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I would be really angry about that. The fact that they gave you the old Fraxel brochure is proof that he was being purposely deceptive. I really hope they refund your money.
I haven't had any treatments with the Palomar laser yet...I have one at the end of November. I'll post if I get similar effects like the bleeding. No blue dye but bleeding doesn't sound like a very good trade off in my opinion. My 9 treatments with Fraxel haven't gone above 20. That the is maximum level they will use at the place I go. I am happy with my improvement and the cost has been relatively reasonable. However, I want to have spot treatments on my cheeks and I think I will try and find another PS who uses higher settings.
Good luck to you, I really hope you see great improvement....and call that doctor out on his misleading tactics...
I'm sure he told me it was the new Fraxel. I thought I was seeing some results, but today it looks like all the swelling is gone, and it's back to the way it was. After having my number on 60, I believe I should have seen something. I am really bothered by all this pin point bleeding I'm getting. Did you get this, and what # were you on? I paid $3000 for 6 treatments for my chin, cheeks, and temples. He told me he gave me a discount because this is my second time. What bothers me is the last time I was there I asked for a brochure on the new Fraxel, and they gave me a copy of the old one. What does that tell you? I don't want to go through this again with this machine, because of all the bleeding. A person on here told me they weren't getting all this bleeding with the real Fraxel.
I would be really angry about that. The fact that they gave you the old Fraxel brochure is proof that he was being purposely deceptive. I really hope they refund your money.
I haven't had any treatments with the Palomar laser yet...I have one at the end of November. I'll post if I get similar effects like the bleeding. No blue dye but bleeding doesn't sound like a very good trade off in my opinion. My 9 treatments with Fraxel haven't gone above 20. That the is maximum level they will use at the place I go. I am happy with my improvement and the cost has been relatively reasonable. However, I want to have spot treatments on my cheeks and I think I will try and find another PS who uses higher settings.
Good luck to you, I really hope you see great improvement....and call that doctor out on his misleading tactics...
I'm sure he told me it was the new Fraxel. I thought I was seeing some results, but today it looks like all the swelling is gone, and it's back to the way it was. After having my number on 60, I believe I should have seen something. I am really bothered by all this pin point bleeding I'm getting. Did you get this, and what # were you on? I paid $3000 for 6 treatments for my chin, cheeks, and temples. He told me he gave me a discount because this is my second time. What bothers me is the last time I was there I asked for a brochure on the new Fraxel, and they gave me a copy of the old one. What does that tell you? I don't want to go through this again with this machine, because of all the bleeding. A person on here told me they weren't getting all this bleeding with the real Fraxel.
I would rather have the old Fraxel, with the blue dye and the pain, and see results, rather than go through what I went through with the Palomar machine and have more bleeding and less results. I'm surprised your doctor wouldn't go higher on you with the old Fraxel. The highest I went to was 24, but I felt I got good results from that. They probably won't start on such a high number with you. I believe the first one was at 45, and it wasn't bad at all. I was so excited to be getting this done again, now I feel I'm at square one . Good luck on your Palomar, maybe you'll have better luck with it.
kaa,
fraxel is a form of erbium but more advanced and less invasive but more effective, for it is newer technology.
mz43020,
may i ask how old you are and why you think 18 is not a high enough setting, i have my 1st appointment this saturday, and i was planning on starting out at 20, but i'm considering going even harder like 30 or 40.... i have pretty fair/white skinned for an asian, and i have been getting ready with a hyperpigmentation cream that is really strong to help suppress the organism that makes hyper-pigmentation so my doc can go deep and be aggressive, also i sure hope he gets his machine calibrated.
Hi I am asian with fair skin too. I am 22 years old. You doctor is using the older model on you right? I think preping your skin for the procedure is important because some people have had pigmentation problem w/o it. My doctor will go higher next time. She just want see if I could tolerate the pain first. I'm not so sure about 30 and up, that sound way too dangerous to me. The reason I said it isn't high enough is because I'm not seeing much improvements from it. I'm going for 2nd treatment next month on the 20th. Keep me updated with your progress okay :).
u know what betty, i too was looking for an answer to all of my shallow scarring and pores and etc. and i come to realization that the newest technology for all of this is fraxel, i mean if it wasn't a "miracle" laser why would it be on the news so much, and is perhaps the most expensive treatment out there, i am no dermatologist but i remember this derm sayin that he can give me a 80 percent improvement wit erbium yag, and thank goodness a member i met here did da same operation wit the same derm and he said he got like a 3 percent improvement, so you have to remember that derm are business man, they can only sell what they think of which machine they have that will help. i haven't gotten fraxel done yet but trust me, i know how u feel, but soon, i am doin fraxel, real soon, 2 more days!!!
