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hatethyself

The dangers of Fraxel

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http://www.dailymail.co.uk/pages/live/fema...picbox&ct=5

Last week The Mail on Sunday revealed how television newsreader Kate Silverton's violent reaction to laser therapy left her in pain, unable to work and facing the threat of lasting skin damage.

Kate, 37, underwent Fraxel therapy to reduce minor facial scarring – the legacy of teenage acne. This is her compellingly honest account of her experience and a warning to anyone tempted to believe knife-free surgery is risk-free...

Looking back, I suppose I already had an instinct that something wasn't right. When I asked the nurse for the mirror, I'm sure I caught a flicker of reluctance as she handed it over.

Still, I steeled myself with a "Get a grip, Silverton, it's fine." But I didn't feel fine – my face hurt and I was worried.

A glance in the mirror would reassure me I had done the right thing. Or perhaps not.

The face that stared back at me was already red, raw and swollen. There were deep lines running between my nose and mouth and my face had dropped, giving me a puffy, hangdog expression.

http://img.dailymail.co.uk/i/pix/2008/02_0...MOS_468x518.jpg

I might have found it funny were it not for the fact it was so painful and I had the terrible sense that something had gone badly wrong. That was just the beginning.

Last week it was revealed that I had undergone Fraxel laser therapy to treat acne scars on my face. It was also revealed that it had, indeed, gone horribly wrong.

My skin reacted so violently that, instead of a couple of days' recovery and back to work, I was absent for two weeks and am still facing possible long-term damage and scarring.

To be honest, I was mortified when people first found out. Then the emails started coming in.

Some were messages of sympathy and they've been lovely. Others have been from women who have had similar treatments, with remarkably similar reactions.

The journalist in me was angry for them as well as for me, and so I find myself writing about a subject I never thought I would do publicly.

Thousands of people are insecure about facial marks and scars for all sorts of reasons and to varying degrees.

It's not necessarily about vanity. Your face is linked to your identity – it is the image you present to the world.

The fact that others might see the problem as a superficial one adds a layer of self-consciousness and guilt to an already distressing situation.

I have continually reminded myself in these past few weeks to keep a sense of perspective. I have reported from war zones and interviewed people who have had terrible things happen in their lives too many times for me to allow this to become an all-consuming event.

But I am concerned by the way information is given to people going to private clinics about the potential risks associated with this type of "minor" surgery.

We as patients – and we are still patients even if we are paying for treatment – have the right to be made fully aware of all the risks before making such important decisions.

I know how much it meant to me to be told there was finally a "safe" way to reduce the scarring on my cheeks – the scarring that had been a constant reminder of my acne-ridden teenage years.

Doing the work I do, I've tried to deal with and conceal my scars with make-up and a little self-confidence. I realised I'd never have perfect, peachy skin.

But it's always been there – a button easily pressed. Last year, I was asked to present Ultimate Wild Water – a BBC1 prime-time programme where I spent almost the entire time in a wetsuit and in the water.

The hour-long programme was filmed in the unforgiving High Definition format – and I wore no make-up throughout.

I did have reservations – what woman wouldn't? But I wanted the programme to be authentic and honest and, besides, I told myself I really should confront this two-decade-old demon.

I didn't watch the programme back in High Definition but I thought I looked OK. I had indeed beaten my demon. Eamonn Holmes called to say: "Well done, kiddo – a woman who's not afraid to appear on TV without make-up – brilliant."

But then there was the senior television executive who exclaimed: "Darling! My God, that was cruel putting you in High Def with no make-up." He didn't mean his words to sting. But they did.

The truth is, it doesn't matter how many people say: "Kate, you look lovely," it's the one negative note that resonates. Like the solitary email when I was presenting Breakfast on BBC1 that read: "Kate's skin looks like a lizard." Nice, thanks for that.

I developed acne when I was about 16. It was so severe I was referred to a dermatologist who, after all other medication failed, finally prescribed Roaccutane, a particularly powerful drug that eventually helped reduce the red, angry lumps on my face.

I was prescribed it again in my early 20s but by then my skin was already scarred on both cheeks.

After university, I trained as a radio journalist at the BBC then went to Tyne Tees television. The news editor was gruff and of the old school of journalism. He would shout and swear at you from across the room. I liked him. He called a spade a spade and taught me so much.

