacing or deep chemical peels, both of which required a minimum of two weeks downtime while the raw skin healed.

Dr. Rokhsar presented his study results at the 25th Annual Meeting of American Society of Laser Medicine and Surgery (ASLMS) held in Orlando, Florida, last month. He reported that 50% of his subjects experienced significant improvement in the texture, color and overall appearance of their acne scars, while 80% of study patients reported at least moderate improvement in their acne scars.

“This improvement is revolutionary because it is the most significant positive response we have ever been able to achieve using a non-abrasive, minimal downtime procedure,� said Dr. Rokhsar, a board-certified dermatologist who pioneered the science of fractional resurfacing which is the scientific underpinning of the Fraxel laser treatment (FLT).


Other key advantages of Fraxel Laser Treatment (FLT) are:
*No general anesthesia – FLT is well tolerated
with a topical anesthetic

*Convenience – the procedure takes about 30
minutes in the doctor’s office

*Excellent safety profile

Dr. Rokhsar devoted most of the past year to refining and developing applications for Fraxel laser technology and is considered one of the world’s most experienced physicians on clinical effects of this breakthrough laser technology. He was one of the first to introduce Fraxel laser treatment to the aesthetic medical community at recent national meetings and has trained numerous physicians on the techniques and parameters used for FLT. He has been a featured speaker on this subject at scientific meetings of the American Society for Dermatologic Surgery, American Academy of Cosmetic Surgery, the ASLMS and Australian Academy of Cosmetic Surgery.

Fraxel Laser Treatment also improves wrinkles and photodamage and as well as uneven pigmentation such as age spots and sun spots on the face, neck, chest and hands. In another study on wrinkles and photodamage, Dr. Rokhsar reported at ASLMS that 73% of the subjects noted marked to significant improvement in overall appearance, while 60% of the subjects observed improvement in skin texture as 75-100% improved.

“The results we have seen for acne scars, wrinkles and photodamage are remarkable. There is no other laser that can achieve such dramatic benefits with virtually no risks or interruption to patients’ routine activities," adds Dr. Rokhsar.

Dr. Rokhsar is a board-certified dermatologist with a special interest in cosmetic dermatology and surgery. After graduating from Harvard University, he attended New York University School of Medicine where he received his doctorate in medicine. After his internship at Lenox Hill Hospital in New York City, Dr. Rokhsar completed his dermatology residency at the Albert Einstein College of Medicine in New York City where he was honored for his teaching and leadership skills as Chief Resident. Dr. Rokhsar went on to receive fellowship training in cosmetic, laser and dermatologic Surgery in San Diego.

[lightgirl]

I've had 3 treatments thus far and I see very little improvement as of yet. Good luck.

Ryan

Hi Ryan,

What level is your doctor using on you?

[Sean1977]

Thanks for the info lightgirl.... hope you keep seeing those improvements... very insterested to hear your future results..

Sean...

[noviceflip17]

I too have had 3 treatments. I must say that my skin is smoother and my shallow scars are better, but I just can't be sure about the deep scars I have on my forehead. After reading some of the things people said about Fraxel, I'm not sure whether I should be an optimist or pecimist. I'm being treated by Dr. Edgar Fincher (an associate of Dr. Ronald Moy, apparently well know in the field of dermatology)at UCLA Medical Center for $900. I wasn't lucky enough to get the $500 deal for being on his website, but oh well. He said I'd need 5-8 treatments to improve my scars by 50-80%. While I hope it'll be 80%, I know that's an unrealistic number for me to expect, and I don't want my parents wasting their money on this. I was wondering if anyone could help steer my decision of whether I should stick with Fraxel or give subcision and augmentation a shot. I just can't decide for myself because all I have in my mind is being back to normal by prom! Any suggestions would help.

[WishUallBest]

i havent' even had one yet lol.. and wow 900 that's a large sum there..but yo post some pics of yourself before and after if you could, it'd really help a lot..thanks.

And lightgirl, thanks for the article.. i hope all goes well for you and that improvements are on the rise.

