Ok so my KJ's are to low, so what should I ask for at the next treatment. I can tell he wants to crank it up and I am going to let him at the next one but will turning up the KJ's increase the pain? I'm almost at my peak as far as pain goes.

All of these different settings are confusing me. Just when I think I have about got it something else pops up.

Thanks guys.

I can't wait to see what Shyone's settings are.

 

Billy,

I agree 3KJs is too low for scarring. As far as your treatments are concerned, it would be completely reasonable to expect additional improvement in the 15-20% range with the Fraxel 750 as that is the % of improvement you received from the first set of treatments. I have no data on exactly where the point of diminishing returns are with Fraxel but I suspect it would be somewhere in the 50 -75% range depending on the scars being treated.

The human body is an amazing thing in that by the very fabric of its nature it responds through adaption, refinement & strength in the face of repeated stress. Think immune response, muscle response, brain acuity, ect.

It is well accepted that skin tissue responds to repeated stress in this same manor. Think skin calluses, scar fibrosis, skin contraction, ect. In this same manor it becomes more proficient & stronger at producing collagen in the face of repeated injury.

I believe this to be true and tend to think the most benefit with Fraxel can be obtained through repeated treatment sets and by timing the treatment sets to continue at the peak of collagen production (when improvement is most obvious). In this way each series of treatments should yield better and better results as your body becomes more proficient at collagen production.

Much like doing that next set of laps in the pool when you are tired and your muscles ache. Intuitively you know that performance gains like many things in life come from consistency, exposing yourself to stress, stretching the limit of your abilities, never giving up, instinctively pushing yourself further and further to avoid hitting the wall of mediocrity!!

Now I suppose I should get my a** off this cushy office chair and get some work done. 😆

 

 

KJ is the measurement of total energy used and will go up automatically as your P/S gets more aggressive. It is not a setting that is adjusted manually on the machine. The precise amount of KJ to be reached is usually determined by the size of your face. Talk to your P/S, get his thoughts on the matter and let us know what K/J you hit in your next visit. I can give you some guidance but I suspect is your P/S is just being conservative with your initial treatments to mitigate risks.

 

hehe, thanks shyone and thanks jjp for your private message to me about the bickering feud nonsense. anyways, i agreed with you nannie that though in the begining like i think a week and a half or even 2 weeks, it is hard to assume that the results you have are permanent but after 3 weeks or perhaps 2 weeks to 2 1/2 weeks which varies from person, i think that the results are rather real. though all my scars have re appeared but i must say that i look MUCH better then i did before the 1st treatment, espcially after showers, when my skin used to look like a carpet rug which makes the scars even glow horribly but now the scars are very smooth and softer and some have been teasing me about dissapearing completely, i must rate my improvement so far on a scale of 90% being the best improvement, iw ould say roughly 10-15%, and on my shallowest scars, it is very hard to see now since it is 9.3/10 almost filled in so i am saying perhaps a 70-75% improvement. now my estimation are not 100% accurate for i want to downplay the improvement then over exagerating it. i have stopped exercising for this week and prepping my skin for the 2nd treatment this coming friday. hope that helps. oh yea good luck to everyone, i'm on fraxel 1 btw. lol im so jealous of the fraxel 2 people, hehe..

 

Simply,

That's really fantastic news. It's always nice to hear when someone takes the time to report back positive news.

 

hehe, i should thank you troubled_skin for it is you that posted that pdf file about STL about the laser mjs depth recomendation for scars, so i saved that pdf and will print it out to take to my doc. feel free to post any other valuable information that my doc should know also , charts, graphs, pictures, etc. thanks and good luck to all.

 

Ok so my KJ's are to low, so what should I ask for at the next treatment. I can tell he wants to crank it up and I am going to let him at the next one but will turning up the KJ's increase the pain? I'm almost at my peak as far as pain goes.

All of these different settings are confusing me. Just when I think I have about got it something else pops up.

Thanks guys.

I can't wait to see what Shyone's settings are.

 

Billy,

I agree 3KJs is too low for scarring. As far as your treatments are concerned, it would be completely reasonable to expect additional improvement in the 15-20% range with the Fraxel 750 as that is the % of improvement you received from the first set of treatments. I have no data on exactly where the point of diminishing returns are with Fraxel but I suspect it would be somewhere in the 50 -75% range depending on the scars being treated.