But 11 years on, I still remember the day I realised my attempts to cover up my scars had failed. I was about to go on air when he hollered: "Oi, Silverton, get down to make-up. I don't want to see your pockmarks on screen tonight." He saw me flinch and I know he regretted it instantly.

I then looked at having the scars removed but the treatments seemed so abrasive. They involved either dermabrasion (in those days it meant you would effectively sandpaper the skin) or acid peels that sounded horrific.

I thought I should just get "over it" and see the marks as something innately "me". But I remained self-conscious and sometimes worried my requests for soft lighting might leave people thinking I'm a diva. But the alternative – admitting I was conscious of my acne scars – didn't appeal.

Over the years, I'd managed to convince myself that nobody but me really noticed. That wasn't so easy after the Ultimate Wild Water comment or that email to Breakfast.

At the end of last year, I suddenly feared that my bad skin was the worst-kept secret in television – that everyone talked about it but most were just too polite to say. So I looked into my options.

This was not something I rushed into. I went to Dr Jan Stanek's clinic off Harley Street. I went to him because of his reputation.

He appears on a number of television shows and I know friends who have had other treatments with him. But on arrival, I was told it would be his colleague, Dr Tom Bozek, who would treat me.

I suppose I trusted him before even stepping through his door. I took a friend with me for my consultation on December 18.

We asked numerous, searching questions. Fraxel therapy was sold to me as a dream treatment: non-invasive, highly effective, leaving mild redness and swelling that would disappear within a day, maybe two. I pushed for information on possible adverse reactions or long-term side-effects.

I specifically said: "What are the side-effects? What is the potential here because if there are any risks, I won't have this done?" My friend, too, was really specific asking about long-term side-effects.

But Mr Bozek said: "No. I've done thousands of these and nothing has gone wrong." When you're told that, it negates any doubt you might have. You think, "Great".

There was another treatment suggested too – Erbium – which involved burning off the top layer of skin and letting it regenerate over a fortnight. That was far too dramatic.

I asked for more information on Fraxel but I was told there was none to be had. I picked up a small pamphlet in reception and that was that. I kick myself for it now. But I had been reassured by Tom Bozek that this would work, was without real risk and I would be back to work in no time.

Having gone this far, I thought, I should make the leap. It would be a Christmas treat to myself.

I was told that I would need between three and five treatments costing between £500 and £700 a time, depending on the extent of the area covered.

On Fraxel's website, the treatment is compared to restoring a painting, only instead of cotton-buds and fine brushes, the tool Mr Bozek would use was a laser.

I had my first treatment on Saturday, January 5. I went on my own this time. I cleaned my face before going to the clinic but I'd driven through the grime of London by the time I arrived.

I was handed a hairband and anaesthetic cream was plastered over my lower face. I waited an hour as the anaesthetic took hold.

Then a nurse gave me a consent form and one sheet of information. At that stage it seemed a bit late. I felt vulnerable and foolish and I signed. I lay back uncomfortably in the treatment room and cottonwool pads were placed over my eyes. I was told it would feel like hedgehog prickles over my skin.

Now, I've got a high pain threshold, but as it started I thought: "Bloody hell, this really hurts." I said as much. It felt like electric shocks piercing my skin.

I remember thinking: "I don't think I'll be coming back for more of this – it hurts too much." I was overwhelmed with the feeling that something bad was being done to me. Worse, I was allowing it to happen.

When he'd finished, Mr Bozek left the room without a word. The nurse handed me the mirror. She told me to wear an ice-mask and sleep upright. I'd be fine by the next day.

But I wasn't. My eyes were so puffy I could hardly see and my face so swollen and painful I could hardly speak. A day later and it was worse still and these horrible yellow-heads were breaking out over my nose, chin and cheeks. I called the clinic and was told to take painkillers and call in the morning.

But it was a Monday and I was due in at work to read the 8pm news bulletin which had just been launched with great fanfare. It was a crucial week but there was no way I could go on air. I was mortified.

By Tuesday, I was really worried. My face was massive, red, painful and covered in disgusting spots. I was embarrassed to go out but I had to go back to the clinic. I was too worried about the reaction not to.

