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not really. heat shock collagen formation is a delayed response your body has after the wound is created--while its healing itself. if your rewound the area, you create another shock--but you also create another wound. you'd just be undoing the the regeneration and collagen formation that had just taken place.the cumulative effect of fraxel occurs because each treatment covers a new area, not because the prior treated areas are being retreated. there is some overlapping but im convinced that is detrimental (unless the MTZs are fully healed).
re-read my post. I edited it after you posted this.
not really. heat shock collagen formation is a delayed response your body has after the wound is created--while its healing itself. if your rewound the area, you create another shock--but you also create another wound. you'd just be undoing the the regeneration and collagen formation that had just taken place.the cumulative effect of fraxel occurs because each treatment covers a new area, not because the prior treated areas are being retreated. there is some overlapping but im convinced that is detrimental (unless the MTZs are fully healed).
Whether or not rewounding of the area is bad, I don't know. But having had 2 fraxels, I can say that the fraxel lays down a grid of micro-wounds. It has no idea where the last grid was even b/w passes, much less between treatments, so there is likely to be significant rewounding. I would assume, then, that rewounding isn't really that bad...
"Upon significant damage to the basement membrane zone, dermal contents are also expelled as microscopic epidermal and dermal necrotic debris (MENDs). In this way, epidermal and dermal pigmentation are treated without specifically targeting melanin as the chromophore. Zones of collagen denaturation in the dermis trigger the inflammatory cascade, which leads to collagen remodeling and new collagen formation."
zonk,
again increasing the inflammation of a wound isn't going to speed or increase healing. in fact the opposite is likely.
i totally agree that there is rewounding going on. this is impossible to deal with unless you switch from a scanning tip to a stamping tip (like pixel). the down side of stamping is that you often have missed spots and pigment changes in the shape of the laser head!
[one of the fraxel webinars shows pics of a doc who was using fraxel to correct the awful stamping spots of an IPL machine on a womans chest. i had similar problems when a stamping laser was used for laser hair removal. the hair fell out in patches in the shape of the laser head with fine, grid like spots of missed hair in between.]
ive been repeatedly saying i think people really need to get 5-6 treatments to makes sure they are really covering anything close to 100 percent of the face.
another part of the puzzle is that the healing effects continue to take place over six months. so there is a mechanism of action there as well.
i mean the bottom line anyway is that the scanning device is superior to the stamping so there will always be overlap. and its obviously not good to have another treatment before your bronzing is done. and we know you can't wait for more than two months.
so really the window is somewhere around 3-8 weeks. so take an average and say 5-6 weeks, erring on the side of caution.
doh! "Upon significant damage to the basement membrane zone, dermal contents are also expelled as microscopic epidermal and dermal necrotic debris (MENDs). In this way, epidermal and dermal pigmentation are treated without specifically targeting melanin as the chromophore. Zones of collagen denaturation in the dermis trigger the inflammatory cascade, which leads to collagen remodeling and new collagen formation."zonk,
again increasing the inflammation of a wound isn't going to speed or increase healing. in fact the opposite is likely.
i totally agree that there is rewounding going on. this is impossible to deal with unless you switch from a scanning tip to a stamping tip (like pixel). the down side of stamping is that you often have missed spots and pigment changes in the shape of the laser head!
[one of the fraxel webinars shows pics of a doc who was using fraxel to correct the awful stamping spots of an IPL machine on a womans chest. i had similar problems when a stamping laser was used for laser hair removal. the hair fell out in patches in the shape of the laser head with fine, grid like spots of missed hair in between.]
ive been repeatedly saying i think people really need to get 5-6 treatments to makes sure they are really covering anything close to 100 percent of the face.
another part of the puzzle is that the healing effects continue to take place over six months. so there is a mechanism of action there as well.
i mean the bottom line anyway is that the scanning device is superior to the stamping so there will always be overlap. and its obviously not good to have another treatment before your bronzing is done. and we know you can't wait for more than two months.
so really the window is somewhere around 3-8 weeks. so take an average and say 5-6 weeks, erring on the side of caution.
I don't get why you're disagreeing with me, as we are saying the same thing. I never said anything about rewounding a spot would be a good thing.
