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Troubled
You are so knowledgable and provide valuable insight. What has been your treatment plan and experience so far? I know Blaster had spot treatments at 40 on the first machine. I had spots at 30 with no discernible damage. I wish he would return with pre/post phots. Do you have any photos?
In my opinion, the clinical trials that should be done, but apparently have not been, is where a blinded, independent assesor views pre and post photos of a large sample. One group would be treated by SR 1500 and the conrol group would have no treatment. If Reliant incurs the cost of such a study, it might not be much extra cost to have a third group, with treatment by the first generation Fraxel. But, perhaps they would not want to do this because it might demonstrate no need to upgrade, as well as increase the cost of the study. I am not saying this in a negative way toward Reliant, as I think they have come up with a creative solution for acne scarring ( I am hoping I get a better result on my next set, with slightly more aggressive treatment). I just know that many corporate managers will tell you "Don't ask the question if you won't like the answer." Why risk proving that second generation is no more effective than first generation from a clinical, cosmetic perspective, even though you anticipate that the enhanced features of SR 1500 should make a clinical difference. So, while the beta testing you refer to has value, I still think blinded photo assessment is the best approach.
I agree that the FDA has stringent standards compared to most of the world and that is generally a good thing for the American public. However, I also believe the FDA is badly underfunded so that they may accept studies that are less than perfect, especially on matters that are not life threatening and affect only a small percentage of the populace.
I also agree that people will tend to sell what they have, but, while I could be wrong, I trust my doc on this.
Fraxel is overated the cost benefit ratio of up to several expensive treatments is dubious considering variable individual biochemistry on which positive outcomes rely is an unknown variable. Needling injures the skin in the same micro pattern as fraxel leaving the epidermis intact allowing for rapid healing from adjacent skin the needles also penetrate into the dermis just as fraxel does its also generally far less expensive. Bottom line is laser resurfacing such as Fraxel is the most unpredictable modality of scar revision coming in a long way behind excision surgery, dermal fillers and abrasive therapy. Nothing wrong with trying it just beware of unsubstantiated hype and guaranteed results.
I don't consider anything that has made it through the FDA approval process to be unsubstantiated. It's been substantiated, else the FDA would not have approved this laser specifically for acne scarring.
Hype? Sure, I think it's being hyped/talked up. Newly available things ALWAYS are: think IPODs, carb blockers, sneakers that light up when you walk, and the latest blockbuster movie...
Guaranteed results? Do any of us REALLY believe that ANY scar revision treatment is GUARANTEED?
It's IMPOSSIBLE to guarantee results from ANY acne scar revision treatment. Fraxel is no exception. Some excisions fail. Some fillers don't work out. Some abrasive therapy fails. Individual results - in ANY acne scar revision treatment - will vary. Some people will not achieve positive results from excisions, but fillers and abrasion may work. Some will find excisons work, others may find abrasion treatments work, but some may find themselves with additional scarring as a result of an abrasion treatment. Fraxel 2 may work for me but not for you.
The reality is that there are no guarantees with ANY of these procedures.
That said, I'm VERY pleased with the fraxel 2 cost/benefit ratio. For me, worth EVERY PENNY.
AND - I've got two more treatments to go!
Would it be possible or fairly comfortable to drive two hours, have fraxel, then drive home??? The nearest Dr. who has the fraxel is located around 120 miles from where I live. I would really like to try this at least once to see if I could benefit from a series of treatments but didn't really think it was possible to drive 2 hours, have the fraxel, then drive 2 hours home. I also have a child and would most likely have to pick up from school which would involve getting out of the car and walking up to the school. Would I look scary after the fraxel and would I have the stamina to drive home and carry on daily things? I am seriously considering it. I have scheduled an erbium yag peel 20-30 microns but if I had a dr in the area who has a fraxel, I would have tried it long ago. Please advise. Thanks in advance.
Would it be possible or fairly comfortable to drive two hours, have fraxel, then drive home??? The nearest Dr. who has the fraxel is located around 120 miles from where I live. I would really like to try this at least once to see if I could benefit from a series of treatments but didn't really think it was possible to drive 2 hours, have the fraxel, then drive 2 hours home. I also have a child and would most likely have to pick up from school which would involve getting out of the car and walking up to the school. Would I look scary after the fraxel and would I have the stamina to drive home and carry on daily things? I am seriously considering it. I have scheduled an erbium yag peel 20-30 microns but if I had a dr in the area who has a fraxel, I would have tried it long ago. Please advise. Thanks in advance.