The receptionist could barely hide her shock. She asked how I was. "I'm devastated," I said and realised, to my shame, that was true. The spots were breaking out as you looked at them. It was alarming.

I was told the reaction must be due to bacteria on my skin and prescribed antibiotics but I decided to go to see my own GP. By then, I was so horrified by my appearance that I swathed myself in a scarf and ran to my car, terrified of meeting anyone.

My GP doubled my antibiotic dose and, on a friend's advice, I sought a second opinion from consultant dermatologist, Nick Parkhouse. He has been wonderful. He asked if I had cried yet which I promptly did in his office – most embarrassing. I felt exposed and dismayed by how upset I was. It all seemed so self-indulgent.

But he reminded me he is used to seeing the results of cosmetic procedures that have gone wrong and said the shock is akin to that of a car crash. I balked at that. It sounded ludicrous.

But talking later with my friend and colleague Dr Jonty Heaversedge, the BBC's Street Doctor, he spoke in similar terms, which I found very reassuring.

He joked and said he felt stressed when he got a single spot (I laughed and said I had lost count of mine) but I was shocked when I realised how long it would take until my ravaged skin would be significantly better.

Nick Parkhouse said he could not guarantee there would not be long-term damage and worse scarring than before. He also said the skin eruptions might recur.

Mr Bozek had seen me in the same state and said: "It'll be OK. You'll be back to work in a day or two."

He said that he had done 1,100 treatments and never personally seen such a reaction but that "one or two cases will be like this".

I said: "This is the first time you've mentioned this." I suppose that's when my upset began to tip towards anger. I felt so betrayed.

I've been told to stay out of the sun and not to swim in chlorinated pools. That, on top of everything else, has really impacted on my well-being. I love swimming and find it therapeutic physically and mentally.

It was a friend who suggested I seek legal advice, pointing out that, at the very least, I'm self-employed and have lost earnings. I have instructed lawyers to see what legal action I can take.

I had never really devoted much thought to this subject before but since having the treatment, and this horrendous reaction, that has changed – dramatically.

It is absolutely crucial that anybody considering undergoing any sort of medical procedure is as aware as it is possible to be of any risks, however slim.

I realise I have to be careful here. I don't want to sound bitter – like a woman who got unlucky and is lashing out. I know that no one can ever truly guarantee the outcome of surgery and I know there are people who will think: "Well, she knew there must be risks." But it's simply not good enough to adopt a "buyer beware" attitude to medicine.

Before I had Fraxel, I was asked in an interview: "Do you have any regrets?" I said: "No". That is no longer true. I absolutely regret having this treatment. And what lies at the heart of my regret are two awful words, "If only..."

If only I had known all about the risks. If only I had been fully aware and informed. If I had, I honestly don't believe I would have gone ahead.

My skin is still painful and fragile. I am using heavy make-up to hide the spots that have persisted for weeks. Worryingly, new spots have appeared recently. Something, somewhere, went wrong with my treatment. And however brave a face I'm trying to put on this now, I wouldn't wish this, or the regret that I feel, on anybody.

• A spokesperson for Dr Stanek said: "Due to patient confidentiality, Dr Stanek cannot comment on the treatment of a specific patient. His clinic adheres to the highest international standards, and independent consultants who operate within the clinic are among the leading practioners in their field."

Kate Silverton did not receive any payment for this article.

She used tane huh? The usual suspect

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I don't understand what that is. Is it an infection? A resurgence of acne? Burn marks? Other than the pimples, or whatever they are, it doesn't look like the fraxel really harmed her skin. She definitely had some swelling, which I would imagine is to be expected. Is it possible this is related to after-care?

By the way, I thought her story about her experience with acne scars was touching. It is hard for me to imagine when I look at her before picture with makeup. Goes to show that we are our harshest critics. When her producer made the comment about her "pock marks", he probably did so because he didn't see it as a big deal and didn't think it would hurt her since she is obviously very attractive.

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Isn't the daily mail the equivalent of US's national enquirer? That's the impression I get.

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I had a pretty severe reaction when my doc went at my right temple at 70 mjs. A lot of it has to do with settings that are too high. Fortunately, my skin has healed back to normal. The scars, of course, didn't improve much.

