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WOw, billyboy, that is great! I'd be interested in hearing your thoughts a couple of weeks out. I've dropped the ball on fraxel. You may remember that I underwent four treatments last year. I considered waiting for fraxel 2 to come to an office closer to me (as opposed to driving four hours round trip) but from what I've been seeing on this board, even people with fraxel 2 are not seeing results that make them want to jump for joy. I am currently looking into needling (by a professional). The cost can't be beat. If after a year or so of the needling treatments I don't see more improvement, I may go back to fraxel, but I'm starting to think it may be better to dabble in something less high-tech and less invasive for a while and wait for more feedback on all this technology before I jump back in.
Chrissy, I agree with your assessment that fraxel 2 results seem disappointing based on posts on this board, so I temper my excitement with that knowledge. I mentioned to her that few posters are reporting good results. That said, there are not too many data points. She was surprised by this. Also, her comments about the 50% rule of thumb and my shallow scarring encouraged me.
Chrissy, I agree with your assessment that fraxel 2 results seem disappointing based on posts on this board, so I temper my excitement with that knowledge. I mentioned to her that few posters are reporting good results. That said, there are not too many data points. She was surprised by this. Also, her comments about the 50% rule of thumb and my shallow scarring encouraged me.
Hey billyboy,
That is great news! I really hope you get the results you are looking for with the newer Fraxel. I think I'm starting on Monday with the SR1500, also. I hope we both have good things to report!
Got lucky today. I'm as excited as I've been since first fraxel, but I will try to be objective now and in later posts.A Reliant rep/training nurse did my treatment with SR 1500. She mentioned that an upgrade will soon eliminate need for blue due (no biggie for me) and that a new machine will soon be released that goes to 70 mjs. She was awesome.
My doc has resisted buying the 1500 because Dr Tina Alster said at an ASDS meeting that she saw no clinical difference, so I am his guinea pig for him making a buy decision and he wants me to report what differences I notice, which I am happy to do. So far, I notice that it is way less painful and I have less burning and swelling. Before, I would shake and grit my teeth with SR 750 and I would have to wait after treatment for 1 hour with Zimmer cooling before I felt ready to drive 70 miles home. Today, I left right away. The total energy per my sig is way down even though she went into my neck and she did extra passes at my request on 2 areas on my left cheek. This is not huge for me as I can tolerate pain, but it is nicer. Also, the SR 1500 enables faster treatment.
I asked rep what differences they see in efficacy between machines, noting my disappointment with scarring efficacy of SR 750 (say 15-20% so far), while noting how happy I am with rejuvenation. She said that SR 1500 is way better for acne scars because of deeper dermal remodeling (1160 microns) at 40 and that they use a rule of thumb of 50% improvment for a treamtnet series. I really think she was being honest about this.
She said my scars are shallow, except for the depression from a failed excision, and that fraxel is a god treatment for someone like me with shallow depth but moderate quantity. Normaly, they would not treat me this high, but did so at my request becasue I have tolerated previous treatments jsut fine, and have lighter but tan skin (ie., nondark).
I am really hopeful that this machine will amke the difference I have been seeking.
Has anyone else been treated by both machines? If so, have you noticed an improved efficacy?
Hey Billy!
Congratulations! It looks like you ended up getting treated with the SR1500 after all. Actually 7kj is considered very high due to the absence of density at 40mj/cm2. Is there any way you can get a full trial of 5 treatments with the new machine? I highly doubt that one treatment would make much of a difference if any.
Troubled and others
Thanks. I have paid for one more and if I conclude this is the answer, I would buy 4 more. My issue is that my doc has not committed to the SR 1500. He wants me to report back on difference and keep my eye out for other reports on these boards. There are the obvious ones I mentioned above, but I think he wants to get at efficacy. Frankly, this will be almost impossible for me to assess because if I see a lot of improvement, how do I know the cause (the SR 1500 or the cumulative effect of prior treatments finally kicking in). I guess if I see no major improvment, that could be interpreted negatively, but then you note that you really need more than 1 to test this hypothesis.
I want to give an honest answer becasue I owe my doc that duty, but it will be hard to draw conclusions. In any event, I am going to wait extra long for the next treatment to help answer this question.
Again, I would appreciate input from others on clinical efficacy.