I would not be able to, but that's because I use meds for the treatments. Even if I wasn't drugged, I don't think I would be able to do it because I spend the drive home putting cooling masks, ice cold cloths, etc, on my face...
Well, I would have had it but I live in West Texas and the closest Fraxel is in Amarillo, around 120 miles away. I keep thinking a Dr. around here will get one and I will be one of the first here to jump. Doesn't look like it will happen. I lived in Dallas for 10 years and there are several there. I suppose I will go ahead with my Erbium laser appt. and hope for the best. One side of my face has several smallish type scars and one larger one. I get the general consenses that the Fraxel seems to be doing the most for people with mild to moderate scarring. I am not too keen on needling since it could damage the skin further and an older person, biochemistry (whatever) or cellular turnover may not be that of a 20-30 year old. I had considered it but read some not so great results. I am so glad it seems so many are benefiting from the Fraxel. Good luck to all.
shyone, What kind of pain meds are they giving you? When I asked about some they laughed at me like that was totally unnecessary.
Dr. Friedman wants to be agressive with me but I don't know if I can stand going up much higher then this last time.
I have taken a lot of pics during my treatments but I don't feel comfortable posting them on an open forum. Maybe after my treatment is done and they show a good amount of improvement I will but for now I'm still uncomfortable with my skin. I have just had my second one done yesterday so there is nothing to show but an extremely red and very swollen face for now.
I do want to have some kind of fillers after I'm done with this treatment on my deeper/ bigger scars and the lines around my mouth. I asked the nurse about this after my treatment and she laughed and said I probably wouldn't need any after I'm done with the Fraxel 2. Yeah, that's some of the hype.
billyboy, I will call the office next week to ask for more setting information and to make sure I got all the setting correctly.
Yes, my settings are high, my doctor wants to be very agressive. He's very excited about this laser. Yes, it is very new technology and he said that I was lucky to be among the first to be getting this done.
I'm going stir crazy stuck in the house all day.
Billyboy,
In answer to your questions, I have personally undergone treatments with both lasers so can speak from experience in saying there are clear differences between the 750 & 1500. Not only from the perspective of treatment results but also in terms of comfort.
From a professional standpoint, I also happen to have a medical degree so I believe I am uniquely qualified to offer some insight on the subject. My earlier post in reference to the SR1500 is based on the simple principle of atrophic scar dynamics. Most atrophic acne scars do not extend beyond the reticular dermis as this is the last layer of the dermis. (Beyond that you would be in subcutaneous fat). The 1500 allows a depth as far as 1.2 microns which means it is capable of treating much deeper acne scarring then the original Fraxel. Deeper injury = greater tissue/healing response as long as this is done in a controlled manor. As far as the original Fraxel , again there is well documented evidence about using too high of a setting. Treating at level 40 should NEVER be done with the old Fraxel unless your goal is to risk blistering and further scarring. Your doctor should already be aware of this if he owns a Fraxel laser. It is possible Blaster slipped by without injury because his Dr. used very low density at level 40 but then what would be the point?
Regarding the FDA. Who is saying the FDA did not use a blind study with a control group?
troubled skin,
since you are a specialist who has a medical degree. i have a question. is it possible that in the fraxel 1, i plan to have my next treatment at 20mjs for a full face and additional passes on the scarred area. my question is would the extra mjs affect and perhaps cost further scarring on normal skin that is not scarred. i was wondering so perhaps in the future, i can continue to pressure my doc to go further more deeper, with perhaps 25mjs next time on my scarred areas only and 20 mjs or lower depending on your answer on non scarred areas for i am doing a full face treatment. i have atrophic acne scars that are not deep at all but would like to wipe them out completely. thanks in advance.
troubled skin,
since you are a specialist who has a medical degree. i have a question. is it possible that in the fraxel 1, i plan to have my next treatment at 20mjs for a full face and additional passes on the scarred area. my question is would the extra mjs affect and perhaps cost further scarring on normal skin that is not scarred. i was wondering so perhaps in the future, i can continue to pressure my doc to go further more deeper, with perhaps 25mjs next time on my scarred areas only and 20 mjs or lower depending on your answer on non scarred areas for i am doing a full face treatment. i have atrophic acne scars that are not deep at all but would like to wipe them out completely. thanks in advance.