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I really wonder what caused this procedure to go so terribly wrong for her. I know that after dermabrasion some people develop milia and blocked pores so maybe this is akin to that...so incredibly sad. I have a great deal of admiration for her for having gone into a very public line of business. I hope it works out for her!

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I remember seeing her on TV years ago and thought her skin was flawless..wow

I guess some people will have a bad reaction to lasers penetrating their face. I've had 4 yag laser treatments so i think im safe from weird side effects.

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Wow good read. I'm still going to do my first fraxel in a few weeks, but this article has I guess given me some insight into the risks of it all. I guess when you're desperate like me, you just have to hope for the best and hope that the worst stays the hell away!!

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Sad. Just because she's famous she gets sympathy and a lawyer to sue.

Every single person who has had fraxel for acne scars has had this exact same experience!!

All the info on fraxel is geared towards wrinkle treatment and it's billed as a no-downtime procedure. For acne scars, the treatment levels are much higher. The down-time is considerable.

There will always be severe swelling, bleeding, acne, etc. from treating with fraxel at high levels for acne scars. Her doctor could have made that clearer, especially given her job.

It's ridiculous to think you can get fraxel for acne scars and be back to work on Monday. You need at least 10 days to look semi-normal. (or even more if you have a job where people stare at your face!)

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I was already scared of fraxel, but now I'm even more leery.

Aside from this woman's reaction I'm worried they don't know enough about long-term effects. I often wonder if it will cause accelerated aging. Either way, the jury's still out for me...I'll wait.

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Just about every surgery (minor or major) has some risks. Unfortunately Kate doesn't give us a better idea of what happened to her face, she just pinpoints how she wish she never had it.

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It's strange how each of the links to this article that I've clicked on say "info not found" etc.

I've searched for the article on several sites using the woman's name as the search term.

I wonder if someone or some company is willfully trying to "erase" the story from the internet.

If I had been smart enough to take before and after photos of my PSR (Portrait/ Rhytec) plasma treatment, I'd be suing the grapes off of the doctor that added scars to my face.

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Isn't the daily mail the equivalent of US's national enquirer? That's the impression I get.

Absolutely not! The Daily Mail is a regular English newspaper, not a smutty tabloid like the Enquirer!

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In the pic it looks more like pimples from inflammation (like folliculitis) than scars. I wonder how she is doing now and what the doctor has said. For any laser, they say if you have active herpes virus you might have a breakout like this. I hope she is better now.

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that slutty little reporter. bet she has herpes . . .

seriously though everyone gets those acne breakouts after fraxel. her doctor should have told her this.

i guess most doctors are so aloof and non-caring that they don't even realize this was happening to every patient receiving treatment! cos they only see them a month later when acne is gone . . .

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Hi,

I had to respond to the article about Kate Silverton and her experience of Fraxel. I have conducted my own research on Fraxel in the UK and here are my findings (and recommendations!) based on that information. My aim is NOT to dissuede anyone from having the treatment but far too few of you seem to be aware of the fundamentals in choosing this type of scar treatment & who performs it, particularly in the UK:

Before I start, my view is that Kate Silverton was absolutley CORRECT to persue the derm./practice involved in her treatment. Not a registered plactic surgeon, not equipped to provide adequate aftercare (passed over to a nurse to deal with the fallout - ethically absolutley lacking). I could go on. THis will be settled out of the public arena and it's between them, I can't comment further than I have as these are the only facts I know.

Now to my factfinding:

I paid £70 ($150?) for an initial consultation with a nurse in a privately run clinic in central London. THis clinic and the dermatologist who owns it is factually, one of the TOP dermatologists in the UK. His practice is well regarded as are his many publications in the field and on the subject itself. I chose not to pay a higher fee (£200 - 300) for an initial consultation with the dermatologist himself, or his partner, as my reasoning was this - I did not require confirmation that I had acne, nor did I need to know the type of scars I had. Previous dermatologists had already discussed treatments with me and I am now in a post-acne with scars phase. I knew I wanted Fraxel, I didn't want oit done by Kate's dermatologist, and wanted the information on it and check if I was a suitable candidate. I assumed that if a nurse is qualified to charge clients and given free reign to do so, then the information should be the same level as that of a dermatologist (about the treatment). Now there are 2 things I found:

(i) at no time in that consultation was my face examined. THe nurse did not get any closer than 4-5 feet across a desk. NOT GOOD ENOUGH.