The human body is an amazing thing in that by the very fabric of its nature it responds through adaption, refinement & strength in the face of repeated stress. Think immune response, muscle response, brain acuity, ect.

It is well accepted that skin tissue responds to repeated stress in this same manor. Think skin calluses, scar fibrosis, skin contraction, ect. In this same manor it becomes more proficient & stronger at producing collagen in the face of repeated injury.

I believe this to be true and tend to think the most benefit with Fraxel can be obtained through repeated treatment sets and by timing the treatment sets to continue at the peak of collagen production (when improvement is most obvious). In this way each series of treatments should yield better and better results as your body becomes more proficient at collagen production.

Much like doing that next set of laps in the pool when you are tired and your muscles ache. Intuitively you know that performance gains like many things in life come from consistency, exposing yourself to stress, stretching the limit of your abilities, never giving up, instinctively pushing yourself further and further to avoid hitting the wall of mediocrity!!

Now I suppose I should get my a** off this cushy office chair and get some work done. 😆

 

 

KJ is the measurement of total energy used and will go up automatically as your P/S gets more aggressive. It is not a setting that is adjusted manually on the machine. The precise amount of KJ to be reached is usually determined by the size of your face. Talk to your P/S, get his thoughts on the matter and let us know what K/J you hit in your next visit. I can give you some guidance but I suspect is your P/S is just being conservative with your initial treatments to mitigate risks.

 

Well, I have a small face, I'm a tiny person. My doctor said he was being aggressive but I will ask him about the KJ's at my next visit in a month. Just when I thought he was being super aggressive with me now I am starting to wonder. Next time I'm telling him to go as agressive as he feels is appropriate for my scars. I want to take full advantage of the remaining 3 sessions.

And like Simply Me said, lets just concentrate on the knowledge and experiences in this thread and ignore the 'other' BS. 😀

JJP

Yes, smaller face should have less KJs. I would defer to Troubled, because he is the expert, but I also think female skin tends to be thinner, which is another reason to ease up on KJs.

Troubled - Thanks for Laser News article. I actually saw Dr Chis Zachary while he was at UCSF. Apparently, he is now at Irvine campus per the article. What he said is consistent with what he told me years ago.

1. He stopped using CO2 in favor of Erbium Yag due to hypo and scarring problems.

2. He told me he would not treat me with Erbium because he did not think my scarring was bad enough to justify the risks. He suggested I wait for Fraxel and/or Smoothbeem which were in the process of coming out at the time, but UC did not have them.

Anyway, I think his advice was excellent on this. However, he was the doc who did three scar excisions, 2 of which turned out horribly, and he admitted as much to me. While I realize that one can not generalize, I would caution anyone looking at excisions; in particular, go with a P/S not a derm for excisions.

Despite my limited, to reasonable, success with Fraxel, I think Fraxel is virtually risk free, making it an attractive, yet expensive option. Every time I post, it reminds me how much I wish I had not had those excisions and why I am reasonably ok with less than stellar scar improvment from Fraxel.

Billy,

Thank you for your kind words however, I do not consider myself an expert. Much is still needed to be learned about fractional phototherymolysis as a technology and we are only just touching the surface. I also have an excellent contact who works for Reliant that has been instrumental in shedding light on the subject.

What eludes me are such dramatic differences in reported results on this forum for acne scarring. I do NOT believe Fraxel is all hype, far from it. There are just too many elite P/S who are claiming outstanding results with Fraxel. Some are the absolute best in the minds of medicine with enormous reputations to stand behind. It seems to me that at least in part, these differences in results can be explained by under or even over treatment on the part of the P/S. There seems to be a sweet spot that must be hit but there are so many opinions and such little data with this new technology that no-one seems to really know what that is. I recently read an article from Reliant that stated if the hand piece is not held correctly that can even attribute to penetration differences?