I am not a specialist. Most doctors do not like to go beyond 20 for full face with the 750. Fraxel is very safe at reasonable settings. As you know Billyboy received spot treatments at level 30 with ok results. I would say spot treatments of 30 would be the limit of where I would allow my doctor to go with the original Fraxel. For full face 20. If you have a good relationship always listen to and trust your Dr's judgment.
shyone, What kind of pain meds are they giving you? When I asked about some they laughed at me like that was totally unnecessary.
Dr. Friedman wants to be agressive with me but I don't know if I can stand going up much higher then this last time.
I have taken a lot of pics during my treatments but I don't feel comfortable posting them on an open forum. Maybe after my treatment is done and they show a good amount of improvement I will but for now I'm still uncomfortable with my skin. I have just had my second one done yesterday so there is nothing to show but an extremely red and very swollen face for now.
I do want to have some kind of fillers after I'm done with this treatment on my deeper/ bigger scars and the lines around my mouth. I asked the nurse about this after my treatment and she laughed and said I probably wouldn't need any after I'm done with the Fraxel 2. Yeah, that's some of the hype.
billyboy, I will call the office next week to ask for more setting information and to make sure I got all the setting correctly.
Yes, my settings are high, my doctor wants to be very agressive. He's very excited about this laser. Yes, it is very new technology and he said that I was lucky to be among the first to be getting this done.
I'm going stir crazy stuck in the house all day.
They gave me darvocette and valium. Doesn't do shit for the pain IMO, but I'm not supposed to drive when under their influence.
The lines around my mouth are MUCH softer now - I was just noticing how much improvement I'm seeing on them this morning, and even said to my husband that IF I decide to try a filler, it isn't going to take nearly as much as it would have had I not done the fraxel. He smiled and said he doesn't think I'll even need them by the time I'm done! :clap:
When I scrutinize the lines in the magnifying mirror, it's really clear that they are not nearly as deep as they were. They're not gone, but they are changed already. I have seen more changes lately, towards the end of my unintended 5 week break from treatment. Based on my experience, I'm confident that improvement will continue for at least a few months after treatment. :dance:
Dr. Jih has told me from the start that she is aggressive - I think I'm seeing results because she's been so aggressive.
I go in Monday for #4. 🙂
Billyboy,
In answer to your questions, I have personally undergone treatments with both lasers so can speak from experience in saying there are clear differences between the 750 & 1500. Not only from the perspective of treatment results but also in terms of comfort.
From a professional standpoint, I also happen to have a medical degree so I believe I am uniquely qualified to offer some insight on the subject. My earlier post in reference to the SR1500 is based on the simple principle of atrophic scar dynamics. Most atrophic acne scars do not extend beyond the reticular dermis as this is the last layer of the dermis. (Beyond that you would be in subcutaneous fat). The 1500 allows a depth as far as 1.2 microns which means it is capable of treating much deeper acne scarring then the original Fraxel. Deeper injury = greater tissue/healing response as long as this is done in a controlled manor. As far as the original Fraxel , again there is well documented evidence about using too high of a setting. Treating at level 40 should NEVER be done with the old Fraxel unless your goal is to risk blistering and further scarring. Your doctor should already be aware of this if he owns a Fraxel laser. It is possible Blaster slipped by without injury because his Dr. used very low density at level 40 but then what would be the point?
Regarding the FDA. Who is saying the FDA did not use a blind study with a control group?
I read the clinical study. There was no control group. One study did have independent doctors observing and rating the before and after.
It's not that hard to get FDA approved. All they have to show is that it helps moderately. Remember during clinical trials a lot of the factors we are concerned with are not present, such as: cost/result ratio, overall affordability, finding a practitioner, finding a skilled practitioner, etc. The clinical trial is "product-centered" not "patient-centered."
Do you mean the SR1500 goes 1.2 MILLIMETERS? 1.2 microns is about 1/100 the thickness of a piece of paper (100 microns thick). From what I read the new fraxel goes about 1 mm deep and each MTZ is 100 microns wide with a spacing between them of about 200 microns.
For comparison a human hair is about 100 microns in diameter, the average pore is 60 microns in diameter. The stratum corneum (layer of dead skin) is 25 microns deep.
Jamesjoyce,
Thank you for your keen observation. The depth of penetration is 1.2 millimeters at it's highest level. In reference to what you read about MTZ width, I should comment the spot size and width of MTZ's are NOT fixed with the SR1500. FYI: I am also including a clip of from an e-mail that an account manager at Reliant sent me concerning this.