I've tried Eribum laser before. I only went up to 20micron though. It didn't help me at all. I also have shallow scarring. Betty, If you do try eribum, you gonna need to go higher than 20micron.
can somebody tell me what is the level that is the lowest to deepest? is it like 10 to 60??? or is it vice versa being the lowest is a high number and going deep is a lower number?i would like to know so i can have an educated conversation with my doc this saturday. thx
basically those numbers from 10 to 60 represent the energy in mJ
so a low number means less energy and therefore it can't go as deep. so 10 will reach cells only higher in the epidermis
a higher number is more energy and penetrates deeper. it aims to get cells both in the epidermis and right down into the dermis
I am so ashamed. It appears I have been duped. Someone that I referred to Dr Kovak PM'd me and told me they believe he isn't using the new Fraxel, as I thought, and is using the Palomar Lux 1540 laser. This person sent me an article about this laser. It isn't even approved by the FDA for acne scarring, but for soft tissue coagulation. The reason I experienced so much bleeding is because the Fraxel makes smaller holes. Also, Fraxel sells for $100,000, and the Palomar $45,000. This is apparently why I haven't been getting the blue dye. This machine is not proven with solid clinical studies. I am sick about this. I'm very sorry I've mislead all of you. I have always been under the impression that this was the new Fraxel. He told me he was the 2nd person in the U.S. to have this. I'm calling him tomorrow and going to try to get my money back for the rest of the treatments. I don't want to be a guinea pig for a machine that is not even approved for this. I had so much faith in these doctors, I can't tell you how upset I am.
I talked to Dr. Kovak this afternoon, and he told me he is using the Palomar on me. The thing that really bugs me is I feel I've been mislead. He told me the old Fraxel wasn't FDA certified for acne scarring when he did it on me(this is true). I asked him about the bigger holes with Palomer to cause more bleeding, and he didn't agree with it. He said the bleeding isn't a bad thing. He told me that he would have one of his patients call me to tell me what they think of the Palomar. He also said he would refund my money if I change my mind. I don't feel like I trust him anymore, and I'm pretty sure I've read on here that you don't get a lot of bleeding from the the newer Fraxel, and I would feel more comfortable with that. Someone else PM'd me and said he has taken Fraxel off of his web site. Another person said they signed a release and they were 100% positive it said it was for Fraxel.
I am so ashamed. It appears I have been duped. Someone that I referred to Dr Kovak PM'd me and told me they believe he isn't using the new Fraxel, as I thought, and is using the Palomar Lux 1540 laser. This person sent me an article about this laser. It isn't even approved by the FDA for acne scarring, but for soft tissue coagulation. The reason I experienced so much bleeding is because the Fraxel makes smaller holes. Also, Fraxel sells for $100,000, and the Palomar $45,000. This is apparently why I haven't been getting the blue dye. This machine is not proven with solid clinical studies. I am sick about this. I'm very sorry I've mislead all of you. I have always been under the impression that this was the new Fraxel. He told me he was the 2nd person in the U.S. to have this. I'm calling him tomorrow and going to try to get my money back for the rest of the treatments. I don't want to be a guinea pig for a machine that is not even approved for this. I had so much faith in these doctors, I can't tell you how upset I am.
I talked to Dr. Kovak this afternoon, and he told me he is using the Palomar on me. The thing that really bugs me is I feel I've been mislead. He told me the old Fraxel wasn't FDA certified for acne scarring when he did it on me(this is true). I asked him about the bigger holes with Palomer to cause more bleeding, and he didn't agree with it. He said the bleeding isn't a bad thing. He told me that he would have one of his patients call me to tell me what they think of the Palomar. He also said he would refund my money if I change my mind. I don't feel like I trust him anymore, and I'm pretty sure I've read on here that you don't get a lot of bleeding from the the newer Fraxel, and I would feel more comfortable with that. Someone else PM'd me and said he has taken Fraxel off of his web site. Another person said they signed a release and they were 100% positive it said it was for Fraxel.
