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I am getting my first Fraxel tomorrow. I am trying to remodel / smooth the edges on two medium-depth pitted acne scars (one on my nose and one on my cheek).
I just took several "before" pictures.
I plan to take pictures over the next few days (to evaluate the healing process).
And then more pictures several months after my last treatment (to evaluate the effectiveness).
-Ralph
Met with Doc who has SR 1500. I was told by fraxel rep that he would tend to be less expensive than others around SF because he is in EAST Bay (very close to where I live) where wages, houses, etc are lower.
He would not budge on his price of $4600 for 4 and could not convince me that the 1500 is so much better than the SR 750 to make up for the $2800 price my prior Doc is offerring (he has increased prices since but will give me the prior pricing as I am former patient).
Hi,
I thought I'd share this:
There are two kinds of FDA approval. One is called "510k." The other is called "PMA" (Pre-Market Approval).
To get 510k approval little information on the safety and efficacy of a treatment or device has to be shown. 510k is an FDA approval for Reliant Tech to market the fraxel as an acne scar treatment.
PMA is much harder to get and requires a lot more evidence to be presented. Fraxel does not have a PMA in any area. This is not uncommon, no lasers are required by the FDA to get PMA.
Google "fraxel" and "510k". You can get the actual FDA documents from their website.
non-reliant pics
woman with red marks
http://www.dermassocseattle.com/cosmetic/wrinkle_topic6.htm
hypopigmentation
http://www.yourskinforlife.com/dermatology...ces/fraxel.html
stretch marks
http://www.westlakedermatology.com/fraxel.htm
I asked a doctor about Fraxel for stretch marks. I lift weights and am in great shape. one downside to lifting
weights and putting on muscle is that those prone to stretch marks will get little white lines on certain areas.
I have them on my arms (think of NBA players almost all have stretch marks there from weight lifting) And
on the sides of the thighs. I do not really care about the thigh scars as they are covered up unless I am
naked. THe ones on my arms I wanted to treat. I was told that nothing under the sun would do anyhting
for a stretch mark. The only solution to stretch marks would be to cut them out (which is not even an option
as that will leave a scar) or to have a tummy tuck or skin removal (pulls the skin tight and makes the marks
appear to be lessened) Anyway I have just white lines as I am still muscular and my skin is tight. I dont
think that picture is real or that it shows the results of some form of tummy tuck or skin removal.
I had my 1st Fraxel laser treatment today. As I said in my previous post, I am trying to reduce / smooth out some old medium-depth scars on my nose and cheeks. Previous treatments with Smoothbeam and C6 Medlite lasers did nothing for these scars. Neither did copper peptides.
The doctor 1st prepped the 3 affected areas of my skin with a lidocaine numbing cream. He then sent me back out to the waiting room to sit for 30 minutes (with plastic cellphane wrap on top of the cream).
Then he took me back to the laser room and wiped off all of the numbing cream. Next, he applied the blue pigmented cream and smeared it over the affected scars on my skin. Then he applied some vasoline-type gel on top of the blue cream.
He set the machine to: Energy = 20, and Density = 125. He did 9 total passes on each scar in various directions. (he would do 3 passes on one scar, then move to a different one and do 3, and cycling until all scars got 9 passes).
He also used a Zimmer cooling device that blows cold air on the skin. The procedure was not painful at all. It just felt a little warm when he was going over the scars. I don't know if that was because of the numbing cream, or the Zimmer cooling device, or I have a very high pain threshold.
After the procedure, I had 3 small red/puffy squares over my face. They felt like localized sun burns... The burning sensation lasted about 1 hour.
Here is the amazing part: 2 hours later, 95 % of the redness was gone. My skin is already starting to flake superficially. AND I CANNOT SEE my worst scar (the one on my nose). But, the ones on my cheeks are still there...
He wants me to come back in 3 weeks for my next treatment. And he recommends a total of 5 treatments...
I don't know what I am more happy about: The fact that there is virtually no downtime... Or, the scar on my nose is practically invisible!
