Lasers in the field of resurfacng have been of limited utility in the brown skin
Downtime, and postinflamatory pigmentation, have been the major problems

Resurfacing in India

Resurfacing lasers have traditionally been used for wrinkles in the west In India, more important indications are acne scarring, chicken pox scarring, pigmentation and it they can work, strech marks

Ablative Skin Resurfacing



Existing treatments were either too mild( such as MDA/sup chemical peels) or too aggressive( such as dermabrasion/CO2 resurfacing)

Fractional photothermolysis

In 2003, Manstein and colleagues introduced the concept of fractional photothermolysis to bridge the gap between ablative and nonablative resurfacing. Manstein D, Herron GS, Sink RK, et al. Fractional photothermolysis:a new concept for cutaneous remodeling using microscopic patterns of thermal injury. Lasers Surg Med2004;34:426–38.

2940nm Er:YAG Pixel


skin is treated in fractions (hence the name fractional photothermolysis) or pixels (skin is divided in to zones or pixels,just like a digital camera), thereby removing tissue by scattered ablation( destruction), in contrast to the total ablation done by previous lasers







PixelTM Fractional Laser Resurfacing



The total collateral microdamage depends on the number of passes, matrix,size, and the level of energy used.

The Pixel thus treats only a small fraction of the skin (about 25-35%), and leaves the rest of skin unaffected( see figure below). This generates a pattern of microscopic noncontiguous collumns of thermal injury within the dermis.

Level : epidermis superior dermis Biopsy: 0h; immiedately after




Coagulation of the epidermis and superior dermis




Fractional Laser Resurfacing




7 days After Pixel-rapid repithelialization



Normal epidermis and inflammatory infiltrate in the dermis Little risk of infeciton/pigmentation/scarring minimum down time

The Laser Swing
Laser Skin Resurfacing: Past, Present and Future




Fractional / Non Fractional Lasers Water Absorption Graph




Pixel 2940nm laser Specifications

Laser Type: Er:YAG
Wavelength: 2940nm
Pulse duration: 1, 1.5, 2 msec
Number of Pixels: 49 or 81 dots/ cm2
Treatment Area: 11 x11mm
Beam Delivery: Direct
Maximum Pulse Energy: 1400mJ/Pulse
Maximum Pixel Energy:
17 mJ/Pixel (81 dot Pixel size)
28 mJ/Pixel (49 dot Pixel size)
Repetition rate: 2 Hz
The single-pass ablation microzone of each pixel measures approximately 150 mm in diameter and 120–140 mm in depth

Pixel Technology Spot Size



Results


Before

After


Our experience


Our methods


Methods n=67


Patient feedback on treatment


Pixel laser(n=67)


All patients became fairer


Postoperative changes