That's aweful that he mislead you. Are you seeing any improvements from Palomar? If not, you should ask for your money back and go for the Fraxel.
I am so ashamed. It appears I have been duped. Someone that I referred to Dr Kovak PM'd me and told me they believe he isn't using the new Fraxel, as I thought, and is using the Palomar Lux 1540 laser. This person sent me an article about this laser. It isn't even approved by the FDA for acne scarring, but for soft tissue coagulation. The reason I experienced so much bleeding is because the Fraxel makes smaller holes. Also, Fraxel sells for $100,000, and the Palomar $45,000. This is apparently why I haven't been getting the blue dye. This machine is not proven with solid clinical studies. I am sick about this. I'm very sorry I've mislead all of you. I have always been under the impression that this was the new Fraxel. He told me he was the 2nd person in the U.S. to have this. I'm calling him tomorrow and going to try to get my money back for the rest of the treatments. I don't want to be a guinea pig for a machine that is not even approved for this. I had so much faith in these doctors, I can't tell you how upset I am.
I talked to Dr. Kovak this afternoon, and he told me he is using the Palomar on me. The thing that really bugs me is I feel I've been mislead. He told me the old Fraxel wasn't FDA certified for acne scarring when he did it on me(this is true). I asked him about the bigger holes with Palomer to cause more bleeding, and he didn't agree with it. He said the bleeding isn't a bad thing. He told me that he would have one of his patients call me to tell me what they think of the Palomar. He also said he would refund my money if I change my mind. I don't feel like I trust him anymore, and I'm pretty sure I've read on here that you don't get a lot of bleeding from the the newer Fraxel, and I would feel more comfortable with that. Someone else PM'd me and said he has taken Fraxel off of his web site. Another person said they signed a release and they were 100% positive it said it was for Fraxel.
ouch 🙁
how's your skin responded to it? have you had any positive results from it?
i think if it were me, unless i'd seen a really good result, i'd definitely ask for my money back
I am so ashamed. It appears I have been duped. Someone that I referred to Dr Kovak PM'd me and told me they believe he isn't using the new Fraxel, as I thought, and is using the Palomar Lux 1540 laser. This person sent me an article about this laser. It isn't even approved by the FDA for acne scarring, but for soft tissue coagulation. The reason I experienced so much bleeding is because the Fraxel makes smaller holes. Also, Fraxel sells for $100,000, and the Palomar $45,000. This is apparently why I haven't been getting the blue dye. This machine is not proven with solid clinical studies. I am sick about this. I'm very sorry I've mislead all of you. I have always been under the impression that this was the new Fraxel. He told me he was the 2nd person in the U.S. to have this. I'm calling him tomorrow and going to try to get my money back for the rest of the treatments. I don't want to be a guinea pig for a machine that is not even approved for this. I had so much faith in these doctors, I can't tell you how upset I am.
I talked to Dr. Kovak this afternoon, and he told me he is using the Palomar on me. The thing that really bugs me is I feel I've been mislead. He told me the old Fraxel wasn't FDA certified for acne scarring when he did it on me(this is true). I asked him about the bigger holes with Palomer to cause more bleeding, and he didn't agree with it. He said the bleeding isn't a bad thing. He told me that he would have one of his patients call me to tell me what they think of the Palomar. He also said he would refund my money if I change my mind. I don't feel like I trust him anymore, and I'm pretty sure I've read on here that you don't get a lot of bleeding from the the newer Fraxel, and I would feel more comfortable with that. Someone else PM'd me and said he has taken Fraxel off of his web site. Another person said they signed a release and they were 100% positive it said it was for Fraxel.
Sounds like a "bait and switch" routine he's using: make people think they're getting the latest Fraxel and once he's got their money, he uses the cheaper machine on them. Face it, most of us would not know the difference.
If he's doing this, then it's VERY bad. Also, if this is what this doctor is doing, it CERTAINLY sounds to me as though you have grounds for a lawsuit. Possibly a nice chunky one, too. As a healthcare professional myself, I don't take shit like this lightly. If this had happened with me, I would definitely be on the phone with a few malpractice attorneys to see if I had legal recourse. Which is exactly what I would encourage you to do, Cubs.