(ii) at no time did she refer back to the medical checklist I had to fill in upon arriving - some of which I may add I annotated with 'to be discussed at consultation' as the details were too lenghty to write in total. I shouldhave been queried about at least one of these things! NOT GOOD ENOUGH.

(iii) When I pushed to have treatment with just 2 weeks (10 days) inbetween, I was told that would not be a problem. I have since research this and it is really not advised, it is really not advised, it is REALLY NOT advised. I should have been told no, and not been in a position to bargain. Where is the patient care here? NOT GOOD ENOUGH.

(iv) Most worryingly, I asked specifically if the treatment effects are temporary or will last 'forever'. Forever is the response I got. Absolute tosh. THere are NO findings to support this. NOT GOOD ENOUGH.

(v) Most importantly for me, I wanted to see before & after photos of patients of THAT clinic (not Fraxel's marketing crap) to judge for myself the reality of how effective the treatment can be for my type of scars and on my type of skin/tone. They told me that due to patient confidentiality this was not possible. However, I was asked to sign a form as part of my medical questionnaire which categorically requested my permission as part of the registering process to allow photos to be used in their training material and/or publicty. I declined the publicity section but agreed to the training section. Now how can a clinic flogging a treatment at £4000+ not provide a bais set of before & after photos of their own handywork? Patient confidentiality is not a good enough reason - digital technology is at a state where the main face can be blocked out and still photos of cheeks/chin taken perfectly well without harming patient confidentiality. Would you buy a car without seeing it? Would you buy a flat-off plan without seeing the spec? For goodness sake, this should not be happening. My father is a doctor and in his own words, if a true professional wants to flog his wares then he should be willing to stand by his work and prove it. Clinics - Photos please! NOT GOOD ENOUGH.

I left politley after drawing my own conclusions and paying the fee in the name of research!

Can I please encourage anyone looking into Fraxel in the UK to consider the above points. It may mean the difference btween choosing the right practice or not and saving yourself £4000+ on a treatment which, in the wrong hands, could show little improvement and leave you wondering why the hell you chose one clinic over another. Be sensible and make sure they inspire you with confidence because anyone can use a laser when taught, it takes the right operator to make it work effectivleyfor you.

A second dermatologist (22 yrs experience with lasers, well known), provided adeuqte information to the 1st four points above. However, same story on the Fraxel photos. Now I really find this disturbing because they are more than willing to show you their own before & after photos for more established treatments (eg fillers etc). Wonder why this is? I'll tell you - it's because Fraxel is so now that effects however good are varied as this is such new technology. Don't rely on the fraxel website for photos please - it's in their interest to showcase the very best results, plain and simple.

THis is such a COSTLY procedure that I am sure, in the right hands, may help a great deal of us very effectively, but my message is simple - get informed and don't believe the hype. You are the client - you are paying a whad of money with very little comeback (read the small print). Check out any clinic with scrutiny.

I am getting Fraxel done in Autumn and have chosen someone based on this research. I know there are no guarantees but at least I know I've tried to source the best operator for me. Good luck anyone having fraxel soon, I hope it goes well.

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I have been having fraxel treatments for some time and it is worth every penny and all the pain, suffering and downtime.

I found the treatments to be painful, even with numbing cream and vicodin. I endured the pain for the price of beauty. Ugh, I am so vain! I first had my face done and I will tell you that whoever said it was a "lunchtime" procedure is crazy! And no, I could not go back to work within a few days. I was red and swollen for SEVERAL days. Once the healing began, my skin wasn't aweful, but it wasn't great either. The top layers of my skin were sloughing (which was not noticible with good moinsturizing) and when your skin sloughs, it is because that skin is dead. (Think about the stage your skin goes through after a sunburn. Once it starts to peel, it doesn't look very radiant). However, it didn't take long and my skin started to look great!

My second treatment left me with large whiteheads! It was unbelievable! I guess all the bad stuff was surfacing. I called the treatment center to notify them of the HUGE zits (predomantly around my mouth and chin) and they prescribed an antibiotic. Eventually the zits healed and again, it was a little wait until I was radiant. The pain, swelling and downtime was the same as the first fraxel treatment.