I donat know if you had a chance to read the section about Fraxel on page 7. But for the benefit of everyone these are the quotes:

Dr. Geronemus: Fraxel is the aoetreatment of choicea for

acne scarring: aoeThe scars are significantly better. This is a

gradual response. We do see some short-term edema, but over

the long-term collagen formation occurs, and there is a longer

term benefitaWhat we found looking at 60 acne scars was an

average quantitative improvement of 50 %.

a Illinois: aoeThe Fraxel has quick effect and no downtime.a

a Massachusetts dermatologist: aoeI use a lot of Fraxel, with

good results. Itas great for melasma and acne. Patients

are demanding very little downtime.a

a Texas: aoeThe Fraxel is very good, but it is also very

expensive. The technology is cool.a

a Georgia: aoeI like the Fraxel laser but it costs $100,000.

Iam excited about it because itas better for face and skin.a

a North Carolina: aoeThe most exciting thing here is the

Fraxel laser treatment. Iam typical in that I follow something

for a few years before I make a decision to get the

device. Non-ablative is definitely the trend now, and

Fraxel is a happy medium. Thereas no downtime, little

pain during the procedure, and no liniments to apply.a

a Ohio: aoeFraxel is still the big thing this year. Last year it

was a buzz, and this year itas a bigger buzz. It does what

it says itas going to do, but it also has a steep learning

curve.a

a California: You can get the neck to match the face by

using the Fraxel on the neck and chest. And itas the ice

pick scars and dilated pores that do so well with Fraxel.

Thereas an individual wound-healing response, and not

everybody is going to get that, but there is a larger

probability of improving acne scars with Fraxel than with

any other technology.a

Day 26 Fraxel 1 SR15000.

Hey guys, I'm not seeing any improvements on this first treatment. Everything is back to normal, pretty bummed out. All of my scars are still there. I'm most bummed about not seeing any changes on the Chicken Pox Scar, my doc. also focus on that specific spot. I'm going for 2nd treatment this Friday 11/17. Does anyone know if I would be able to see difference after the 2nd treatment?? I'm so tired of waiting for my skin to change and having to wait for weeks btw. treatments.

ps: I can't believe people would pay 1k for one treatment and to have no change.

Day 26 Fraxel 1 SR15000.

Hey guys, I'm not seeing any improvements on this first treatment. Everything is back to normal, pretty bummed out. All of my scars are still there. I'm most bummed about not seeing any changes on the Chicken Pox Scar, my doc. also focus on that specific spot. I'm going for 2nd treatment this Friday 11/17. Does anyone know if I would be able to see difference after the 2nd treatment?? I'm so tired of waiting for my skin to change and having to wait for weeks btw. treatments.

ps: I can't believe people would pay 1k for one treatment and to have no change.

 

I started really seeing changes after treatment #3. Don't be too bummed yet!

 

Day 26 Fraxel 1 SR15000.

Hey guys, I'm not seeing any improvements on this first treatment. Everything is back to normal, pretty bummed out. All of my scars are still there. I'm most bummed about not seeing any changes on the Chicken Pox Scar, my doc. also focus on that specific spot. I'm going for 2nd treatment this Friday 11/17. Does anyone know if I would be able to see difference after the 2nd treatment?? I'm so tired of waiting for my skin to change and having to wait for weeks btw. treatments.

ps: I can't believe people would pay 1k for one treatment and to have no change.

 

I started really seeing changes after treatment #3. Don't be too bummed yet!

 

I'm only getting 3 treatments. My question is will 3 treatment be enough for me? I feel like I need 10 treatments to be happy. I'm trying to stay up but I'm frustrated too.

I'm only getting 3 treatments. My question is will 3 treatment be enough for me? I feel like I need 10 treatments to be happy. I'm trying to stay up but I'm frustrated too.

 

How happy you are after 3 treatments is related to what your expectations are for your outcome, you know?

Yeah, my expectation is to have ~80% out of 100%. If I see more than 50%, I will be happy too but I would continue with treatments. Do you guys think thats achievable or am I leading myself to dissapointment?

Okay I just took few pictures. I realized that the chicken pox scar (left side) that was excised looks alot worse than before. I cannot stand that scar and its driving me crazy!! I will be so happy if that is eradicated! I'm not happy with my overall skin texture on both cheeks. It doesn't look like normal skin (It looks rough). Pores size are back to normal. I circled scars and all the major problem areas I could see on the each pic. I'll leave the pic. on here for 1-2 days (skin is disgusting) but I'm looking for advice and comments again.

ps: I really want to see pics. from others that's going through the treatment w/ me. I want to see results or improvement w/ my own eyes.