I understand that results vary and I may see very little improvement from my series of Fraxel treatments, but I have not been misled or lied to about which technology was being used. It is UNACCEPTABLE for a physician to mislead patients in this way. And I think it is probably ILLEGAL, too.
RELIANT - IF YOU ARE READING THIS - SEND A DETECTIVE INTO THIS GUY'S OFFICE. FIND OUT IF HE IS DOING BAIT AND SWITCH. IF HE IS, PLEASE - SUE HIM. OR DO WHATEVER YOU CAN IN ORDER TO STOP HIM. WE HAVE SUFFERED ENOUGH FROM THESE FRIKKEN SCARS AND THE LAST THING WE NEED IS A SCUMBUCKET MONEY HUNGRY ASSHOLE DOC LYING ABOUT OWNING YOUR TECHNOLOGY AND THEREBY CAUSING US TO SUFFER MORE. THANK YOU.
Also, to those who asked about the max level of the new fraxel, it is my understanding from my doctor's office that the new fraxel goes to 40mjs maximum. Please note that Cubs doctor was NOT using the new fraxel when he went to 60 - he was using a different laser altogether.
Confusion reins supreme. I had the first Fraxel and the machine went to 40mjs max. My highest treatment was 25, with 2 extra passes at 30 over scarred areas. I don't see how the new mahcine can go 30% deeper if the max setting is the same 40mjs, as I believe depth of thermal injury is proportional to mjs. Anyone understand this?
I am so ashamed. It appears I have been duped. Someone that I referred to Dr Kovak PM'd me and told me they believe he isn't using the new Fraxel, as I thought, and is using the Palomar Lux 1540 laser. This person sent me an article about this laser. It isn't even approved by the FDA for acne scarring, but for soft tissue coagulation. The reason I experienced so much bleeding is because the Fraxel makes smaller holes. Also, Fraxel sells for $100,000, and the Palomar $45,000. This is apparently why I haven't been getting the blue dye. This machine is not proven with solid clinical studies. I am sick about this. I'm very sorry I've mislead all of you. I have always been under the impression that this was the new Fraxel. He told me he was the 2nd person in the U.S. to have this. I'm calling him tomorrow and going to try to get my money back for the rest of the treatments. I don't want to be a guinea pig for a machine that is not even approved for this. I had so much faith in these doctors, I can't tell you how upset I am.
I talked to Dr. Kovak this afternoon, and he told me he is using the Palomar on me. The thing that really bugs me is I feel I've been mislead. He told me the old Fraxel wasn't FDA certified for acne scarring when he did it on me(this is true). I asked him about the bigger holes with Palomer to cause more bleeding, and he didn't agree with it. He said the bleeding isn't a bad thing. He told me that he would have one of his patients call me to tell me what they think of the Palomar. He also said he would refund my money if I change my mind. I don't feel like I trust him anymore, and I'm pretty sure I've read on here that you don't get a lot of bleeding from the the newer Fraxel, and I would feel more comfortable with that. Someone else PM'd me and said he has taken Fraxel off of his web site. Another person said they signed a release and they were 100% positive it said it was for Fraxel.
That's aweful that he mislead you. Are you seeing any improvements from Palomar? If not, you should ask for your money back and go for the Fraxel.
I feel I saw a little improvement between the 1st and 2nd treatment. I don't see any improvement after the 2nd. I thought it would be a lot better after 60. It hasn't been 2 weeks yet though.
I am so ashamed. It appears I have been duped. Someone that I referred to Dr Kovak PM'd me and told me they believe he isn't using the new Fraxel, as I thought, and is using the Palomar Lux 1540 laser. This person sent me an article about this laser. It isn't even approved by the FDA for acne scarring, but for soft tissue coagulation. The reason I experienced so much bleeding is because the Fraxel makes smaller holes. Also, Fraxel sells for $100,000, and the Palomar $45,000. This is apparently why I haven't been getting the blue dye. This machine is not proven with solid clinical studies. I am sick about this. I'm very sorry I've mislead all of you. I have always been under the impression that this was the new Fraxel. He told me he was the 2nd person in the U.S. to have this. I'm calling him tomorrow and going to try to get my money back for the rest of the treatments. I don't want to be a guinea pig for a machine that is not even approved for this. I had so much faith in these doctors, I can't tell you how upset I am.