Congrats Billyboy. Wow you have done 7 Fraxel treatments total, that is great to be able to do that many! I don't see why your doctor doesn't upgrade except for the money aspect. He shouldn't have to buy a whole new machine, I thought it was just a software upgrade. What is your doctor charging you per treatment if you don't mind me asking? I ended up paying $800 per treatment for mine with the package deal.
If I could afford it I would have another round of treatments when they get the new tip so no more blue dye and also wait for the next software upgrade to do higher levels. After I pay off this treatment I will look into it but for now I just can't jusitfy the money.
I can't believe the 750 was more painful as I can barely take the 1500 at level 10 and when the doctor tried to go up another level I could only take a few passes and he had to turn it down a few times.
I was supposed to go in today and let the doctor look at my skin but I just did not want to deal with it right now so I am going to wait another month to see if I get even more improvment.
I have been using my topicals again on a regular basis and I think that has helped my skin get back together from the on and off again skincare since doing the Fraxels. Today my skin looks pretty good. I woke up with only one pimple on my nose. I can see my scars softening but I don't want to get to excited as my skin changes so much from week to week. Like I said before I have one scar that is about 75% improved and the others are softer but a few havn't changed at all.
Good luck BillyBoy, can't wait to hear how it turns out for you but like Troubled said I'm not sure if just one treatment with the 1500 will do enough for you to notice a big chage. I bet you will wake up swollen tomorrow.
JJP
I am paying $2,800 for 4, which is low by CA standards, but I travel to Stockton, which is way less expensive than SF. My doc is hesitant to incur cost because he was told by Alster and perhaps a few others that they don't see a clinical difference (I don't knwo if this comment was related specifically to scarring, as it could be directed at all types of skin conditions). Untuitively, going deeper at 40 kjs should really help with scarring. I am not sure if it software upgrade or an entire new machine. I think it is the latter, but don't know for sure.
I can never understand your settings in your sig, or maybe you just have a really small face. On the surface you had more aggressive treatment settings than I. Yet, my KJs are way higher than yours.
Actually, my face does not look bad now. i think it has become accustomed to fraxel attacks and maybe the deeper penetration with less density form SR 1500 at the surface makes the visible facial effects less noticable. As to pain, I say this to everyone I meet; most people don't know what really bad pain is. I have adapted to it the past few years, so I am resilient to pain.
I am a tiny person but I too don't really understand why my KJ settings are so much lower then everyone else. I told my doc I was concerned (well maybe I only told his nurses, I spend way more time with them) and Troubled has tried to explain it to me but it still escapes me. I have the basic principle down but I don't understand with the treatment I seem to get (Full face, multiple passes horizontilly and verticaly) why mine are so low.
I am pretty sure it's just a system upgrad and not a whole new machine but I"m sure even the upgrade is costly so I guess your doctor doesn't see a cost benefit ration. Where as my doctor is doing trials with Reliant and is the first to have the latest upgrades..........not saying one is better then the other at all just funny how doctors are so different.
I usually have a somewhat good tolerance for pain as most people doing the 1500 at high levels have all had oral pain med and I think I have had the hightest settings used with only the numbing and the zimmer. I leave the office about 15 mins after the procedure and drive 30 mins home. It's the next 2 to 3 days that keep me house bound 
I'm a bit glad to be done at the moment actually. Having a month off where I don't have to worry about recovering is nice.
I think Shyone might be going in for another couple treatments. I can't wait to hear from her.
Just got back from my second fraxel. This time I had the Fraxel 2 with Dr. Duffy's nurse Stephanie. She was really great and even called me the day after to see how I was doing. I highly recommend them if you are in the LA area.
The settings used were 40mj @ level 12. I think the Fraxel 2 is a lot less painful than the Fraxel 1 from what I can remember. I didn't flake and peel as much this time around either. However, I am extremely red everywhere except a small pale patch around the eyes. I look like a racoon.
I'm wondering if my fraxel 1 settings weren't higher overall than my fraxel 2. I did level 12 on the fraxel 1 machine as well. Does anyone know what the comparable conversion would be from the first machine to the second??
The redness is very severe. I am currently icing and using the Aloe & Green Tea Mask as well as using Aloe Gel. I will start on the Cosmelan as soon as I finish flaking.
