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Widgie, who was the doctor that responded? Would he mind if you revealed his name - I'm just so impressed that he answered you so thoroughly. I guess b/c it's a learning facility they are more intrigued with inquiries than annoyed! Anyway, thanks for posting his/her response - it's most informative!
Thanks for posting the information by that doctor. Maybe the total energy output is the piece many doctors are missing. Okay, so I was originally going to get the treatment done for half the price in my hometown but since I am in NYC for several weeks I think I'm going to bite the bullet and do it with Dr Rokshar. I've already had a consultation with him about 7 months ago and he's a great guy. To answer the previous question, Dr Rokshar is very experienced and I think he is the main trainer for new physicians around the world for Reliant Technologies. Go to him if you live in the city. $1500 a pop.
"The only thing I didn't mention is perhaps the most important. I believe that the results are more dependant on the total energy used than the exact settings used. I once compared my treatments to another Fraxel physician who was not getting great results and on the surface they appeared to be equivalent. When I asked how much total energy was used I was consistently significantly higher. This happens because although the same parameters are used the amount of overlap can vary significantly from physician to physician significantly. That doesn't mean the other physician was giving a bad treatment, it just might take more sessions to get the same result."
Yes, this was very informative. So is this going against what some people have been saying on here about the higher settings? The setting the Dr is referring to is the mtz right? Other people on here have been saying the higher mj is better (ex: 25, 30, etc...)? Or am I totally off base here and both the Dr. and some people on this board are talking about the same thing.....mj's. If the setting is mtz's that the dr. is referring to then this sounds a lot safer than the mj's because it sounds like you seriously risk getting burned from what I've been reading on here.
Widgie, who was the doctor that responded? Would he mind if you revealed his name - I'm just so impressed that he answered you so thoroughly. I guess b/c it's a learning facility they are more intrigued with inquiries than annoyed! Anyway, thanks for posting his/her response - it's most informative!
Sure, his name is Ramsey Markus, M.D., Baylor Dermatology, Director of Laser Surgery. (I asked his permission to use his name and post his email.)
I also was very impressed with his response. This reaffirms the fact that different doctors use different techniques that can affect the outcome of Fraxel treatments. And also, they are still learning how to use the laser to achieve the best results. In that respect, I guess all of us currently receiving treatments are 'guinea pigs' to a certain degree. But I'm ok with that....:) I've seen definite results so far and I would not hesitate to get more treatments after my current round if they somehow 'perfect' the optimal treatment plan for scarring in the future.
I agree with Peachpie that I have much improved texture, not the reverse.
I also agree with Baylor Doc who said total energy is generally the best comparison. That's why I posted mine last time. This is not perfect becasue some people only have spot treatment (eg, Coolbreeeze on cheeks) and I had nurse turn down energy and passes above lip becasue I have no issues there and it is pain sensitive for me. Also, we went light on forehead as my only issue there is wrinkles. I just wanted enough burn to avoid a demarcation line.
I'm surprised about his discussion of density because my Doc's machine only has 2 settings: 125 and 250 mtz per cm2.
Lastly, I agree with Widgie that I am happy, but not ecstatic, with results; very low risk, short downtime, decent results and reasonable cost if you look around.
Hello- does anyone have a good doctor to get this done in NYC. Sorry if this has been answered the thread is very long.
thanks!
In NYC you can go to www.laserskinsurgery.com.
they are the ones that completed the clinical trial that got fraxel FDA approved for acne scars. and only MDs perform the actual procedure not nurses or techs.
Widgie, who was the doctor that responded? Would he mind if you revealed his name - I'm just so impressed that he answered you so thoroughly. I guess b/c it's a learning facility they are more intrigued with inquiries than annoyed! Anyway, thanks for posting his/her response - it's most informative!
Sure, his name is Ramsey Markus, M.D., Baylor Dermatology, Director of Laser Surgery. (I asked his permission to use his name and post his email.)
I also was very impressed with his response. This reaffirms the fact that different doctors use different techniques that can affect the outcome of Fraxel treatments. And also, they are still learning how to use the laser to achieve the best results. In that respect, I guess all of us currently receiving treatments are 'guinea pigs' to a certain degree. But I'm ok with that....:) I've seen definite results so far and I would not hesitate to get more treatments after my current round if they somehow 'perfect' the optimal treatment plan for scarring in the future.
Wow, that's an impressive response. I think that site must not get a lot of traffic. must not advertise or be search engline optimized. I just came across it when i posted a few days ago and ive been researching since sept. 05! I'm sure he'll become dispondent now that we're all sure to barrage him with emails.
I am new to this forum.
I am going to try out Fraxel this December. Is it possible to receive treatments about 10 days apart? If so, what sort of negative impacts can I expect from doing them in short succession like that?