I talked to Dr. Kovak this afternoon, and he told me he is using the Palomar on me. The thing that really bugs me is I feel I've been mislead. He told me the old Fraxel wasn't FDA certified for acne scarring when he did it on me(this is true). I asked him about the bigger holes with Palomer to cause more bleeding, and he didn't agree with it. He said the bleeding isn't a bad thing. He told me that he would have one of his patients call me to tell me what they think of the Palomar. He also said he would refund my money if I change my mind. I don't feel like I trust him anymore, and I'm pretty sure I've read on here that you don't get a lot of bleeding from the the newer Fraxel, and I would feel more comfortable with that. Someone else PM'd me and said he has taken Fraxel off of his web site. Another person said they signed a release and they were 100% positive it said it was for Fraxel.
Sounds like a "bait and switch" routine he's using: make people think they're getting the latest Fraxel and once he's got their money, he uses the cheaper machine on them. Face it, most of us would not know the difference.
If he's doing this, then it's VERY bad. Also, if this is what this doctor is doing, it CERTAINLY sounds to me as though you have grounds for a lawsuit. Possibly a nice chunky one, too. As a healthcare professional myself, I don't take shit like this lightly. If this had happened with me, I would definitely be on the phone with a few malpractice attorneys to see if I had legal recourse. Which is exactly what I would encourage you to do, Cubs.
I understand that results vary and I may see very little improvement from my series of Fraxel treatments, but I have not been misled or lied to about which technology was being used. It is UNACCEPTABLE for a physician to mislead patients in this way. And I think it is probably ILLEGAL, too.
RELIANT - IF YOU ARE READING THIS - SEND A DETECTIVE INTO THIS GUY'S OFFICE. FIND OUT IF HE IS DOING BAIT AND SWITCH. IF HE IS, PLEASE - SUE HIM. OR DO WHATEVER YOU CAN IN ORDER TO STOP HIM. WE HAVE SUFFERED ENOUGH FROM THESE FRIKKEN SCARS AND THE LAST THING WE NEED IS A SCUMBUCKET MONEY HUNGRY ASSHOLE DOC LYING ABOUT OWNING YOUR TECHNOLOGY AND THEREBY CAUSING US TO SUFFER MORE. THANK YOU.
Also, to those who asked about the max level of the new fraxel, it is my understanding from my doctor's office that the new fraxel goes to 40mjs maximum. Please note that Cubs doctor was NOT using the new fraxel when he went to 60 - he was using a different laser altogether.
This is scaring the hell out of me. I've talked to quite a few people, and I think he's going to be getting a lot of phone calls today. I really just want to get out of this nightmare, and get my money back. As disgusted as I am with him now, I still remember that he helped me a lot with the first round of the "real" Fraxel.
I am so ashamed. It appears I have been duped. Someone that I referred to Dr Kovak PM'd me and told me they believe he isn't using the new Fraxel, as I thought, and is using the Palomar Lux 1540 laser. This person sent me an article about this laser. It isn't even approved by the FDA for acne scarring, but for soft tissue coagulation. The reason I experienced so much bleeding is because the Fraxel makes smaller holes. Also, Fraxel sells for $100,000, and the Palomar $45,000. This is apparently why I haven't been getting the blue dye. This machine is not proven with solid clinical studies. I am sick about this. I'm very sorry I've mislead all of you. I have always been under the impression that this was the new Fraxel. He told me he was the 2nd person in the U.S. to have this. I'm calling him tomorrow and going to try to get my money back for the rest of the treatments. I don't want to be a guinea pig for a machine that is not even approved for this. I had so much faith in these doctors, I can't tell you how upset I am.
I talked to Dr. Kovak this afternoon, and he told me he is using the Palomar on me. The thing that really bugs me is I feel I've been mislead. He told me the old Fraxel wasn't FDA certified for acne scarring when he did it on me(this is true). I asked him about the bigger holes with Palomer to cause more bleeding, and he didn't agree with it. He said the bleeding isn't a bad thing. He told me that he would have one of his patients call me to tell me what they think of the Palomar. He also said he would refund my money if I change my mind. I don't feel like I trust him anymore, and I'm pretty sure I've read on here that you don't get a lot of bleeding from the the newer Fraxel, and I would feel more comfortable with that. Someone else PM'd me and said he has taken Fraxel off of his web site. Another person said they signed a release and they were 100% positive it said it was for Fraxel.
ouch 🙁
how's your skin responded to it? have you had any positive results from it?
i think if it were me, unless i'd seen a really good result, i'd definitely ask for my money back
This Palomar may be o.k., but I'm going with my gut feeling for now, and getting my money back. Hopefully there are other doctors in this area who are doing the new Fraxel.