For those who are interested, Reliant is doing a Webinar on Fraxel 2 next Tuesday: http://www.reliant-tech.com/webinars.cfm
The New Fraxela SR1500 Laser: Scientific and Clinical Advancements in the Field of Laser Resurfacing
During this one hour seminar Dr. Geronemus and Dr. Rahman will discuss the advanced intelligence of the NEW Fraxel SR1500 Laser.
I just got home from my second Fraxel treatment. My first treatment was with Fraxel 1 @ 22/125, which I am told was kind of high. This last treatment was with the new Fraxel 2 machine @ 40mjs - level 9, 8 passes. I don't know how much higher that setting was compared to my first treament but, I have to say, the pain was INTENSE!! I have a very high tolerance for pain and this definitely put that to the test. At some points I thought I would have to make her stop just so I could breathe, but I didn't. After 2 passes my face was throbbing and by the time I got to my car I was already swollen. I don't think I can go higher but I won't go down either, I want to get my moneys worth and at $1000 a pop, I'll endure a little pain....I just hope it's all worth it in the end.
cautiouslyoptimistic, sounds like we are on the same page.
Just got back from 2nd Fraxel 1 treatment. I told the Derm to turn it up and do more passes. It was so painful. I had 6 numbing shots and numbing cream. I don't think I have felt that much pain (and I have given birth twice). I couldn't stop shaking and the nurse had to hold my legs down.
I really trust my Dr and we talked a lot before she started. It took over an hour and before I left I was already swelled. Last time it took 3 weeks to look somewhat normal..I bet this time will be more. But it's worth it if it helps. I just dread the next week where I can homebound and look like hell.
Anyway, my stats are in my sig. Hope everyone is doing well. My Grandfather passed away this morning, so during the hour of Fraxel pain, I just kept thinking of memories and it was a nice distraction.
cautiouslyoptimistic, It is not easy to make direct comparisons between the 750 and the 1500. The only measure that is directly comparable is total KJs. But, it is my understanding that the 1500 enables deeper/better dermal remodeling treatment with fewer KJs due to combo of higher mjs, less beem splaying, and lower density. Hence, the lower pain levels with the 1500.
I have not flaked the last 2 times, but it is clear that I will have major flaking this time. Normally, I shave at day 3. When do others start shaving?
The nurse told me the same thing about not being able to compare the 750 to the 1500. I'm just assuming the level must have been much higher than my first treament based on how much more it hurt this time.
With my last treatment, all the redness, swelling and flaking was gone after 3 days, I think it's going to take a bit longer this time.
My friends and family don't understand why I'm putting myself through this, all I can tell them is, you're not the one who has to look at this skin in the mirror everyday. Hopefully, I won't have to for much longer either! 
For those who are interested, Reliant is doing a Webinar on Fraxel 2 next Tuesday: http://www.reliant-tech.com/webinars.cfmThe New Fraxel SR1500 Laser: Scientific and Clinical Advancements in the Field of Laser Resurfacing
During this one hour seminar Dr. Geronemus and Dr. Rahman will discuss the advanced intelligence of the NEW Fraxel SR1500 Laser.
hmm. both nyc doctors. should be interesting. do you im them questions? is it live? will it be recast?
Its been 12 days since my 3rd Fraxel treatment. I just get spot treatment on a few pitted and ice-pick scars.The good news is that my scars are still barely visible. That means: either the micro-swelling is lasting longer than it did for my first two treatments... or, there is collagen remodelling taking place.
The bad news is that this time (unlike my first two treatments), I am getting tons of small little pustules and white-heads around the periphery of the treated areas (and some within the treated areas).
So, my down-time lasted much longer (2 weeks). It was much more embarrassing going to work this time. But, maybe it will all be worth it at the end...
-Ralphie
Ralphie, has there been any change over the last 4 days?
Zonk,
I think I am finally starting to see some permanent changes!
I am now 17 days after my 3rd Fraxel treatment. And the edges of my scars are still nice and smooth (they are not sharp-edged, like they were before my 1st treatment).
Normally my micro-swelling only lasts about 12 days. On my first two treatments, it was like my scars magically reappeared on day 12 or 13. Now, although they are slightly visible - the scars have much much softer edges and blend in with the surrounding skin.