With 20% random coverage in 2 separate treatments, 4% of skin would get a double hit, 64% would not be hit at all, and 32% would be hit once. Middle school math. In theory, you never get to 100% coverage, but you get close.
hi everyone - really interesting thread today.
hi billyboy - great math skills. you've had fraxel many times - probably the most footer postings i have seen on this site. do you see real improvement? in which areas of the face do you see the most improvement; and who's your dr. thank you in advance for your response.
in response to an earlier posting today regarding mico injections - i had a few chicken pock scars filled with radiesse a few years ago - they were gone 5 minutes after he injected them - they are still gone. a few years ago i picked to death a zit and was left with a hole and again had it filled with radiesse (i think radiesse changed it's name it was formerly known as something else) - it is still totally gone.
i have ice-pick scars now and i think the micro injection thing might work-- but on the other types of scars (if you have relatively clear skin) - it really does work -- i had mine done by a plastic surgeon. and ...much cheaper than fraxel. thoughts?
With 20% random coverage in 2 separate treatments, 4% of skin would get a double hit, 64% would not be hit at all, and 32% would be hit once. Middle school math. In theory, you never get to 100% coverage, but you get close.
Interesting. Can I ask: After 5 sessions @ 20% how much coverage and how many double-hits are probable? The likelihood for double wounding must increase with each subsequent session, but of course the time between wounding increases.
I've enjoyed reading through your posts here Billy. Have you had any change in results since your last update? Have you thought about trying more sessions at 40Mj? Or even deeper but dialling back the level, perhaps on one scar - like 60mj @ Level 6?* The doctors on that Reliant webinar seemed to indicate that for acne scars depth is key, 40Mj seems like the benchmark for the 1500, and they seem quite prepared to go above 40 when they can....
*he says, from the comfort of his armchair........... :whistle:
Question for "mag" -I notice you said your doctor is doing treatments every 2-2.5 weeks. Many people have been doing them only 1x/month. Has he said why/if every 2-2.5 weeks is better?
Thank you.
My doc said that treatments should be spaced from 2 weeks to max 6 weeks apart. Anything shorter or longer might affect the results in a negaitive way, but if you stay within the time frame he provided, it shouldn't matter whether you do it every 2 weeks or once a month. I think a lot of people opt for 1x/month treatment because of the following reasons: inability to take time off work more often than once a month, not everybody wants to compromise more than a week a month of their social life while the skin is in its healing stage, financial issue - high cost of treatments.
can somebody please answer my question from above?? I wanted to know if it would be possible to get fraxel on Saturday and go to work on Monday...I can't take off for my second fraxel because my boss is going to be on vacation...also did any of you get bruisng from the fraxel treatments or did it just get pink and swollen???? My upper cheeks got really bruised the first time?? It looked like i got beat up or i was in a bad accident...is that normal?
can somebody please answer my question from above?? I wanted to know if it would be possible to get fraxel on Saturday and go to work on Monday...I can't take off for my second fraxel because my boss is going to be on vacation...also did any of you get bruisng from the fraxel treatments or did it just get pink and swollen???? My upper cheeks got really bruised the first time?? It looked like i got beat up or i was in a bad accident...is that normal?
Hi Faith, no, I didn't have any bruising at all. I did get red and swelled so bad that I didn't look like myself in the mirror. I've never heard of anyone bruising from Fraxel but I'm no expert. As far as downtime, everyone is different. You've already had one treatment, right? The downtime from that should be a pretty good indication of how long it will take before you can go back to work. I couldn't leave the house until at least the fourth day after my treatments, the downtime was the same for all 4 of my Fraxels.
can somebody please answer my question from above?? I wanted to know if it would be possible to get fraxel on Saturday and go to work on Monday...I can't take off for my second fraxel because my boss is going to be on vacation...also did any of you get bruisng from the fraxel treatments or did it just get pink and swollen???? My upper cheeks got really bruised the first time?? It looked like i got beat up or i was in a bad accident...is that normal?
Thank you for the response..i went for my first fraxel on Friday and was ready for work by Monday...i dind't really get swollen at all..it was just my upper cheeks that were bruised but by moday it had peeled..i thought maybe i irritated it becuase i was trying to get the blue dye off and maybe i scrubbed too hard..