My dry skin finally came off this morning. I honestly don't see any improvements right now. Things look the same. I'm hoping to see some changes on the 2nd treatment. Most of my scars are quite shallow too and I don't understand why i'm not responding well to it.
i think it just needs more time/treatments
i didn't see much of a difference after my first treatment (i've also got shallow scars generally)
but i'm a week out from my 2nd treatment and i really feel my skin is starting to improve
My dry skin finally came off this morning. I honestly don't see any improvements right now. Things look the same. I'm hoping to see some changes on the 2nd treatment. Most of my scars are quite shallow too and I don't understand why i'm not responding well to it.
i think it just needs more time/treatments
i didn't see much of a difference after my first treatment (i've also got shallow scars generally)
but i'm a week out from my 2nd treatment and i really feel my skin is starting to improve
Thanks, that is what I wanted to hear. I'll try and stay positive. I've also been taking Vitamin C and B6 everyday, plus eat healthy.
I just talked to someone who is a patient of Dr. Kovak. He says he has had 22 sessions of laser total, between the old and new. He claims fraxel is a technology, not a patent name from Reliant. He says the Palomar is a fraxel machine, and it's newer and better than Reliant's. He had some problems his first treatment with the Palomar. His setting was at 70, and he had bad bruising and some marks. He told Dr. Kovak to go back down on the settings, and he has seen 30 to 40 to 50% improvements on different areas of his skin. He said he had some really bad problems caused by another dermatologist when he first went to Dr. Kovak, and he has helped him immensely. What do I do now? Have I started this uproar over nothing? I'm going to give myself until next week to think this over about whether I should go back or not. What do you guys think?
I just talked to someone who is a patient of Dr. Kovak. He says he has had 22 sessions of laser total, between the old and new. He claims fraxel is a technology, not a patent name from Reliant. He says the Palomar is a fraxel machine, and it's newer and better than Reliant's. He had some problems his first treatment with the Palomar. His setting was at 70, and he had bad bruising and some marks. He told Dr. Kovak to go back down on the settings, and he has seen 30 to 40 to 50% improvements on different areas of his skin. He said he had some really bad problems caused by another dermatologist when he first went to Dr. Kovak, and he has helped him immensely. What do I do now? Have I started this uproar over nothing? I'm going to give myself until next week to think this over about whether I should go back or not. What do you guys think?
Only you can decide if you feel comfortable enough to go back but please approach this with caution. The issue here is not if Palomar has a decent laser or not but more importantly that he has compromised your trust by outright lying to you about the laser treatment you were receiving. If you do decide to go back, how can you ever be sure that he is being honest with you from this point forward or even that the reference he just had call you was a legitimate one? If I were you I would seriously consider filling a complaint with the state medical board.
Also, if you look into Dr. Kovak's background, there are some red flags. He has an MD in general medicine. He claims board certification yet it is only certified in emergency medicine. He claims some type of training with Dr. Alster who does happen to be an excellent laser surgeon but this appears to be some type of fee based elective course to pad his credentials. If you look closely there's really no formal skin care training from an accredited medical school at all in his background.
Logically speaking then why would any internist do a complete 360 away from his chosen specialty in medical school and without board certification in plastic surgery or dermatology suddenly decide to get into skincare and laser medicine if it were not for the $$? Perhaps only Dr. Kovak can justify his reasoning but I think I have seen enough to know he would not be the Dr. for me. I'm not sure if you will ever get this message so I sent you a PM about this.
For all of you who are new to fraxel, my biggest recommendation would be to not expect results immediately after treatment. If you see improvement after a treatment, it is only swelling which can persist for several weeks and make your scars look great. I went through 4 treatments last winter, and I'm doing 5 more this winter. It takes months for the collagen to begin filling in your scars. Usually by the time you have your 3rd or 4th treatment, enough time has passed to start seeing the results from the 1st treatment. That is why you hear many people say that you don't notice any improvement until after you're 3rd treatment.