Glad to hear you had no pain or much downtime with your first treatment. Did you have the Fraxel 1 (750) or the Fraxel 2 (1500)?
I just had my third treatment today and I put my setting in my signture (except the nurse didn't write down the density, I will call tomorrow), boy is my signature getting long 
Pretty much business as usual except OWWWWWWWWWW!!! Man this one was a toughie to get through. The doc and the nurse always pat me on the back as I'm wiping tears out of my eyes and telling me how tough I am and congratulation me on taking the pain.
Dr. Friedman asked me what new's I had gotten off the internet (not sure if I am annoying him with all the information I get here or not) and when I told him that I read that the KJ setting should be for a face: Small 5-6 kJ Medium 6-7kJ, Large 7-8 kJ .my doctor just laughed and said these were the settings for the Fraxel 1, not the 2.
I still don't understand how that works really, since as my treatment gets more agressive my KJ settings gets lower. Should I be asking the doctor to do more passes then 8 or 10 and do them at a lower fluence?
Ok i'm waiting for the extreme swelling tomorrow! Two more Fraxels to go!
Hey, jjp - had my fifth one on Monday.
I am still swollen and red today. I had MASSIVE flaking yesterday, still going today but not as much since most of my face flaked off yesterday...
I'm going back in March so they can get "after" pics, and I'll decide whether to have another round at that point, too. If I get decent improvement from this one by March, I MAY do a couple more.
It is now 24 hours after my 1st Fraxel spot treatment for depressed scarring. (Energy = 20, Density = 125)
No pain, No swelling. Very mild redness that is starting to 'bronze.' Some flaking around my nose, but no flaking around my cheeks yet.
The once-obvious depressed scar on my nose is still practically invisible. No noticable changes to the scars on my cheeks.
To answer the question of whether he used Fraxel 1 or Fraxel 2... I don't know. I forgot to look at the side of the machine. I was busy focusing on all of the numbers and settings on the monitor...
Hi,
I thought I'd share this:
There are two kinds of FDA approval. One is called "510k." The other is called "PMA" (Pre-Market Approval).
To get 510k approval little information on the safety and efficacy of a treatment or device has to be shown. 510k is an FDA approval for Reliant Tech to market the fraxel as an acne scar treatment.
PMA is much harder to get and requires a lot more evidence to be presented. Fraxel does not have a PMA in any area. This is not uncommon, no lasers are required by the FDA to get PMA.
Google "fraxel" and "510k". You can get the actual FDA documents from their website.
non-reliant pics
woman with red marks
http://www.dermassocseattle.com/cosmetic/wrinkle_topic6.htm
hypopigmentation
http://www.yourskinforlife.com/dermatology...ces/fraxel.html
stretch marks
http://www.westlakedermatology.com/fraxel.htm
I asked a doctor about Fraxel for stretch marks. I lift weights and am in great shape. one downside to lifting
weights and putting on muscle is that those prone to stretch marks will get little white lines on certain areas.
I have them on my arms (think of NBA players almost all have stretch marks there from weight lifting) And
on the sides of the thighs. I do not really care about the thigh scars as they are covered up unless I am
naked. THe ones on my arms I wanted to treat. I was told that nothing under the sun would do anyhting
for a stretch mark. The only solution to stretch marks would be to cut them out (which is not even an option
as that will leave a scar) or to have a tummy tuck or skin removal (pulls the skin tight and makes the marks
appear to be lessened) Anyway I have just white lines as I am still muscular and my skin is tight. I dont
think that picture is real or that it shows the results of some form of tummy tuck or skin removal.
Sometimes they heal on their own if you lose weight/mass. Lots of body builders get them at competition time, when they retire they tend to slim down and the stretch marks get better.
No thats not really the case at all. Stretch marks become MUCH MORE noticable on the older guys with less
muscle at the gym. Its like a female having a baby. Unless the marks are red then losing weight will make
them much more noticable. At this point they are white lines that show up when I am tanned. If I lost
weight and muscle they would be loose and look more noticable.