The attached PDF file at the bottom of the page nicely demonstrates the changes in spot sizes and MTZ width with one pass after succesively increasing mJ/cm2:
As far as the FDA is concerned, if what you are saying is correct then the study may have been subject to flaws. However, I would not pass off FDA approval too lightly. There are LOTS of laser manufacturers that have attempted FDA approval for acne scarring but never made the grade. I will expand more on this as time allows.
Dear All,
Many of you have asked when considering a "fractional device" what are the critical components to consider? One of the most important elements to ensure you are getting a good consistent treatment is the system in which the energy is delivered. We at Reliant-Technologies use the analogy if I were to ask you to paint a large wall, and I gave you two choices to paint with, either a roller or a sponge, the majority would say a roller. (unless you are my wife who customizes all of her painting around the home-this mind you after she has used a roller to apply the base coat!) This makes perfect sense to get a good consistent treatment. Reliant uses an optical scanning system revolutionary to the medical industry.
The second thing to consider is the ability to change the spot size as well as the depth of penetration. One physician told me depth is where the money is. I have been experimenting with the Reliant Treatment Tip Test Paper, and wanted to share with you the change in the number of MTZ's per cm2 at four different treatment levels. Those treatment levels were 10mj, 20mj, 30mj and 40mj. I have scanned this into a PDF File for you to better understand as we increase the energy level (mj) we increase the depth of penetration and reduce the number of MTZ's per cm2. This is critical if you want to effect tissue, and collagen remodeling. The SR1500 allows you to go as deep as 1.2 millimeters. Consider a patient with acne scarring, you have to have the ability to penetrate to the reticular dermis to effect that type of scarring. With the Fraxel SR1500, the system automatically adjusts the spot size as well as the depth to maximize the treatment. This also has a significant impact on the discomfort of the treatment. Laying down fewer spot sizes at higher energy levels makes the treatment very tolerable. Reliant-Technologies is the only fractional device that offers this unique approach to the treatment.
I hope this information is helpful to you as you are trying to decide which fractional device best suites your practice needs?
Jamesjoyce,
Thank you for your keen observation. The depth of penetration is 1.2 millimeters at it's highest level. FYI I am also including a clip of from an e-mail that an account manager at Reliant sent me concerning this.
As far as the FDA is concerned, if what you are saying is correct then the study may have been subject to flaws. However, I would not pass off FDA aprroval too lightly. There are LOTS of lasers manufacturers that have attempted FDA approval but never made the grade.
Dear All,
Many of you have asked when considering a "fractional device" what are the critical components to consider? One of the most important elements to ensure you are getting a good consistent treatment is the system in which the energy is delivered. We at Reliant-Technologies use the analogy if I were to ask you to paint a large wall, and I gave you two choices to paint with, either a roller or a sponge, the majority would say a roller. (unless you are my wife who customizes all of her painting around the home-this mind you after she has used a roller to apply the base coat!) This makes perfect sense to get a good consistent treatment. Reliant uses an optical scanning system revolutionary to the medical industry.
The second thing to consider is the ability to change the spot size as well as the depth of penetration. One physician told me depth is where the money is. I have been experimenting with the Reliant Treatment Tip Test Paper, and wanted to share with you the change in the number of MTZ's per cm2 at four different treatment levels. Those treatment levels were 10mj, 20mj, 30mj and 40mj. I have scanned this into a PDF File for you to better understand as we increase the energy level (mj) we increase the depth of penetration and reduce the number of MTZ's per cm2. This is critical if you want to effect tissue, and collagen remodeling. The SR1500 allows you to go as deep as 1.2 millimeters. Consider a patient with acne scarring, you have to have the ability to penetrate to the reticular dermis to effect that type of scarring. With the Fraxel SR1500, the system automatically adjusts the spot size as well as the depth to maximize the treatment. This also has a significant impact on the discomfort of the treatment. Laying down fewer spot sizes at higher energy levels makes the treatment very tolerable. Reliant-Technologies is the only fractional device that offers this unique approach to the treatment.
I hope this information is helpful to you as you are trying to decide which fractional device best suites your practice needs?
Thanks, Troubled - and thanks Reliant Account Manager person!