I still have not noticed any raising of the center portion of the scars. But the edges are much smoother - and when I look at myself in a mirror with backlight (to create shadows), my scars are much less noticable to me (which means they are probably much less noticable to other people). Also, when I rub my finger over the scars, it is more difficult for me to feel the rim of the pitted scar. Its almost as if my scars have gone from sharp 'boxcar' scars to smooth 'rolling' scars.
I actually did something different this time, and I don't know if I should be giving myself credit ... OR, if the Fraxel is finally starting to cause remodelling on its own... BUT, On day 12 (after the pustules and white-heads resolved, and the pinkness resolved), I applied a layer of 0.25 % tretinoin to my scars and the surrounding skin. I've actually been applying it every other night since day 12.
It seems to be working! I know I should probably stop using it because I have another Fraxel coming up in 2 weeks - but, I'm scared that once I stop, the scars will return.
-Ralphie
Zonk,I think I am finally starting to see some permanent changes!
I am now 17 days after my 3rd Fraxel treatment. And the edges of my scars are still nice and smooth (they are not sharp-edged, like they were before my 1st treatment).
Normally my micro-swelling only lasts about 12 days. On my first two treatments, it was like my scars magically reappeared on day 12 or 13. Now, although they are slightly visible - the scars have much much softer edges and blend in with the surrounding skin.
I still have not noticed any raising of the center portion of the scars. But the edges are much smoother - and when I look at myself in a mirror with backlight (to create shadows), my scars are much less noticable to me (which means they are probably much less noticable to other people). Also, when I rub my finger over the scars, it is more difficult for me to feel the rim of the pitted scar. Its almost as if my scars have gone from sharp 'boxcar' scars to smooth 'rolling' scars.
I actually did something different this time, and I don't know if I should be giving myself credit ... OR, if the Fraxel is finally starting to cause remodelling on its own... BUT, On day 12 (after the pustules and white-heads resolved, and the pinkness resolved), I applied a layer of 0.25 % tretinoin to my scars and the surrounding skin. I've actually been applying it every other night since day 12.
It seems to be working! I know I should probably stop using it because I have another Fraxel coming up in 2 weeks - but, I'm scared that once I stop, the scars will return.
-Ralphie
That's great news. Have you talked to your derm about using tretinoin to help stimulate collagen growth? I always wondered if you could supplement laser resurfacing w/ tretinoin (after the skin healed) to help promote collagen growth.
nantynannie
It's been awhile since I've been on but I wanted to respond to your question. I too was completely clear (well...maybe 95% clear) when I got my Fraxels. I have so far gotten 2 treatments at 20mjs and have broken out both times. I got those "tiny bumps, not so pimply things" like you too. I think mine were deep clogged pores or something b/c after about a month they morphed into pimples. Now I have so many new scars on my temples and jawline area. So sad...so I've decided to go on Accutane before continuuing any treatments b/c I've got cystic acne and I go through these periods when I'm very clear then I start breaking out again. Good luck
Nope. I never asked him about using topicals at the same time...But, using this 0.25% tretinoin cream every other day seems to really augment the effects of Fraxel.
-Ralphie
I have my first fraxel this friday. I will ask them what they think.
You really shouldn't be using any type of retinol cream during fraxel. I'm surprised your Dr. didn't advise you of this. Avoid any benzoil peroxide and alpha hydroxy acids as well.
Max Kim, there is no single answer on tretinoin usage, except that it is contraindicated pre and post fraxel for some period of time as it interferes with reepithelization. My doc sasy 7 days on both ends. After that, he said it might help stimulate collagen, but unlikely to make much visible difference. He thinks taz might work better, but even there he doubts most people will notice a visible difference in collagen plumping.
I asked the fraxel rep/nurse and she said 4 days. Ironically, I think Zakia Rahman said 10 days in her webinar, but I have forgotten.
In any event, now that I have started to have minor breakouts, I plan to use it outside of the 7 day corridor becasue it speeds up healing.
Nope. I never asked him about using topicals at the same time...But, using this 0.25% tretinoin cream every other day seems to really augment the effects of Fraxel.
-Ralphie
I have my first fraxel this friday. I will ask them what they think.
You really shouldn't be using any type of retinol cream during fraxel. I'm surprised your Dr. didn't advise you of this. Avoid any benzoil peroxide and alpha hydroxy acids as well.
of course my doctor told me not to use retinoids, but we're talking 12 days post-fraxel, which is well outside the bad range.