All muscle guys have stretch marks. They use tanners and things over them to cover the marks for photos
and things. NOne that i have talked to have ever heard of anyhting working or any marks just going away.
Its not an issue for most though as a hard body is worth some very hard to see little lines. I use body
makeup on them at the beach and thigns so its all good.
Just got back from my 3rd treatment. I told the doc. to spot treat all of my surgical scars. She did that but i'm not sure they count as passes. She also won't go higher than 25 (energy level). She only did 8 passes this time and @ energy level 8. The settings are lower than my 2nd treatment.
Hey, jjp - had my fifth one on Monday.
I am still swollen and red today. I had MASSIVE flaking yesterday, still going today but not as much since most of my face flaked off yesterday...
I'm going back in March so they can get "after" pics, and I'll decide whether to have another round at that point, too. If I get decent improvement from this one by March, I MAY do a couple more.
Have you seen any type of improvement at all yet?
Most definitely! :clap:
For now, of course, I'm puffy and red and flakey post treatment. :redface:
And remember - I'm not in the ideal candidate age range - I'm 46. You younger ones will be able to get much better improvement than I'm able to get.
Have you seen any type of improvement at all yet?
Most definitely! :clap:
For now, of course, I'm puffy and red and flakey post treatment. :redface:
And remember - I'm not in the ideal candidate age range - I'm 46. You younger ones will be able to get much better improvement than I'm able to get.
I'm so happy to hear you're getting good results! I'm starting again on January 5th, and I'm 51. You're the closest one to my age I've seen on here yet, except maybe for Drewboy. I think he's around our age. Keep us updated, please!
Have you seen any type of improvement at all yet?
Most definitely! :clap:
For now, of course, I'm puffy and red and flakey post treatment. :redface:
And remember - I'm not in the ideal candidate age range - I'm 46. You younger ones will be able to get much better improvement than I'm able to get.
Will you be posting photos anytime soon? I think we all would love to view them.
Hey, jjp - had my fifth one on Monday.
I am still swollen and red today. I had MASSIVE flaking yesterday, still going today but not as much since most of my face flaked off yesterday...
I'm going back in March so they can get "after" pics, and I'll decide whether to have another round at that point, too. If I get decent improvement from this one by March, I MAY do a couple more.
I'm so glad to hear you have had such good results. I'm not 'old' but I'm not young either 😉 I told him to go as agressive as he wanted to and he sure did. I am completely swollen and extremely red but I'm totally used to it now and it does not phase me anymore. He did say I might be swollen a little longer this time since we went from level 8 to 10 and he went really close to my eyes. Like you said I almost had to stop at one point but I kept saying, I'm fine I'm fine. At one point I think both the doctor and the nurse were very concerned about me because I couldn't talk I was concentrating so hard on keeping it together.
I still can't believe you get all of those pain meds before your Fraxel and they have never mentioned that as an option for me even when I mentioned that I knew someone on pain med they just laughed (that was before I found out we were goign to the same clinic!!!)!! I feel like wonder woman taking all of this pain. LOL Just kiddin.
I forgot to call about the density settings today. For some reason I thought this was your 4th not your 5th one...WOW! You must have started right when they upgraded the machine to be done already.
I did the buy 4 get the 5th one free deal. I will probably do a couple more around June or July if I see good results.
Just out of curiosity why did you choose to have Dr. Jie do the Fraxels and not Dr. Friedman?
Ok, its now been 2 days (almost 48 hours) since my 1st Fraxel treatment... (Energy = 20, Density = 125, Passes = 9)
The Good News: All of my scars are near invisible. Remember, initially it was only the pitted scar on my nose. But now the ice-pick/pitted scar on my cheek is near invisible (this happened last night).
The Bad News: My skin is becoming more bronze / dry / rough. Remember, initially I was happy because the swelling went away in about 1 - 2 hours, and there was minimal redness. Now you can clearly see 4 small tan squares on my cheeks! Embarrassing - but it will be worth it if my scars stay invisible.
Overall, I am extremely happy with the results... But remember its ONLY been 2 days.