Well, I would have had it but I live in West Texas and the closest Fraxel is in Amarillo, around 120 miles away. I keep thinking a Dr. around here will get one and I will be one of the first here to jump. Doesn't look like it will happen. I lived in Dallas for 10 years and there are several there. I suppose I will go ahead with my Erbium laser appt. and hope for the best. One side of my face has several smallish type scars and one larger one. I get the general consenses that the Fraxel seems to be doing the most for people with mild to moderate scarring. I am not too keen on needling since it could damage the skin further and an older person, biochemistry (whatever) or cellular turnover may not be that of a 20-30 year old. I had considered it but read some not so great results. I am so glad it seems so many are benefiting from the Fraxel. Good luck to all.
I know this is an extra expense, but maybe you could get a hotel near the office or part way home? Some offices will coordinate this for you. You need to ice immediately following the procedure off and on for the duration of the afternoon/evening. Maybe you could split up the drive somehow?
My doc uses meds too and that would mean no driving at all afterward, but he gives you a choice. Hope you are able to work it out.
Hi and thanks for your suggestion. I had considered getting a hotel for the night. Driving up in the morning, getting a hotel that night and driving back the next morning. My scarring, except for one scar may be considered minor to alot, but with all the peels, smoothbeam and everything I have done, it seems the rest of my skin is smooth and it makes the scars appear very obvious. I suppose I will go ahead with the erbium peel at 20-30 microns and go from there. I planned on having a few of these as well as possibly an excision on one scar in between the peels. I have spent quite a bit on treatments and honestly would fork over the money for this but the drive is an issue. I have a six year old and I doubt my husband would understand it. He seems okay with the erbium peel and is taking off a few days to pick her up from school. If I don't see any improvements after one erbium and 400.00 plus meds. I already spent 125.00 for the consult. I'll scrap this plan and plan on a fraxel in Amarillo. It would be an undertaking since first I'd have to drive up for a consult, then shedule one. I am fairly certain they would recommend it. I try to be objective about my skin and it seems I would probably be a good candidat. Oh well. I suppose I am bummed since I think I may have a new scar from a breakout. I had it zapped with smoothbeam but the scab fell off prematurely. It may still heal up. 
According to link posted, Reliant is recruiting for treatment for Asian skin with Fraxel 2
http://www.craigslist.org/pen/vol/232213597.html
Where are they located? Has anyone tried calling them?
Edited: I relooked the site: Its located in SF CA? That's too far from me.
According to link posted, Reliant is recruiting for treatment for Asian skin with Fraxel 2
http://www.craigslist.org/pen/vol/232213597.html
Where are they located? Has anyone tried calling them?
Edited: I relooked the site: Its located in SF CA? That's too far from me.
i just gave them a call now, and left a message. hopefully it'll go thru, but i would be very interested in doing this, i think.
They gave me darvocette and valium. Doesn't do shit for the pain IMO, but I'm not supposed to drive when under their influence.
The lines around my mouth are MUCH softer now - I was just noticing how much improvement I'm seeing on them this morning, and even said to my husband that IF I decide to try a filler, it isn't going to take nearly as much as it would have had I not done the fraxel. He smiled and said he doesn't think I'll even need them by the time I'm done! :clap:
When I scrutinize the lines in the magnifying mirror, it's really clear that they are not nearly as deep as they were. They're not gone, but they are changed already. I have seen more changes lately, towards the end of my unintended 5 week break from treatment. Based on my experience, I'm confident that improvement will continue for at least a few months after treatment. :dance:
Dr. Jih has told me from the start that she is aggressive - I think I'm seeing results because she's been so aggressive.
I go in Monday for #4. 🙂
Wow! I'm still surprised you are getting these pain meds. All I have had is the triple numbing cream that makes my face really red. No Motrin even. The nurse told me to even wait 30 mins after the laser to take the Motrin. Dr. Ji must be a lot different then Dr. Friedman, he laughed at me when I told him someone was taking these pain killers ( I hadn't remembered it was someone from my same office!).
But I guess if it's not doing anything for the pain then I won't even bother. It's uncomfortable but it's over pretty quickly so I don't think messing myself up with those meds would even be worth it. My treatment is very agressive as well. As I sit her with my red swollen face I can see track marks from the laser head where it went over my face. There are white marks in between them. I guess he did turn up the % covered because I don't remember seeing this before!
I'm not sure if you have the same nurse as me but you might want to tell her that you too are on this message board and if it's the same one encourage her to join and give us some advise. She seemed very intrigued.
Troubled Skin, thanks so much for all of the information you have provided. It's very interesting and nice to hear this from someone who has actually had these treatments too.
How many have you had done and have you seen any improvements yet? Thanks again.