[birch]

Just got back from my3rd Fraxel. The doctor went even more aggressive this time. Still at 20/1250 but did more passes (so I guess I was wrong before about the # of passes not really mattering) for a total energy of 2.06kj.

My 1st and 2nd treatments were also at 20/1250 but with 1.06kj and 1.60kj respectively.

No pain at all with the Zimmer machine. Actually felt a little bit of brain freeze like you get eating a snowcone too fast.

Pretty swollen and there was some pinpoint bleeding which he said he expected and is no big deal - just need to use a little aquafor - but he feels it's really necessary to be aggressive for such deep scars.

My 4th treatment will be in 2 weeks and I'm hopeful that if I see any improvement from this one then #'s 4 and 5 will be great.

[lightgirl]

Just got back from my3rd Fraxel. The doctor went even more aggressive this time. Still at 20/1250 but did more passes (so I guess I was wrong before about the # of passes not really mattering) for a total energy of 2.06kj.

My 1st and 2nd treatments were also at 20/1250 but with 1.06kj and 1.60kj respectively.

No pain at all with the Zimmer machine. Actually felt a little bit of brain freeze like you get eating a snowcone too fast.

Pretty swollen and there was some pinpoint bleeding which he said he expected and is no big deal - just need to use a little aquafor - but he feels it's really necessary to be aggressive for such deep scars.

My 4th treatment will be in 2 weeks and I'm hopeful that if I see any improvement from this one then #'s 4 and 5 will be great.

I had little red dots on two of mine, which were gone in a couple of days with neosporin. I think I have determined that the cold air machine was not as cold as it usually is--it was a new nurse with my doctor. That could have been why I experienced some pain. Looks like we are in the same boat Birch both stuck inside swollen and red for a few days! I am really swollen today!

[lightgirl]

hmm lightgirl have u seen any improvements as of now? and what kind of scars do u have? I'm thinkin bout takin this step also.

Thanks Sean and Wishuallbest for your positive thoughts as I am sitting here bored and swollen! I am interested in what you both decide to do so keep me posted and I will let you know my progress and I promise to post photos in the future!

What did you think of the doctor's study that I added to a previous post?

[birch]

I had little red dots on two of mine, which were gone in a couple of days with neosporin. I think I have determined that the cold air machine was not as cold as it usually is--it was a new nurse with my doctor. That could have been why I experienced some pain. Looks like we are in the same boat Birch both stuck inside swollen and red for a few days! I am really swollen today!
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Yeah forsure. I'm defiinitely a cave-dweller right now. It's supposed to rain for the next 3-4 days though so I don't feel so bad.

I bet the Zimmer temp was the problem lightgirl, the nurse told me some people actually don't like it because it can get too cold! Not me, I'll take chilled brain over hot iron torture anyday.

I have this stuff called Sin-Echh for swelling. It's homeopathic and I'm not sure if it actually works, but some doctors reccomend it following surgery. You can get it here:

www.alpinepharm.com/orsinher.html

I don't take the full dose it reccomends because Fraxel really isn't all that invasive. I forgot to take one before the treatment this morning so took two after but I have a bunch of aquafor on right now so can't really tell if the swelling has gone down any yet.

[Sean1977]

Lightgirl,

I found the article interesting.. so it sounds like using fraxel at these higher settings does produce much better results. I'm assuming when he says 50% of his patients saw *significant* improvement, that would be 40% or better.. and atleast 80% of them saw moderate improvement, probably 25% to 40%... That would still mean 2 out of 10 saw probably under 25% improvement.

I was also wondering for the swelling and redness... how long on average is it before you look "presentable". If you get fraxel at these settings done say on a friday morning, are you able to return on monday morning with no one noticing?

Sean..

