Vbeam Perfecta will cause 0 hematoma and depending on how you react, little swelling that will subside within 2-12 hours. However, It must be the Perfecta (perfected version) and not the older Vbeam that was notorious for causing prolonged bruising.

2/10 pain

2-12 hours

Hello,

I have had several Vbeam sessions in my life already.

If you want fast results you have to go for a purpura treatment. Means that you will have lots of bruises which are dark purple.

If your are patient, you can go for a mild vbeam, like I do. You will need more sessions but there will be little to no downtime. The day after my last vbeam I looked nearly normal. Only a little redness. But no bruises or swelling.

I have chosen the mild treatment because I couldn't handle the bruises in the past. Last year I had 2 purpura treatments and couldn't leave the house for a very long time. I was also left with hemosiderin staining after the bruises have faded. It took month to go away.

And about the pain... I didn't have any. So I would say 1/2of 10

@tomato12 do you happen to remember the settings for the non purpuric treatments? also if you dont mind, can you share the name of the doc who did purpuric treatments? Very few docs are comfortable with purpuric settings .

@keving100it depends on your skin type, thickness, and ethnicity, there are no "settings". I have had "purpuric" and non purpuric vbeams maybe 20 in my lifetime. I have them done after any treatment. If you tell the doctor to go hard some do oblige and turn it up. It's very easy to get purpuric vbeams, thinner blood with dilated vessels (drink lots of water and wear super warm clothes). I suppose the thinking with some is the bruise causes more blood to be absorbed by the body and when you go light, your not hitting the vein and blood cells as hard, thus making multiple treatments necessary. The new perfecta machine does not bruise as much because of the optics and cooling upgrade. But you can still bruise. Drs do not want to bruise you as that is when people complain of down time or pain, also $$$ of extra treatments. Take vitamin K and arnica montanna topically and internally to get rid of bruises.

Thanks so much @beautifulambition. So far I had 3 treatments of Vbeam at 6ms pulse width, 7 mm spot size and 6.5 J/cm2 fluence. These are non purpura settings. I have got no improvement from these treatments. Doctors at realself have commented that if you decrease the pulse width and increase the fluence, you can get purpura. Thats why I wanted to know the exact settings so maybe I can atleast get a test spot with those settings. Unfortunately, the doctors here charge $300 per treatment and I cant afford 10+ treaments if go non purpura each time L

@keving100what is the vbeam for scars or PIE / Hyperpigmentation? Maybe Vbeam is not a good treatment for you there are other options like IPL, BBL, and 1064nm laser. You should never need 10 treatments. Have they tried turning it up all the way? Some people have extremely thick skin or their blood is supper thick. That makes since decrease width or the spot of the laser (focus is in a smaller area) and fluence is the power. Watch some videos on Youtube, see if you can see the settings they use on the machine by pausing it (it's not universal), they stopped going so high because of high down time and some where not getting any diffrence with bruising than mild redness. I know though I have seen some skin that does not respond and needs another type of laser. The test spot is a good idea at a high percentage, to test and see.

On 15.2.2017 at 1:45 AM, keving100 said:

@tomato12 do you happen to remember the settings for the non purpuric treatments? also if you dont mind, can you share the name of the doc who did purpuric treatments? Very few docs are comfortable with purpuric settings .

 Sorry i dont know bout the setting. And name of my doc won't help you as I am living in Germany  

@beautifulambition isn't it contra productive to take aspirins before vbeam? I have always thought that blood thinning medications prevent the blood from clotting. But don't we want achieve blood clotting with vbeam? 
 

"Contra productive to take aspirins before vbeam? "

I think my comment is taken out of context. Most people should not take aspirin before any laser procedure.

You will get bruises and have longer down time. This is why people don't do it. Also if you bleed easy or are taking meds, spices, or vitamins to thin your blood they are afraid of blood issues.This poster is doing a test spot, has done other treatments with no results, and does not know if his doctor will reduce spot size and turn up the fluence. This is the proper time to test if this works for them as they are doing a test spot. You can also dilate your blood vessels for a better vbeam by drinking lots of water and being super warm, wear warm clothes that day which could help ;-P They may have supper thick veins or they are deep. There are other procedures which may work as well BBL, IPL, and other laser frequencies like used in tattoo removal. Most people should not do this with specifically the aspirin.

With most procedures being on a blood thinner will increase your degree of bruising and this included lasers. There are other IPL lasers that do not cause significant bruising like the Sciton BBL. Discuss with your laser specialist.
Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon

No blood clotting is needed with vbeam, your destroying a vein and red blood vessels, the body absorbs them.