Thank you for the response..i went for my first fraxel on Friday and was ready for work by Monday...i dind't really get swollen at all..it was just my upper cheeks that were bruised but by moday it had peeled..i thought maybe i irritated it becuase i was trying to get the blue dye off and maybe i scrubbed too hard..
With 20% random coverage in 2 separate treatments, 4% of skin would get a double hit, 64% would not be hit at all, and 32% would be hit once. Middle school math. In theory, you never get to 100% coverage, but you get close.hi everyone - really interesting thread today.
hi billyboy - great math skills. you've had fraxel many times - probably the most footer postings i have seen on this site. do you see real improvement? in which areas of the face do you see the most improvement; and who's your dr. thank you in advance for your response.
in response to an earlier posting today regarding mico injections - i had a few chicken pock scars filled with radiesse a few years ago - they were gone 5 minutes after he injected them - they are still gone. a few years ago i picked to death a zit and was left with a hole and again had it filled with radiesse (i think radiesse changed it's name it was formerly known as something else) - it is still totally gone.
i have ice-pick scars now and i think the micro injection thing might work-- but on the other types of scars (if you have relatively clear skin) - it really does work -- i had mine done by a plastic surgeon. and ...much cheaper than fraxel. thoughts?
is radiesse a permanent filler? i read an article that cited a study done that showed any collagen fillers even temp will encourage the body to lay down their own collagen over time. so that as you repeat injections over the same spot the results get better and better and seem to last longer and longer (really it is your body filling it in).
btw, i wonder if elizabeth hurley has had fraxel and or fillers. supposedly she has lots of acne scars but they are really hard to see in most glam shots. so i was excited when i saw her in a documentary. cause they don't photoshop video unless its an expensive harry potter movie where every main character has acne. so anyway they showed extreme close ups of her face (it was all about faces and evolution and emotion). of course she was wearing make up but her scars were not detectable except maybe one or two.
Random treatments produce a binomial distribution of "multiple hits". With 5 random treatments at 20% coverage, the probability of 5 hits is .2 to the 5th power or .03%. The probablity of no coverage is .8 to the 5th or 32.8%. Because it is geometric function as opposed to linear function, it takes many treatments to get close to 100% coverage.
I will have 8. If I am getting 20% coverage each time, the area with no coverage is .2 to the 8th power or 16.8%. However, it is possilbe that bulk heating and resulting healing response may increase the coverage area. Also, I think I am getting more than 20% now with higher settings.
Fraxel has been worthwhile for me, but not great. I think my age and beach going ways may hurt me. Also, I think my early treatments were too low on the mjs. I did not see any real improvement after 4. On shallow rolling scars, I would say I have seen up to a 50% improvement, but I have seen virtually no improvement to 3 excision scars or to a few scarred pores. Overall, I say 25%. But, it is an easy procedure with essentially no downside risk, which makes the limited upside easier to accept.
Very few seem to report the 50% improvement that is quoted by some docs after only say 5 or 6 treatments. Hope this helps.
Random treatments produce a binomial distribution of "multiple hits". With 5 random treatments at 20% coverage, the probability of 5 hits is .2 to the 5th power or .03%. The probablity of no coverage is .8 to the 5th or 32.8%. Because it is geometric function as opposed to linear function, it takes many treatments to get close to 100% coverage.I will have 8. If I am getting 20% coverage each time, the area with no coverage is .2 to the 8th power or 16.8%. However, it is possilbe that bulk heating and resulting healing response may increase the coverage area. Also, I think I am getting more than 20% now with higher settings.
Fraxel has been worthwhile for me, but not great. I think my age and beach going ways may hurt me. Also, I think my early treatments were too low on the mjs. I did not see any real improvement after 4. On shallow rolling scars, I would say I have seen up to a 50% improvement, but I have seen virtually no improvement to 3 excision scars or to a few scarred pores. Overall, I say 25%. But, it is an easy procedure with essentially no downside risk, which makes the limited upside easier to accept.
Very few seem to report the 50% improvement that is quoted by some docs after only say 5 or 6 treatments. Hope this helps.
You beat me to the math.