The improvement is so gradual, that you will not notice it from week to week. The best and only real way to judge your improvement is to take really good before pics, and then take an identical pic a few months AFTER your last treatment. It is very difficult to get good clear pics at good angles, so take your time and do it right. I would not recommend using natural light from windows, as light changes from time of day and also time of year and your scars will look different. Use ceiling lights/bathroom lights, something that you know will look the same 6 months later. If your doc offers VISIA, I would definitely recommend it as it is probably the best way to judge your results.
It wasn't until after I saw my after pics that I realized how much improvement I got from my 4 treatments. I would estimate around 35% improvement from my treatments which ranged from level 16 to 19. My doc says it's closer to 50% improvement, but I don't agree.
Sean..
If Troublied skin has it right on credentials, you should run as fast as you can from Dr. Lack. He has no formal training, residency in dermatology and may be dishonest to boot. On of the biggest problems in medicine is untrained Dr. crossing over into higher paid specialties without adequate training.
There are no licensing rules restricting his ability to claim that he is a PS or dermatologic surgeon, even though he did not go through a residency or a cetification process in those specialties.
Sean is also right as to expected timeframes for seeing improvment - it takes many months. He had a bigger improvement than I did. I took my pictures outdoors to get harsh lighting so scars were more visible, but it made it hard to compare pre and post.
Billyboy,
In answer to your previous post about depth relationship. The new Fraxel (SR1500) has been optimized so that the erbium laser energy does not splay out at settings above 20 mjs. In other words while an energy level of 20 may be proportionate on both machines, the total depth of penetration on the SR1500 can reach an additional 30% deeper because the mtz's are more accurately focused and reach more uniform depth throughout the entire mtz pattern instead of fraying out at or around the level of the papillary dermis. For all of you techies out there this depth level is now approaching the deeper reticular dermis in some areas of the face which is far deeper then any laser could ever even begin to approach through full ablation.
I have read some of your many posts about your challenges with Fraxel and feel for you. There are some non responders to Fraxel for reasons that are still yet unclear but far more non responders have been treated by practitioners that do not fully understand the relationship between the density and power levels being used and especially the relationship of those settings to the type of scars being treated. Also, power levels really mean very little if treatment is concluded before the total energy on the kJ counter reaches the recommended levels of at least 8-9 for a larger face as is the case with many males.
If Troublied skin has it right on credentials, you should run as fast as you can from Dr. Lack. He has no formal training, residency in dermatology and may be dishonest to boot. On of the biggest problems in medicine is untrained Dr. crossing over into higher paid specialties without adequate training.
There are no licensing rules restricting his ability to claim that he is a PS or dermatologic surgeon, even though he did not go through a residency or a cetification process in those specialties.
Sean is also right as to expected timeframes for seeing improvment - it takes many months. He had a bigger improvement than I did. I took my pictures outdoors to get harsh lighting so scars were more visible, but it made it hard to compare pre and post.
i for one, am thinking of starting out at level 30 mjs, is that too harsh? this is my 1st treatment and i have had fair results in the past with 1 session of vbeam where there were no cream applied to the skin during the vbeam, just straight laser on skin and i surpassed that but dr. skipton have given me a few new light scars... blahhh
my doc said that having light skinned and with proper preparation (hyperpigmentation cream 2 weeks before treatment), he can go deep. now as how deep he was planning, i'm not sure but i want to tell him to start high so perhaps on the final 4th treatment, he can hit 60 mjs. not sure if i need to be that harsh even though my scars are very shallow, but i really want to get rid of the pores, wrinkles, and have a smooth texture. what do you guys think? plz only replies from those with credential experiences with the fraxel would be appreciated.
p.s. i plan to do fraxel once every 3 weeks, i guess that makes it once a month. also i read that the upper layer of skin is renewed after 28 days, so every 28 days, we get a new layer of skin on top. also would a lower setting be more helpful to the pores? or perhaps an aggressive setting, sigh i'm so confused.
Troubled skin
First, as to my mistake about Dr. Lack vs. Dr. Kovak - oops. I have no idea how to edit a post other than to say that I am sorry for picking up the wrong name. Run to Dr Lack, run away from Dr Kovak is the correct message.
I understood your post about SR 1500. Thank you for the explanation. You seem very knowledgable. My total energy was 13 (subject to rechecking my notes) in my last treatment, so it was very aggressive by the standards others were posting at that time. I was happy enough with Fraxel, that I am willing to try again. I have wondered whether I should wait for new machine or just try higher settings on the machine my Doc has. I have several scarred pores that did not respond at all. Do your think they should be pretreated? Eg. subscision to unbind?