Ok, its now been 2 days (almost 48 hours) since my 1st Fraxel treatment... (Energy = 20, Density = 125, Passes = 9)The Good News: All of my scars are near invisible. Remember, initially it was only the pitted scar on my nose. But now the ice-pick/pitted scar on my cheek is near invisible (this happened last night).
The Bad News: My skin is becoming more bronze / dry / rough. Remember, initially I was happy because the swelling went away in about 1 - 2 hours, and there was minimal redness. Now you can clearly see 4 small tan squares on my cheeks! Embarrassing - but it will be worth it if my scars stay invisible.
Overall, I am extremely happy with the results... But remember its ONLY been 2 days.
Ralphie,
I don't mean to discourage you, but I think you should be careful what conclusions you draw 2 days after your first fraxel. Fraxel will cause some swelling (I know you think your swelling has gone down) that will last for about a week. That swelling temporarily makes your scars look like they've disappeared. Think of it like how your skin looks better right when you wake up in the morning because your face has swelled a little bit from lying down for 8-9 hours.
Most people don't see results until after the third fraxel, so I'm guessing what you're seeing is swelling.
TROUBLED,
Hi there, I know you have tried to explain this before but I was hoping for one more time or maybe a simpler explanation. My last fraxel treatment was very painful, the first was not. I am assuming it has to do with treatment levels since everything else was the same. I was noticing that even though some of us on the board have the same treatment levels (level 8 or level 10 for fraxel II), the KJ's differ greatly even for full face. For acne scarring, is it best to have higher MJ's, KJ's, or what and what is density? I know some of it has to do with face size, etc. but I am sooo confused...it seems like my PA knows what she is doing but I have two more treatments left and want to make sure I get the most out of them. Also, this last one hurt pretty bad and I am not looking forward to another one at that level if it was the level that caused the pain. If that is the only way to get results I will do it but I want to make sure....thanks.
Ok, its now been 2 days (almost 48 hours) since my 1st Fraxel treatment... (Energy = 20, Density = 125, Passes = 9)The Good News: All of my scars are near invisible. Remember, initially it was only the pitted scar on my nose. But now the ice-pick/pitted scar on my cheek is near invisible (this happened last night).
The Bad News: My skin is becoming more bronze / dry / rough. Remember, initially I was happy because the swelling went away in about 1 - 2 hours, and there was minimal redness. Now you can clearly see 4 small tan squares on my cheeks! Embarrassing - but it will be worth it if my scars stay invisible.
Overall, I am extremely happy with the results... But remember its ONLY been 2 days.
Careful Ralphie. You are setting yourself up for dissapointment. You still have "microswelling" and your scars will reappear. This has happened to everyone on here.
TROUBLED,Hi there, I know you have tried to explain this before but I was hoping for one more time or maybe a simpler explanation. My last fraxel treatment was very painful, the first was not. I am assuming it has to do with treatment levels since everything else was the same. I was noticing that even though some of us on the board have the same treatment levels (level 8 or level 10 for fraxel II), the KJ's differ greatly even for full face. For acne scarring, is it best to have higher MJ's, KJ's, or what and what is density? I know some of it has to do with face size, etc. but I am sooo confused...it seems like my PA knows what she is doing but I have two more treatments left and want to make sure I get the most out of them. Also, this last one hurt pretty bad and I am not looking forward to another one at that level if it was the level that caused the pain. If that is the only way to get results I will do it but I want to make sure....thanks.
Nantynannie,
There are several factors at work which can explain why your pain is increasing with each TX. Among the most common is increasing mj/density with each treatment. Also, your body may still be in the healing phase from your last TX. The more aggressive your treatments are the longer healing takes. Other factors that may contribute to additional pain would be the SR1500 increases total skin coverage by 3% with each level increase until as much as 32% total surface coverage is reached at treatment level 10. It also reaches a depth of 1.2mm at 40mj/cm2! That is a lot of punishment for those acne scars and unfortunately you in the process! While Fraxel 2 is said to be less painfull when compared to equivalent setting on the old Fraxel. Treatment with Fraxel 2 is usually much deeper/more aggressive and for this reason you might consider asking your doctor for a nerve block next time. They usually work quite well.