Here's how billyboy did his calculations, assuming 20% coverage
Tx1: 20%
Tx1 overlap: 0%*20% = 0%
Tx2: 20%+20%*80% = 36%
Tx2 overlap: 20%*20% = 4%
Tx3: 36%+20%*64% = 48.8%
Tx3 overlap: 20%*36% = 7.2%
Tx4: 48.8%+20%*51.2% = 59.04%
Tx4 overlap: 20%*48.8% = 9.76%
Tx5: 59.04%+20%*40.96% = 67.232%
Tx5 overlap: 20%*59.04% = 11.808%
I didn't check my calculations, but these numbers match what billyboy said above, I think.
The formula for treatment x is as follows:
(Total coverage after previous treatment)+(Treatment x coverage)*(1 - Total coverage after previous treatment)
The overlap formula for treatment x is:
(Treatment x coverage)*(1 - Total coverage after previous treatment)
Hopefully, I've given enough information to generalize for your specific treatments. If not, you probably need to review your middle school probability lessons :naughty:
Random treatments produce a binomial distribution of "multiple hits". With 5 random treatments at 20% coverage, the probability of 5 hits is .2 to the 5th power or .03%. The probablity of no coverage is .8 to the 5th or 32.8%. Because it is geometric function as opposed to linear function, it takes many treatments to get close to 100% coverage.You beat me to the math.
Here's how billyboy did his calculations, assuming 20% coverage
Tx1: 20%
Tx1 overlap: 0%*20% = 0%
Tx2: 20%+20%*80% = 36%
Tx2 overlap: 20%*20% = 4%
Tx3: 36%+20%*64% = 48.8%
Tx3 overlap: 20%*36% = 7.2%
Tx4: 48.8%+20%*51.2% = 59.04%
Tx4 overlap: 20%*48.8% = 9.76%
Tx5: 59.04%+20%*40.96% = 67.232%
Tx5 overlap: 20%*59.04% = 11.808%
I didn't check my calculations, but these numbers match what billyboy said above, I think.
The formula for treatment x is as follows:
(Total coverage after previous treatment)+(Treatment x coverage)*(1 - Total coverage after previous treatment)
The overlap formula for treatment x is:
(Treatment x coverage)*(1 - Total coverage after previous treatment)
Hopefully, I've given enough information to generalize for your specific treatments. If not, you probably need to review your middle school probability lessons :naughty:
Yeah. That's what I got too.... *cough* 😉
A question I posted to that Dr Garcia online forum:
Question: What is `heat shock protein`? I read Retin A is not recommended when having Fraxel because it inhibits heat shock protein. But I note you use Retin A until a few days before Portrait. Thanks
Answer: It is a protein induced in the skin that can kill bacteria, it is made in response to an injury. I do not see how Retin-A would negatively affect the Fraxel. I will say that Retin-A use while doing a series of Fraxels can be risky as the skin is like baby skin and overly sensitive and where before the treatment you easily tolerated it, after the treatment you might be super sensitive to it, so it needs careful use.
Hi Cautiously... can you please give us an update on your progress? A while ago you were worried about new scars, but then they seemed to disappear? Have you continued treatment? Can you see improvement? Cheers 🙂
The good news is I haven't noticed any more new scarring, the bad news is I'm not seeing any improvement in my old scars. I haven't had anymore Fraxel treatments. I'm thinking about doing Restylane again.
is radiesse a permanent filler? i read an article that cited a study done that showed any collagen fillers even temp will encourage the body to lay down their own collagen over time. so that as you repeat injections over the same spot the results get better and better and seem to last longer and longer (really it is your body filling it in).
Hi TCBC. Yeah, I heard of reports of residual collagen formation around Restalyne. Can you give a link to that paper?
Radiesse & Sculptra are designed to instigate collagen formation. I understand Radiesse typically lasts 2-3 years but has a high incidence of lumps that can last 5-7 years and there is no antidote. It is supposed to be a good viscous filler for accurate placement under scars. I opted for Sculptra. It can form lumps too (I had one), but not quite as common as Radiesse. And at least with Sculptra there is an antidote - 5FU injection. They say Sculptra lasts 18 months - 2 years but for me it was 3 years. I think I had a slight amount of residual collagen/ fibrotic tissue but I can't really be sure.
Of course new products will continue to be developed, which is why I think temp fillers are the smart move. I would only go for a permanent filler if there was a safe antidote. Doesn't exist yet.