Also, I have some deep scars (not sure if these would be classified as "ice-pick") caused by cysts over the years which are just below the cheeks and below the corners of the mouth (basically on the chin region). Will this Fraxel help out much with that sort of scarring, or will I need implants and stuff to rebuild the structure of the skin in that region? I am hoping to avoid any sort of implanting.
Thanks
I am going to try out Fraxel this December. Is it possible to receive treatments about 10 days apart? If so, what sort of negative impacts can I expect from doing them in short succession like that?
Hi Furo,
I had the first 4 of my treatments spaced one week apart. It was ok, mostly because they used lower settings and my skin didn't have a sensitive reaction. (Excessive swelling or redness). However, as they increased the settings, I spaced my treatments 2 weeks apart and I think that it's much better as it allows my skin to fully heal. Others in this forum have had their treatments spaced a month or more apart and say that it's better to allow even more time for healing. It will really depend on who your doctor is, what settings they use and how your skin reacts. Fraxel is definitely not a one size fits all kind of treatment.
I had the first 4 of my treatments spaced one week apart. It was ok, mostly because they used lower settings and my skin didn't have a sensitive reaction. (Excessive swelling or redness). However, as they increased the settings, I spaced my treatments 2 weeks apart and I think that it's much better as it allows my skin to fully heal.
Told nurse that I might want to try # 5. She advised me to wait until 6 or 8 weeks, as patients will see improvement during this period. I sort of knew this, but she was very emphatic about it. If so, I would up up my rating from decent.
From my experience, Fraxel softens scars. While it eliminates very shallow scars, don't expect much on deeper scars.
Furo, I believe your objective to have a series completed in 7 weeks with a single Doc is incompatible with a truly successful result. If you want to get your money's worth, you probably need to change your objective or find another time for doing this.
I had the first 4 of my treatments spaced one week apart. It was ok, mostly because they used lower settings and my skin didn't have a sensitive reaction. (Excessive swelling or redness). However, as they increased the settings, I spaced my treatments 2 weeks apart and I think that it's much better as it allows my skin to fully heal.Okay it sounds like you have had alot of these treatments. How many total? From the research I have seen four treatments seemed like a full course. And what % improvement have you seen, if any, after the first four treatments?
I will only have about 7 weeks total to get this done, and then I will be moving, and I do not want to switch doctors and continue. I want it all to be done by only one doctor.
Has anyone had to switch doctors? Will this Fraxel help with the deeper "pitted" scars to raise them and flatten them?
thanks
I've had 6 treatments so far and will go for my 7th on Friday. I am already planning to have 3 more done after that. I have had improvement in the texture of my skin and some smoothing out of the scarring overall. But I have widespread 'shallow' scarring. I do have two deeper little scars and the Fraxel may have improved them a bit, but not nearly to the point of having them even with the rest of my skin.
I also was treated at relatively low settings compared to others in this forum. The big question is whether or not fewer treatments with high settings is more effective or many treatments at mid-level settings. No one really has a concrete answer to that, including many docs.
Hi,
My doc mentioned quite clearly if you are treating skin spots and improving texture than sure lower settings will work fine, but anything to do with acne scarring requires modelling in the dermis, where lower settings cannot reach. Hence regardless of the number of treatments you do at lower settings, they will have no bearing on your acne scar improvement. Your skin texture will be great, but the depth of the scars is unlikely to change.
Ideally high settings with 6-8 treatments would cover 100% of the face. There is a point of diminishing return he tells me and he generally recommends patients to take 6 months off to let the collagen remodel before deciding for another course of treatments.
Fewer treatments at high settings wouldn't do much as there would be insufficient coverage of the skin. Each fraxel only treats 12-20% of the skin at one time. Hence an average of 16% coverage would require 6 treatments at least.
So the best course appears to be 6-8 treatments at high settings (>20mj) for acne scarring treatment. The studies seem to support this. See earlier posts by me on this thread.
Blaster
I've had 6 treatments so far and will go for my 7th on Friday. I am already planning to have 3 more done after that. I have had improvement in the texture of my skin and some smoothing out of the scarring overall. But I have widespread 'shallow' scarring. I do have two deeper little scars and the Fraxel may have improved them a bit, but not nearly to the point of having them even with the rest of my skin.
I also was treated at relatively low settings compared to others in this forum. The big question is whether or not fewer treatments with high settings is more effective or many treatments at mid-level settings. No one really has a concrete answer to that, including many docs.
We may have talked about this earlier in the thread, but . . .
Assume you get 20 percent coverage of your face during each treatment. It's not really cumulative in the sense that you can just add up 20 percent for each treatment, so that in 5 treatments you'd have 20+20+20+20+20=100.