Here are the orders:

Left Side taken 11/15/06

Left Side taken 11/15/06

Right Side taken 11/15/06

Right Side taken 11/15/06

Left Side post Frxl

Right Side post Frxl

Right Side post Frxl

Right Side before Frxl

mz43026, ask your doctor for photo's. He/she should have pics to show you of patients he has treated.

Fraxel 1 is 750 and Fraxel 2 is 1500.

Fraxel isn't an instant fix. If you expect to see major improvment from one treatment you will be very dissapointed. It takes 3 to 6 months after your last treatment for the collegen to fill in. I am doing 5 treatments and then probably even more 3 to 4 months after my 5th to deal with my deeper scars. You have to be very patient with this treatment. I would wait until a few months after your 3rd treatment to see significant improvemnt and if you aren't satisfied you might want to do one or two more. Talk to your doctor he should be able to tell you what to expect.

It takes time for collegen to grow and this is why I think a LOT of people get frustrated and start saying Fraxel doesn't work(like Keith).

You look young and if you are taking care of your body and your skin and your doctor is giving you the best treatment settings for your problems it will be a bit before you see results.

Hey!!!

Starting my fraxels on December 8th 06..just wanna thank 'Florida' and everyone that wrote info about this procedure. You guys really assured me that I made the right decision. I totally cried when I read some of the posts...My skin has moderate acne scaring and it haunts me everyday. Sometimes I can't even look in the mirror..I feel like a monster! I hate it and I can't wait till I see improvment. I know it won't be 100% but anything is better than the hell I go though on a daily basis. I'm really excited!!!

THANKS AGAIN EVERONE! Wish me luck!!

Hey!!!

Starting my fraxels on December 8th 06..just wanna thank 'Florida' and everyone that wrote info about this procedure. You guys really assured me that I made the right decision. I totally cried when I read some of the posts...My skin has moderate acne scaring and it haunts me everyday. Sometimes I can't even look in the mirror..I feel like a monster! I hate it and I can't wait till I see improvment. I know it won't be 100% but anything is better than the hell I go though on a daily basis. I'm really excited!!!

THANKS AGAIN EVERONE! Wish me luck!! :dance:

 

I'm so happy for you!

Keep us updated!

good luck jennie, i recomend you prep your skin 2 weeks before treatment wit a good hydroquinone cream.

hey mz43029, hang in there buddy, seriously, your scars are not at all visible in the photos but i know we are our own worst critic, like i stated before, my 2nd fraxel is on the same day as you so good luck. also seriously your scars are not bad at all, i can imagine why the doc said he wanted 3 treatment on you only to try, remember to be optimistic and dont stress cause it will destroy your re-habilitation power. hang in there my dear, honestly, i know how you feel, i have some shallow scars on my front right cheek that bugs me the most too and i pray that after all of this fraxel treatments, it will dissapear. keep your head up.

Day 26 Fraxel 1 SR15000.

Hey guys, I'm not seeing any improvements on this first treatment. Everything is back to normal, pretty bummed out. All of my scars are still there. I'm most bummed about not seeing any changes on the Chicken Pox Scar, my doc. also focus on that specific spot. I'm going for 2nd treatment this Friday 11/17. Does anyone know if I would be able to see difference after the 2nd treatment?? I'm so tired of waiting for my skin to change and having to wait for weeks btw. treatments.

ps: I can't believe people would pay 1k for one treatment and to have no change.

 

Hi MZ,

My PA says to expect some visible results between 2 and 3 treatments. Please be patient and don't be disappointed yet. There is a reason this laser is set up as a series of treatments and not just one treatment. If tangible results were obvious from just one treatment, then they would set up one treatment at a time and wait 6 months until everything was healed to see if you wanted another one. I know it sucks that the process takes sooo long!!! I will try to post some pics, but keep in mind I am only 17 days after first treatment so there could still be some swelling I cannot detect.