I just had my 3rd treatment and again, I got the giant zits. (This treatmet was more painful than the others. Perhaps because I have so much soft, new skin now. They zits are about healed now and I know it won't be long before the dull, top layers are replenished with new skin. All of my brown sun spots are gone. I had one on the left side of my face from being exposed to the sun while driving. It was the size of a nickel and now it is completely gone! The pink, scaley pre-cancerous lesions are also gone.

I also had treatments on the top of my hands. They too became swollen and kind of purple. They looked dry at first, just as they do when your skin is leathered due to sun exposure. This too, is temporary until the new skin is exposed. For the first time, I feel like my hands look young again. I used to be embarassed by my old looking hands. Almost all the roughness, dryness and brown spots have disappeared.

Since I was a teenager, I worshiped the sun (now I know better). Growing up, I just had to be tan! I also had many, many sunburns. So my chest was a mess too! I had permanent scaley and red eruptions. I went to many doctors and they all told me it was like scars and it was one of those doctors who suggested that I would be a good candidate for fraxel. I had two treatments to my chest and both times, the lesions looked worse as they were surfacing and shedding. The treatments brought it all out and it had to look worse before it would look better. Well, now for the first time in many years can I wear tank tops and low cut clothing. I am ready to throw out the turtlenecks and clothes that hid my chest. I am no longer embarrased by extremely noticable blotches and scabs. My friend told me that I my skin now looks as soft and flawless as a baby's butt!

Overtime, the skin continues to improve. Each month you will look better than the last. It is not a painless procedure. It is not an immediate result overall. You will have down-time and you will have a few days that you just want to hide out because you will look very scarey. Your eyes my swell up and you will wonder who the monster is that is stairing at you in the mirror. I hear so many people tell me about the side affects, but then I don't hear about the long term result. It is the gradual healing in the months after the treatment that proves the effectiveness of fraxel. Your damaged or scarred skin didn't happen overnight and the fraxel results are not overnight either.

As with standard plastic surgery, you have to look worse to look better. I would not trust any doctor that tells you that you will be able to go right back to work. Unless you work in the dark with no co-workers to scare! When you go under the knife, you feel like your face will never be normal. But in given time, your body heals and the results are seen.

This is fraxel SURGERY. Surgery is very serious and should not be taken lightly. I think the bad publicity is from people who thought this was just a simple procedure. You are getting new skin. That IS serious business.

Good luck to those who decide to have the procedure. Also, I empathize with those of you who were given false expectations and/or had something go wrong in your procedures.

I hope that someday the cost for fraxel becomes more reasonable. My pocketbook is much lighter now but I would do it all over again.

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ChristPunchers be aware that Awalk is only familiar with Re:store, and her problems could well have been the result of the other injections she was getting.

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ChristPunchers be aware that Awalk is only familiar with Re:store, and her problems could well have been the result of the other injections she was getting.

Yes I just re-read her postings. We'll never know exactly what caused her condition but I think Fraxel did more damage in the end then good. Perhaps a better pre-treatment diagnose would have prevented such problems. Either way, lasers are not for everybody.

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ChristPunchers, the problem lies in the word Fraxel, because the differences between Re:store and Re:pair are rather large. I never advocate Re:store, and I urge caution with Re:pair because I consider it the most intense of the laser treatments, and it is certainly the most expensive. Dark skin and sensitive skinned people should look at alternative treatments. High intensity Re:pair is best reserved for the most difficult cases, and even then there must be a multiple treatment plan than can span years.

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Hi

How did your fraxel go - 2 years on?

I've booked to have some done but have read so many scare stories. I'm going to a nurse featured on Embarrassing bodies who treated a woman with severe scarring.

I have mild/medium scarring. I may ask her for a skin text first and see if I can watch her treat other patients with scarring if they are willing.

Hi,

I had to respond to the article about Kate Silverton and her experience of Fraxel. I have conducted my own research on Fraxel in the UK and here are my findings (and recommendations!) based on that information. My aim is NOT to dissuede anyone from having the treatment but far too few of you seem to be aware of the fundamentals in choosing this type of scar treatment & who performs it, particularly in the UK:

Before I start, my view is that Kate Silverton was absolutley CORRECT to persue the derm./practice involved in her treatment. Not a registered plactic surgeon, not equipped to provide adequate aftercare (passed over to a nurse to deal with the fallout - ethically absolutley lacking). I could go on. THis will be settled out of the public arena and it's between them, I can't comment further than I have as these are the only facts I know.