To aspirin, the only good prostaglandin is a dead prostaglandin. It has been shown that high doses of salicylates, including aspirin and sodium salicylate, dilate blood vessels in vivo. So while it blocks prostaglandins that cause pain or cause clotting and narrowing of the blood vessels and inflammation, it also blocks prostaglandins that protect the stomach lining.

With respect to my Dermatological colleagues who have answered this already, we need a little science here. The V-beam laser is a type of pulsed dye laser (long pulse) designed to treat vascular lesions such as port wine stains or the skin vessels of rosacea. Pulsed dye lasers work by emitting laser energy at a 585nm (yellow) wavelength that happens to correspond to an absorption peak of oxyhemoglobin. This means that this color of laser energy is preferentially absorbed by oxygenated blood, which of course is what is in our blood vessels (even veins). The V-beam laser is one kind of pulsed dye laser that operates at or near this same wavelength and has selectable shutter durations and power settings.

Blood vessel abnormalities such as port wine stains are actually capillary malformations, orabnormal dilationsof capillaries close to the surface of the skin. The color of the port wine stain (pink to salmon-red to purple) relates to the flow rates (and subsequent absorption of the oxygen bound to the hemoglobin molecules) within these tiny vessels. Rosacea is a skin condition characterized by sebaceous hyperplasia, skin thickening,dilated vessels, and often certain kinds of intra-follicular bacteria.

Same dilated surface capillaries, different cause. Same treatment (as far as the vessels are concerned).
Neither condition has "broken" vessels, and in fact this is a lay term that is incorrect medically, but often used by physicians because that is the terminology patients use. These vessels are (more) visible because they aredilated, not "broken."

To destroy these dilated vessels enough energy needs to be absorbed by the vessel to do one of two things, preferably without damaging the normal skin structures.
The vessel absorbs enough energy to actually burst, releasing a blush of blood (the bruise) which demonstrates the capillaries in that laser spot received adequate energy to be destroyed. The pulse of energy is timed so that the laser shuts off so fast, heat damage is minimized to other tissues. This combination of proper energy for a specific duration is dependent on vessel diameter, and is termed the thermal relaxation time. Of course, depth of vessel is also important, but these laser wavelengths penetrate only about a millimeter or so before all the energy is absorbed, especially by a port wine stain or the dilated capillaries of rosacea. The bruise takes about two weeks to go away, just like a black eye.
The vessel heats up more slowly and the vessel spasms and the blood is actually constricted away from the vessel. This occurs when the energy is applied slowly, rather than in the half of a thousandth of a second that the pulsed dye laser beam duration is. The vessel (hopefully) heals shut permanently.

A V-beam laser is a long-pulse pulsed dye laser, with shutter durations which can be twice to as much as 20 times the shutter duration (1-10 milliseconds) of the "standard" pulsed dye laser (450 microsecond shutter duration). Typically, this will be enough energy to cause a bruise (bursting) of only a few of the capillaries in a port wine stain or rosacea blush, since usually these energies cause the vessels to heat up and spasm rather than burst. So, a bruise is notnecessary, but if it occurs, it always signifies that at least some of the offending vessels have been properly damaged and will now be gone! The V-beam laser can cause enough thermal damage to blister and scar skin, so proper energy selection is important.

Depending on the size (diameter) and flow rates of the vascular lesion to be treated, V-beam is more nonspecific than the short-duration pulsed dye laser, which is specifically designed to treat the type and diameter of the vessels in port-wine capillary malformations. BTW, pulsed dye laser treatment of larger vascular lesions such as venous malformations or hemangiomas is generallynoteffective, since the target size of the vessel is too large for the energy and pulse duration of this laser. V-beam treatment may be more effective, or other recommendations need be considered. (Outside the scope of this discussion.)

So, bruising DOESN'T "help." It is simply a sign that the capillaries that you want destroyed burst and can be considered "gone." The absence of bruising doesn't mean that the treatment was ineffective, but it COULD mean that. It's all in the energy, the vessel size, the depth and flow rates of the vessels, and therefore the skill and experience of the doctor choosing the laser type, settings, etc. It's not about laser brand names!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars248 reviews
www.mpsmn.com

Most doctors now agree that bruising is not necessary to get good results with the V-beam laser. It is not necessary, but sometimes it helps. The bruising settings on the laser are sometimes better at getting rid of stubborn broken vessels (vessels as opposed to redness). Some studies even show that for redness, it is more effective to NOT bruise (and instead stack pulses or do multiple passes with the laser at settings that do not bruise.)
So the answer is that you do not usually need bruising to get good results. The V-beam is often a series of 4 or 5 treatments. So I often start with settings that do not leave bruises for the first few treatments, and only increase the settings to "bruising" levels if necessary for stubborn areas during the last few treatments.

Todd Minars, MD
Miami Dermatologist
3.7 out of 5 stars6 reviews

This post was very helpful for me! Thank you very much