BTW, I think your skin looks great. I know it is not great to you, but I think it is well enough off that you could get some good results.

mz43026, ask your doctor for photo's. He/she should have pics to show you of patients he has treated.

Fraxel 1 is 750 and Fraxel 2 is 1500.

Fraxel isn't an instant fix. If you expect to see major improvment from one treatment you will be very dissapointed. It takes 3 to 6 months after your last treatment for the collegen to fill in. I am doing 5 treatments and then probably even more 3 to 4 months after my 5th to deal with my deeper scars. You have to be very patient with this treatment. I would wait until a few months after your 3rd treatment to see significant improvemnt and if you aren't satisfied you might want to do one or two more. Talk to your doctor he should be able to tell you what to expect.

It takes time for collegen to grow and this is why I think a LOT of people get frustrated and start saying Fraxel doesn't work(like Keith).

You look young and if you are taking care of your body and your skin and your doctor is giving you the best treatment settings for your problems it will be a bit before you see results.

 

The machines at the docs. office is called SR1500 so I assume it is Fraxel2. I've asked for photos of their patients but I was told that they cannot show them because of patient confidentiality. They showed me photos provided by Reliant but I told them that I don't believe it. I mean how do we know if they weren't photo touched and its not done by my doctor. I was told that I only need 3 treatment but I don't believe thats the case. I feel like I need more treatments to meet my expectation. How many treatments do you guys think I should need??

edited: I would like to see some improvement on my 2nd treatment just so I know that I'm on the right track. If that make sense

good luck jennie, i recomend you prep your skin 2 weeks before treatment wit a good hydroquinone cream.

hey mz43029, hang in there buddy, seriously, your scars are not at all visible in the photos but i know we are our own worst critic, like i stated before, my 2nd fraxel is on the same day as you so good luck. also seriously your scars are not bad at all, i can imagine why the doc said he wanted 3 treatment on you only to try, remember to be optimistic and dont stress cause it will destroy your re-habilitation power. hang in there my dear, honestly, i know how you feel, i have some shallow scars on my front right cheek that bugs me the most too and i pray that after all of this fraxel treatments, it will dissapear. keep your head up.

 

Hey, Good Luck as well. I have to say my scars look worse in person. The picture doesn't show everything. I am very anxious about the whole treatment. I'm trying to be positive but on the back of my head I'm afraid that Fraxel won't help my scars at all. I want to believe most of my doctors words but I've also tried alot of things prior to Fraxel. I been through disappointment and I don't want it to happen to me again. But today I felt so awful about my skin and I had to get 2nd opinion from this forum. Thanks 🙂

 

Day 26 Fraxel 1 SR15000.

Hey guys, I'm not seeing any improvements on this first treatment. Everything is back to normal, pretty bummed out. All of my scars are still there. I'm most bummed about not seeing any changes on the Chicken Pox Scar, my doc. also focus on that specific spot. I'm going for 2nd treatment this Friday 11/17. Does anyone know if I would be able to see difference after the 2nd treatment?? I'm so tired of waiting for my skin to change and having to wait for weeks btw. treatments.

ps: I can't believe people would pay 1k for one treatment and to have no change.

 

Hi MZ,

My PA says to expect some visible results between 2 and 3 treatments. Please be patient and don't be disappointed yet. There is a reason this laser is set up as a series of treatments and not just one treatment. If tangible results were obvious from just one treatment, then they would set up one treatment at a time and wait 6 months until everything was healed to see if you wanted another one. I know it sucks that the process takes sooo long!!! I will try to post some pics, but keep in mind I am only 17 days after first treatment so there could still be some swelling I cannot detect.

BTW, I think your skin looks great. I know it is not great to you, but I think it is well enough off that you could get some good results.

 

Thanks nantynannie. I'm really afraid that I'm wasting time. Its just that the downtimes make me feel like I'm in prison. I want to be out and about. I miss having normal skin and get my life back. I'm tired of thinking about my skin and trying to find solutions for it. Sometimes I think about going for something more invasive but I know I might regret it. I just don't want to waste anymore of my life and be unhappy with myself. I feel bad that others have worse scarring than me but I feel the same way about them even though mine is consider mild-med. I'm so sad right now.

edit: I'm looking forward to seeing your photos too. Good luck with healing 🙂

MZ

Here is my second opinion. You are young and pretty.