20 percent is covered each time but some of it is the same 20 percent as last time. I'd imagine at least half of the same skin is being treated as the last time.
At 20 percent coverage you'd need ten treatments to ensure 100 percent coverage. At 15 percent it'd be like 14-15 sessions. At 12 percent it'd be 16-17 treatments.
Blaster
Intuitively, I believe your Doc is right and you can point to the clinical studies. Also, while you can't read much into my personal experience, I waited almost 8 weeks between #1 and #2. #1 was at 15 mjs. I saw no benefit after 8 weeks. It was only after #2 at 20 mjs that I started to see improvement. Granted, others factos are at play, but I still think you need to go high.
That said, one's person deep scar may be judged shallow by another poster. So, this is subjective by poster.
My package of 4 is over, and I view the first as being ineffective. So, my question is whether I need another 1. Time will tell.
Hi,
My doc mentioned quite clearly if you are treating skin spots and improving texture than sure lower settings will work fine, but anything to do with acne scarring requires modelling in the dermis, where lower settings cannot reach. Hence regardless of the number of treatments you do at lower settings, they will have no bearing on your acne scar improvement. Your skin texture will be great, but the depth of the scars is unlikely to change.
Ideally high settings with 6-8 treatments would cover 100% of the face. There is a point of diminishing return he tells me and he generally recommends patients to take 6 months off to let the collagen remodel before deciding for another course of treatments.
Hi Blaster,
I agree with some of your points but my best argument for numerous treatments at mid-level treatments comes from my own experience and the changes that I have seen in my scarring.
I have shallow, widespread scarring. Only two deeper pits that are small and really don't bother me that much. I have seen clear improvement in the mild scarring. Also, I have a dime sized scar on and above my lip that was shallow and clearly defined. If I ran my finger across the top of my lip, I could feel a 'dip' in the skin level where the scar was. There were two ridges at either end of the scar that were noticeable even when I applied make up to the area. After 6 Fraxel treatments, the scar is almost level with the surrounding skin and is undetectable after applying a dot of concealer (for residual redness) and lipstick. I plan on having permanent lipstick done (for loss of pigment on my actual lip area) after I am finished with the Fraxels and I doubt anyone will even know that the scar was there.
For people who have actual DEEP pitting or ice-pick scars, I definitely agree that higher levels are the only way to produce improvement that would justify the current cost of the treatment. However, for milder scarring, I think that many treatments at mid-high levels (16-20) will also produce noticable results.
I do think that there are many other variables that go into the results that each individual experiences. Some people respond better and heal more quickly. This could be due to age, thickness of skin, the condition of the skin etc, etc... In that respect, Fraxel is no different than any other skin treatment...even topicals. My scarring was caused by using Retin-A. We all know that Retin-A is a godsend for some acne sufferers. In my case, it ruined my skin. When asking 'why did this happen?' to various derms and my PS, no one had an answer. Along the same lines, there IS a chance of blistering and scarring occurring while using very high Fraxel settings. If there wasn't any risk and it absolutely produced the best results, I can't imagine why there would be so many discrepancies between the treatment plans of all the Dr's who currently use Fraxel for acne scarring.
Who knows? Maybe after having 10 treatments done, I will post back and say that there was no more noticable improvement after my 7th treatment. Because my treatments are SO much more reasonable than most everyone else who has posted, I can afford to have the additional sessions and see what happens.
Either way, I will keep updating with my progress and love that others are as well. This thread is so informative and has made going through this process a lot more bearable. 🙂
Widgie
Congrats on your success and best wishes for more.
You make excellent points, especially about the value of this thread.
One thing that would make this more valuable is pictures. I am guilty, but I will post in early/mid Sept. I have some good before pics that highlight my scarring, but I am waiting until the nurse says I am through healing to post after pics. Frankly, I don't know if I can make an informed judgement until then.
Because my treatments are SO much more reasonable than most everyone else who has posted, I can afford to have the additional sessions and see what happens.
Hi Widgie - What town or state do you get yours done? I'm not sure if you mentioned this already or not. Thanks.
I'm in Milwaukee, WI. It's known for beer, brats and apparently affordable Fraxel treatments...;)
Billyboy, I agree about the pictures. I had before pictures on my digital camera, but my boyfriend borrowed it in a hurry and I just deleted them because I didn't want him to accidentally see them. (Vain, I know)
However I KNOW I have before pictures of the scar on my lip. They are on my old computer. Pictures speak louder than words so I will try to get the files when I have time to hook it up. Honestly, it's embarrassing and I'd rather not, but if it helps people to see before and afters then I'll try to oblige.
Have any of you heard if it is recommended not to get Fraxel done while you have a tan? Would the results differ if you got it done while you have a tan?
Also, anybody try this place or here anything about it in NYC (Queens)? Advanced Dermatology