Now to my factfinding:

I paid £70 ($150?) for an initial consultation with a nurse in a privately run clinic in central London. THis clinic and the dermatologist who owns it is factually, one of the TOP dermatologists in the UK. His practice is well regarded as are his many publications in the field and on the subject itself. I chose not to pay a higher fee (£200 - 300) for an initial consultation with the dermatologist himself, or his partner, as my reasoning was this - I did not require confirmation that I had acne, nor did I need to know the type of scars I had. Previous dermatologists had already discussed treatments with me and I am now in a post-acne with scars phase. I knew I wanted Fraxel, I didn't want oit done by Kate's dermatologist, and wanted the information on it and check if I was a suitable candidate. I assumed that if a nurse is qualified to charge clients and given free reign to do so, then the information should be the same level as that of a dermatologist (about the treatment). Now there are 2 things I found:

(i) at no time in that consultation was my face examined. THe nurse did not get any closer than 4-5 feet across a desk. NOT GOOD ENOUGH.

(ii) at no time did she refer back to the medical checklist I had to fill in upon arriving - some of which I may add I annotated with 'to be discussed at consultation' as the details were too lenghty to write in total. I shouldhave been queried about at least one of these things! NOT GOOD ENOUGH.

(iii) When I pushed to have treatment with just 2 weeks (10 days) inbetween, I was told that would not be a problem. I have since research this and it is really not advised, it is really not advised, it is REALLY NOT advised. I should have been told no, and not been in a position to bargain. Where is the patient care here? NOT GOOD ENOUGH.

(iv) Most worryingly, I asked specifically if the treatment effects are temporary or will last 'forever'. Forever is the response I got. Absolute tosh. THere are NO findings to support this. NOT GOOD ENOUGH.

(v) Most importantly for me, I wanted to see before & after photos of patients of THAT clinic (not Fraxel's marketing crap) to judge for myself the reality of how effective the treatment can be for my type of scars and on my type of skin/tone. They told me that due to patient confidentiality this was not possible. However, I was asked to sign a form as part of my medical questionnaire which categorically requested my permission as part of the registering process to allow photos to be used in their training material and/or publicty. I declined the publicity section but agreed to the training section. Now how can a clinic flogging a treatment at £4000+ not provide a bais set of before & after photos of their own handywork? Patient confidentiality is not a good enough reason - digital technology is at a state where the main face can be blocked out and still photos of cheeks/chin taken perfectly well without harming patient confidentiality. Would you buy a car without seeing it? Would you buy a flat-off plan without seeing the spec? For goodness sake, this should not be happening. My father is a doctor and in his own words, if a true professional wants to flog his wares then he should be willing to stand by his work and prove it. Clinics - Photos please! NOT GOOD ENOUGH.

I left politley after drawing my own conclusions and paying the fee in the name of research!

Can I please encourage anyone looking into Fraxel in the UK to consider the above points. It may mean the difference btween choosing the right practice or not and saving yourself £4000+ on a treatment which, in the wrong hands, could show little improvement and leave you wondering why the hell you chose one clinic over another. Be sensible and make sure they inspire you with confidence because anyone can use a laser when taught, it takes the right operator to make it work effectivleyfor you.

A second dermatologist (22 yrs experience with lasers, well known), provided adeuqte information to the 1st four points above. However, same story on the Fraxel photos. Now I really find this disturbing because they are more than willing to show you their own before & after photos for more established treatments (eg fillers etc). Wonder why this is? I'll tell you - it's because Fraxel is so now that effects however good are varied as this is such new technology. Don't rely on the fraxel website for photos please - it's in their interest to showcase the very best results, plain and simple.

THis is such a COSTLY procedure that I am sure, in the right hands, may help a great deal of us very effectively, but my message is simple - get informed and don't believe the hype. You are the client - you are paying a whad of money with very little comeback (read the small print). Check out any clinic with scrutiny.

I am getting Fraxel done in Autumn and have chosen someone based on this research. I know there are no guarantees but at least I know I've tried to source the best operator for me. Good luck anyone having fraxel soon, I hope it goes well.

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