[Headsup]

Hi Birch, How r u? I hope your doing ok.. I am going to see Dr Rokhsar for a Consultation next week to see about Fraxel for My scars(mostly on cheeks some deep some shallow) I was just curious if he recommends doing full face or just hitting the noticable scar areas. Also, Does he have different prices for full face and for the cheek only sessions? Thanks..
About me.. I had Laser done w/ the derma K laser( combo of erbium+CO2) 1-1/2 years ago w/ minimal results. Although I healed relatively fast you still have many months of pinkish color in your face and have to be constantly protected from the sun. I am looking into Fraxel or The Medical Roll-CIT.

[birch]

Hi Birch, How r u? I hope your doing ok..  I am going to see Dr Rokhsar for a Consultation next week to see about Fraxel for My scars(mostly on cheeks some deep some shallow) I was just curious if he recommends doing full face or just hitting the noticable scar areas. Also, Does he have different prices for full face and for the cheek only sessions? Thanks..
About me.. I had Laser done w/ the derma K laser( combo of erbium+CO2) 1-1/2 years ago w/ minimal results. Although I healed relatively fast you still have many months of pinkish color in your face and have to be constantly protected from the sun. I am looking into Fraxel or The Medical Roll-CIT.

For me the swelling goes down in a couple days (although ther's a minimal amount that plumps up the scars really nicely, but alas deceptively for about a week). Then there is a sort of tanned rough skin - just like after a bad sunburn. That lasts until about the 4th or 5th until it starts to flake off. It's completely flaked off by the 6th day leaving really soft smooth skin that's still a little pink, especially under flourescent light. The pinkness is gone by 8-10 days completely. But I bet with a full face none of this woud be nearly as noticable as with spot treatment.

Hey Headsup, I bet you'll like Dr. Rokhsar. He'll answer all your questions and likes to draw diagrams which are really helpful too. Ask him about Roll-CIT. I read about that too and it's really the same concept (and needling too) as Fraxel, just more primitive and I would think with much more chance of bad side effects like infection and scarring, but they do go deeper. It would be interesting to know what Rokhsar thinks since he knows the developers of Fraxel and I'm sure they were aware of CIT and could have programmed the handpiece to work even deeper with bigger holes and wider apart. I'm guessing they considered that a limitation though or just couldn't do it.

He told me the reason they can't go deeper than ~ 750 microns (20mj) is because after that the tiny laser beams start to splay out and do too much damage and will blister and maybe scar. So they would probably like for it to be able to go even deeper, but just haven't figured out a way to do it effectively yet. But either way at 750 microns it's at least twice as deep as CO2 and Erbium really isn't in the same class at only 40 microns.

As for price, I doubt he will go lower than $750 and may not even go below $1250 if it's still a significan amount of surface area. He said it's really no cheaper to do a spot area because they still have the same extensive prep time (a room being taken up for an hour just for the anaesthetic to work in manhattan is costly) and the handpiece tips are very expensive, so that's actually at their cost. I dunno about that, maybe until the machine is paid off.

Good luck, would love to heer how it goes.

Birch

[lightgirl]

Lightgirl,

I found the article interesting.. so it sounds like using fraxel at these higher settings does produce much better results.  I'm assuming when he says 50% of his patients saw *significant* improvement, that would be 40% or better.. and atleast 80% of them saw moderate improvement, probably 25% to 40%...  That would still mean 2 out of 10 saw probably under 25% improvement.


I was also wondering for the swelling and redness...  how long on average is it before you look "presentable".  If you get fraxel at these settings done say on a friday morning, are you able to return on monday morning with no one noticing?


Sean..

Hi Sean,

I always get my treatments done late afternoon on Thursday and swollen for 3 days. Then as Birch described, you have sort of a rough feel and bronze color to the skin, which flakes off and is gone by the 5th or 6th day. Skin is pink for a week to ten days, but not usually red-just pink. I am good to go on the Tuesday following my treatment, and feel confortable being seen in public. I will start to see effects of the treatment in about 3 weeks.

I always have this nice round circle of pinkness on my right cheek so one of the advantages of being a female is that I apply blush to the left cheek to even things out :-), but without make-up I would probably look a little funny with this big round circle of pinkness on one side of my face. I think you could safely go out in public on the 6th day. So get it done close to the weekend.