Regarding the confusion about kJ levels, I understand where you are coming from. This confuses even many doctors that are still in the learning curve.
The variance in kJ levels can be explained by understanding a little bit about the dynamics at work. As mj/cm2 increases, density automatically decreases as the lasers spot size increases. This begins to reduce total kJ levels more substantially as treatment moves upward beyond the 20/mj/cm2 range and continues exponentially up to 40mj/cm2.
Keep in mind that although density and kJ decrease, the relative coverage level increases due to the larger spot size and greater amount of thermal damage surrounding the MTZ ablation points. Most experienced doctors understand this and treat at variable mj to bring up density and kJ and then do additional passes at 40/mj to cover all bases. Shyones signature is a good example of textbook treatment. Of course treatments levels can vary substantially by individual doctor preference and the condition being treated. Hope this clears up any confusion you might have.
TROUBLED,Hi there, I know you have tried to explain this before but I was hoping for one more time or maybe a simpler explanation. My last fraxel treatment was very painful, the first was not. I am assuming it has to do with treatment levels since everything else was the same. I was noticing that even though some of us on the board have the same treatment levels (level 8 or level 10 for fraxel II), the KJ's differ greatly even for full face. For acne scarring, is it best to have higher MJ's, KJ's, or what and what is density? I know some of it has to do with face size, etc. but I am sooo confused...it seems like my PA knows what she is doing but I have two more treatments left and want to make sure I get the most out of them. Also, this last one hurt pretty bad and I am not looking forward to another one at that level if it was the level that caused the pain. If that is the only way to get results I will do it but I want to make sure....thanks.
Nantynannie,
There are several factors at work which can explain why your pain is increasing with each TX. Among the most common is increasing mj/density with each treatment. Your body also might still be in the healing phase from your last TX. The more aggressive the treatment, the longer it takes. Other to consider would be the SR1500 increase total skin coverage by 3% with each level increase until as much as 32% total surface coverage is reached at treatment level 10. It also reaches a depth of 1.2mm at 40mj/cm2! That is a lot of punishment for those acne scars and unfortunately you in the process. You might consider asking your doctor for a nerve block next time. They usually work quite well.
Regarding the confusion about kJ levels, I understand where you are coming from. This confuses even many doctors that are still in the learning curve.
The variance in kJ levels can be explained by understanding a little bit about the dynamics at work. As mj/cm2 increases, density is automatically decreased because the lasers spot size increases. This begins to reduce total kJ levels as treatment goes upward of the 20/mj/cm2 range and continues to decrease up to 40mj/cm2.
Keep in mind that although density and kJ decrease, the relative coverage level increases due to the larger spot size and greater and consequent amount of thermal damage surrounding the MTZ ablation points. Most experienced doctors understand this and treat at variable mj to bring up density and kJ and then do additional passes at 40/mj to cover all bases. Shyones signature is a good example of textbook treatment. Of course treatments levels can vary substantially by individual doctor preference and the condition being treated. Hope this clears up any confusion you might have.
On the Fraxel2, where do we look for the Density? I've gotten the KJs right below the energy level labeled "Actual Size". Next to it says Estimated size. Am I looking at the correct section? I'm not sure at this point why my doc. decreased the settings on me this time. I hope she knows what she is doing.
Could you look at my last treatment settings on my signature and explain to me whether this treatment is more or less aggressive than my second treatment. I notice today that I am not as swollen as I was on my 2nd treatment. I'm not sure if it means that I'm healing better or the setting was lower comparing to my previous one.
I realized now that my doc. is conservative. The highest energy level she goes is 25. Will continuing at that setting help w/ acne scars?