I had several punch floats. They worked pretty well on a few boxcar scars, but failed badly with my scarred pores/tiny icepicks. Anyway, I would appreciate your advice.
A plastic surgeon told me that Dr. Kovak is not a plastic surgeon or a dermatologist. He is only certified in lasers, whatever that means. I guess that is why he pushes lasers so much. #1cubsfan, only you can decide if it is worth it to you to continue treatments with your doctor. Do whatever you feel is best for you. There are other doctors out there though; it is just hard to find the honest ones. If you do decide that you want to find another doctor, post here or pm me. I am near Chicago too, and have been finding out what I can about different doctors, several consults and a few people on here have been kind enough to share doctors to avoid like the plague, as well as a few decent ones. There are people in IL on this board who are happy with their doctors. Good luck.
Billyboy,
If your total energy was 13 on the kJ counter and that number is not being confused with the power level then your treatment was on the aggressive side. One thing to remember with reference to treatment for acne scarring is that ALL treatments rely on your body's ability to repair itself. Whether that would be through re-epithelialization, collagen induction, or both.
The first thing that should be considered is your age. How old are you? As you may know, collagen production markedly decreases with age so the first thing that should be taken into consideration is your age.
Second, you might be surprised to hear as far as lasers are concerned, depth of injury does not always directly correlate with increased collagen production. The degree of thermal injury and total surface area does. [especially with older patients where the ability to generate collagen is diminished to begin with]. That is why CO2 is still the gold standard in treating rhytids (wrinkles) for aging patients. When used in a controlled manor, more thermal injury = more collagen production. Of course, any laser with such powerful ability to cause thermal injury through ablation over a large surface area can cause many complications such as demarcation lines and hyper/hypo pigmentation issues. The bottom line is there's basically no free lunch but fractional technology comes close!
Some basic differences with regard to thermal injury and Fraxel is that Fraxel relies on a fiber ER:YAG laser which is about 10 times more readily absorbed then the CO2 laser. This in a nut shell means Fraxel produces much more limited degrees of thermal injury. In the case of younger patients a more limited amount of thermal injury is enough to induce collagen production when the laser reaches the dermis which would at least partially explain the vast differences in results reported with Fraxel. There are however others that defy explanation if segregated based on age. The body is an amazing thing. The more we understand about it the more it becomes apparent how little we know.
This does not mean complete gloom and doom for older patients with acne scarring. It simply means treatment can be a little more challenging. Combination treatments nearly always yield the best results unless the scarring is very superficial.
For ice pick scarring you might consider exploring TCA cross and if you scars are bound-down subcision has helped many. Needless to say the experience of your chosen Dr. will makes all the difference with the outcome.
The SR 1500 offers some promising upgrades and I would definitely consider resuming treatment with your Dr. (if he gets the new laser). If that's taking too long consider calling Reliant and ask them to put you in contact with providers in your area using the new laser. Reliant also is providing a generous upgrade credit so there may be more physicians upgrading then you might think.
Also, talk to your Dr. about treating you with higher density, multiple passes. Be very careful though with this technigue when passing over the areas of scarred pores. If too many MTZ's are layed down too close together the micro thermal zones begin to connect to form linear lines which can effectively split the pores and exascerbate your problem. They key is striking the right balance and you must have complete confidence that your Dr. can do that. If he doesn't know what you are talking about find a different one. Fraxel's biggest downfall is it's inability to control the exact placement of the MTZ's with a pattern generator but that will be on its way in the near future.
Also, have you considered looking into Fractional CO2 ie. Active FX? Little controlled data is available because it is so new but in theory harnessing the technology of Fraxel with the power of CO2 should yield even better results.
The next thing that I would consider is your diet. Such little scientific data is available in this area with reference to laser treatments but I would not underestimate the results that can come from proper exercise and supplementation before and after undergoing laser treatment. A healthy body will always heal better!! An excellent article on this is available right in the scar forum. I have read it and checked it for accuracy and it is right on the money. http://www.acne.org/messageboard/index.php?showtopic=67916 . Just remember to follow the instructions to the letter as some supplements and vitamins are highly contradicted for any surgical procedures [lasers included]. I hope this is of some help to you.