Fraxel will help and should benefit you more than some because you are young. That said, 3 treatments seems low. I had 4 and my Doc recently told me that Docs, at a recent Derm conference, seemed to be of the opinion that scarring takes more treatments than what I had. From my own experience, it is hard for me to imagine 80% benefit, but I am sure it can happen with the right person and the right # of treatments.

Anyway, good luck.

MZ

Here is my second opinion. You are young and pretty.

Fraxel will help and should benefit you more than some because you are young. That said, 3 treatments seems low. I had 4 and my Doc recently told me that Docs, at a recent Derm conference, seemed to be of the opinion that scarring takes more treatments than what I had. From my own experience, it is hard for me to imagine 80% benefit, but I am sure it can happen with the right person and the right # of treatments.

Anyway, good luck.

 

How much improvement (%) do you think you've had with 4 treatments? How many more treatments are you having now? I think I should ask my doc. on Friday if 3 is enough for me. I don't mind going for more treatments but I will feel better if I saw a good improvement by 3rd treatment. That way I won't be so focused on my skin. Its just horrible looking at my excision scars and then shallow scars scattered all around. I really don't think having excision on my chicken pox scar was a good move.

Simply Me: How many treatments are you getting?

 

MZ

Here is my second opinion. You are young and pretty.

Fraxel will help and should benefit you more than some because you are young. That said, 3 treatments seems low. I had 4 and my Doc recently told me that Docs, at a recent Derm conference, seemed to be of the opinion that scarring takes more treatments than what I had. From my own experience, it is hard for me to imagine 80% benefit, but I am sure it can happen with the right person and the right # of treatments.

Anyway, good luck.

 

How much improvement (%) do you think you've had with 4 treatments? How many more treatments are you having now? I think I should ask my doc. on Friday if 3 is enough for me. I don't mind going for more treatments but I will feel better if I saw a good improvement by 3rd treatment. That way I won't be so focused on my skin. Its just horrible looking at my excision scars and then shallow scars scattered all around. I really don't think having excision on my chicken pox scar was a good move.

Simply Me: How many treatments are you getting?

 

i am having 4 my dear. so far one down, 3 to go. mine is actually post-pone on friday because i have to work now, yay it feels good to go back to work to make some cash to pay for this treatments. sighz, i pray to God that i am not throwing away my ever so hard earned money. so actually it is still on friday but later in the day cause i have to work, so yea that's about it, nothing else to report further. msg me with your AIM sn or something so we can chat if you want, take cares my dear.

MZ, I'm 46 so my collagen is diminished already, and you know what? I see DEFINITE improvement in a couple of saucer shaped "chicken pox" looking scars. This became really noticeable after the third treatment.

You're a lot younger than me, so I think you'll have much better improvement than I can even hope for!

'The waiting is the hardest part'

Hang in there, and good luck!

MZ, I'm 46 so my collagen is diminished already, and you know what? I see DEFINITE improvement in a couple of saucer shaped "chicken pox" looking scars. This became really noticeable after the third treatment.

You're a lot younger than me, so I think you'll have much better improvement than I can even hope for!

'The waiting is the hardest part'

Hang in there, and good luck!

 

For reals, a persons collagen diminshes after a certain age?

 

MZ, I'm 46 so my collagen is diminished already, and you know what? I see DEFINITE improvement in a couple of saucer shaped "chicken pox" looking scars. This became really noticeable after the third treatment.

You're a lot younger than me, so I think you'll have much better improvement than I can even hope for!

'The waiting is the hardest part'

Hang in there, and good luck!

 

For reals, a persons collagen diminshes after a certain age?

 

i read that it diminished after 25. 25 yrs old that is.

I had really nice improvement in color, texture, tone; skin rejuvenation if you will. I'd say 15% on scars, but I am much older, so you might do better. Also, it is very subjective. Some people with a fraxel improvement might say look at how my scars still show, while others, looking at the same change, might instead focus on their improvement. Suffice it to say that I have room for improvement.

I am planning on a series of 4 more. After that, I have at least 1 excision scar that I might try a filler on, as I know fraxel can not fix it.