TROUBLED,Hi there, I know you have tried to explain this before but I was hoping for one more time or maybe a simpler explanation. My last fraxel treatment was very painful, the first was not. I am assuming it has to do with treatment levels since everything else was the same. I was noticing that even though some of us on the board have the same treatment levels (level 8 or level 10 for fraxel II), the KJ's differ greatly even for full face. For acne scarring, is it best to have higher MJ's, KJ's, or what and what is density? I know some of it has to do with face size, etc. but I am sooo confused...it seems like my PA knows what she is doing but I have two more treatments left and want to make sure I get the most out of them. Also, this last one hurt pretty bad and I am not looking forward to another one at that level if it was the level that caused the pain. If that is the only way to get results I will do it but I want to make sure....thanks.
Nantynannie,
There are several factors at work which can explain why your pain is increasing with each TX. Among the most common is increasing mj/density with each treatment. Your body also might still be in the healing phase from your last TX. The more aggressive the treatment, the longer it takes. Other to consider would be the SR1500 increase total skin coverage by 3% with each level increase until as much as 32% total surface coverage is reached at treatment level 10. It also reaches a depth of 1.2mm at 40mj/cm2! That is a lot of punishment for those acne scars and unfortunately you in the process. You might consider asking your doctor for a nerve block next time. They usually work quite well.
Regarding the confusion about kJ levels, I understand where you are coming from. This confuses even many doctors that are still in the learning curve.
The variance in kJ levels can be explained by understanding a little bit about the dynamics at work. As mj/cm2 increases, density is automatically decreased because the lasers spot size increases. This begins to reduce total kJ levels as treatment goes upward of the 20/mj/cm2 range and continues to decrease up to 40mj/cm2.
Keep in mind that although density and kJ decrease, the relative coverage level increases due to the larger spot size and greater and consequent amount of thermal damage surrounding the MTZ ablation points. Most experienced doctors understand this and treat at variable mj to bring up density and kJ and then do additional passes at 40/mj to cover all bases. Shyones signature is a good example of textbook treatment. Of course treatments levels can vary substantially by individual doctor preference and the condition being treated. Hope this clears up any confusion you might have.
On the Fraxel2, where do we look for the Density? I've gotten the KJs right below the energy level labeled "Actual Size". Next to it says Estimated size. Am I looking at the correct section? I'm not sure at this point why my doc. decreased the settings on me this time. I hope she knows what she is doing.
Could you look at my last treatment settings on my signature and explain to me whether this treatment is more or less aggressive than my second treatment. I notice today that I am not as swollen as I was on my 2nd treatment. I'm not sure if it means that I'm healing better or the setting was lower comparing to my previous one.
I realized now that my doc. is conservative. The highest energy level she goes is 25. Will continuing at that setting help w/ acne scars?
Mz,
Density is now preprogrammed into the treatment parameters with Fraxel 2 to ensure consistency between operators. Your doctor did less passes this time at the same fluence at a lower treatment parameter yet reached higher kJ. This indicates the technique was more aggressive. Perhaps longer passes were used as well. Your kJ is high for cheeks only. That is good as long as there is no resulting hyperpigmentation. This is very rare with Fraxel though even on asian skin.
Well I am totally confidant that my doctor knows what he is doing with this laser and which settings to use on my type of scarring. He spends most of the day in the Fraxel room and he has quite a few different lasers. He was one of the first to start using the Fraxel 1 machine and one of only 3 who got the Fraxel 2 upgrade a few months ago. So I know he's quite knowledgable using the Fraxel. If you aren't sure that your doctor or NP knows what they are doing find a new one pronto!!
Level 10 hurt worse then level 8 but that seems rational.
Well I am totally confidant that my doctor knows what he is doing with this laser and which settings to use on my type of scarring. He spends most of the day in the Fraxel room and he as quite a few different lasers. He was one of the first to start using the Fraxel 1 machine and one of only 3 who got the Fraxel 2 upgrade a few months ago. So I know he's quite knowledgable using the Fraxel. If you aren't sure that your doctor or NP knows what they are doing find a new one pronto!!Level 10 hurt worse then level 8 but that seems rational.
Well said. Finding the right Dr. is 90% if the battle.