According to link posted, Reliant is recruiting for treatment for Asian skin with Fraxel 2
http://www.craigslist.org/pen/vol/232213597.html
Where are they located? Has anyone tried calling them?
Edited: I relooked the site: Its located in SF CA? That's too far from me.
I wish they were taking hispanics also. We have the same skin tone sometimes. I wonder if i could get away with saying I am philipina. Some philipinos have even asked me if I am mixed. I am in los angeles but I would travel to get these treatments for free.
Billyboy,
In answer to your questions, I have personally undergone treatments with both lasers so can speak from experience in saying there are clear differences between the 750 & 1500. Not only from the perspective of treatment results but also in terms of comfort.
From a professional standpoint, I also happen to have a medical degree so I believe I am uniquely qualified to offer some insight on the subject. My earlier post in reference to the SR1500 is based on the simple principle of atrophic scar dynamics. Most atrophic acne scars do not extend beyond the reticular dermis as this is the last layer of the dermis. (Beyond that you would be in subcutaneous fat). The 1500 allows a depth as far as 1.2 microns which means it is capable of treating much deeper acne scarring then the original Fraxel. Deeper injury = greater tissue/healing response as long as this is done in a controlled manor. As far as the original Fraxel , again there is well documented evidence about using too high of a setting. Treating at level 40 should NEVER be done with the old Fraxel unless your goal is to risk blistering and further scarring. Your doctor should already be aware of this if he owns a Fraxel laser. It is possible Blaster slipped by without injury because his Dr. used very low density at level 40 but then what would be the point?
Regarding the FDA. Who is saying the FDA did not use a blind study with a control group?
I read the clinical study. There was no control group. One study did have independent doctors observing and rating the before and after.
It's not that hard to get FDA approved. All they have to show is that it helps moderately. Remember during clinical trials a lot of the factors we are concerned with are not present, such as: cost/result ratio, overall affordability, finding a practitioner, finding a skilled practitioner, etc. The clinical trial is "product-centered" not "patient-centered."
Do you mean the SR1500 goes 1.2 MILLIMETERS? 1.2 microns is about 1/100 the thickness of a piece of paper (100 microns thick). From what I read the new fraxel goes about 1 mm deep and each MTZ is 100 microns wide with a spacing between them of about 200 microns.
For comparison a human hair is about 100 microns in diameter, the average pore is 60 microns in diameter. The stratum corneum (layer of dead skin) is 25 microns deep.
So in the PDF:
Area 1 (10 MJ) has the most amount of MTZs; it is completely covered.
Area 4 (40 MJ) has the least amount of MTZs; it is completely sparse.
Do all these test strips show one pass of the laser? Or is it one treatment with the laser?
So at the higher settings we are getting MUCH less coverage. Wow. This MIGHT explain why those with very shallow scarring who got lower settings had such good improvement. Of course their scars where light to begin with but they also got the most coverage per treatment.
Even with multiple passes at 40 MJ I doubt you could achieve the coverage of one pass at 10 MJ (according to this test strip that is).
It looks like if you had treatment at level 30-40 MJ you'd need much more than 5 treatments to get 100 percent coverage. I mean, test strip 4 looks like it covers only 5 percent of the area if that.
JJ and Troubled
JJ asked some good questions on scattergram test strip. Is this strip from model 750 or 1500? I hope Troubled can answer, but I am guessing the 1500.
With 750, it was my understanding that there were only 2 density settings, 125 and 250 mtz per cm2. After my first visit, they always used 125 mtz per cm2 becasue I was at 20 and 25 mjs of intensity, with a few spots at 30 on last session. Furthermore, I believe that hgiher mjs did not affect density, except to extent that size of mtz might get larger due to greater thermal injury of surrounding tissue, causing bigger holes that might get bigger still when hit by subsequent passes.
Also, I did not have a big problem with the pain, so that is not a compelling reason for me to incur extra cost/effort to go for SR 1500. To me the key issue is efficacy and safety. From my prior experience, I think I am safe at my prior levels, but the efficacy was low.
Troubled, if I go forward with another series with model 750, I am thinking about repeating my last treatmnet level, namely, 8 passes at density 125 at level 25, with 2 passes at level 30 over scarred areas, and doing this with 4 treatments spaced 1 month apart. Alternatively, I might go with 6 passes full face at 25 and 4 passes over scarred areas at 30. I would appreciate your thoughts on this. Sounds like you think 40 is unsafe.
Thanks