MCL31 Dermablate - Er:YAG Laser -

Transcription

1 MCL31 Dermablate - Er:YAG Laser -

2 Technology Made in Germany For more than 35 years, Asclepion has been operating on the medical laser market. As the company is based in Jena, famous through the world as the global center of the optics industry since 1846, the company owes it success to the steady development of new technologies and the active collaboration with researchers from German universities and industries. More than 35 years experience in the aesthetic laser medicine and surgery Development, production, service & training center in Jena TOP100 of the most innovative medium-sized businesses in Germany MCL EN 2

3 Milestones of product introduction of Er:YAG laser The sixth generation of the Dermablate series MCL29 Dermablate Dermablate D1 DermaStar MCL30 Dermablate The first Er:YAG laser for dermatology was introduced in 1995 by Asclepion. Now we present the sixth generation for dermatological and aesthetic laser medicine stronger, faster, more efficient, flexible: MCL31 Dermablate. Dermablate Effect MCL EN 3

4 Specifications Laser: Er:YAG, class 4 Wavelength: Energy: Fluence: 2,940 nm Max. 2.5 J Max. 250 J/cm² Pulse duration: µs Frequency: Modes: Spot size Ablation: Spot size MicroSpot*: Spot size Gyn*: 1 20 Hz Ablation, Therm, MicroSpot, Gyn* 1 6 mm (Vario) 8 12 mm (Vario XL*) 13x13mm with variable skin coverage rate of 10 25% V-Spot with 90 reflecting gold-coated mirror V-Spot with 360 reflecting gold-coated cone Dimensions: 36 x 60 x 93 cm (W x D x H) Weight: Approx. 75 Kg * Optional * Available with the Juliet upgrade MCL EN All specifications are subject to change without notice. 4

5 Clinical success and USPs Clinical success 1990: first clinical trials by R. Kaufmann et al. 1996: MCL29 Dermablate was the first Er:YAG laser in dermatology introduced by Aesculap- Meditec (Asclepion), more than 800 systems worldwide Germany: The Dermablate has became a standard tool for dermatologists in the treatment of a wide range of coetaneous lesions more than 20 years experience USPs integrated suction system VarioTEAM technology MicroSpot technology variable coverage and pulse length Sub-ablative mode (coagulation mode) sterilizable distance holder most homogeneous beam profile thermal mode unbeaten reliability, fast amortization Footswitch for adjusting the fluence MCL EN 5

6 Er:YAG vs. CO 2 Advantages of the Er:YAG laser and handpiece technology Ablativ (VarioTEAM) precise and safe ablation very limited thermal damage (necrotic zone 30µm/70µm) superficial treatments possible as well as deep ablation reduced risk of scarring and pigmentation changes many treatments require no anaesthesia short healing process, little side effects Fractional (MicroSpot) integrated smoke evacuation new designed and patented handpiece automatic suction and lens cleaning cooling outlets integrated in distance holders maintenance free Microlens technology with 169 fractional spots per shot up to 20 Hz (quickest fractional technology available) MCL EN 6

7 Integrated filter system integrated smoke evacuation suction directly at the treatment area activation by footswitch for reduced noise pollution more powerful smoke evacuation* up to 50% quieter smoke evacuation (-6dB)* handpiece with patented TEAM technology (Total Evacuation of Ablated Material) easy change of filters HEPA filter (High Efficiency Particulate Air filter) Active coal filter Pre-filter Triple filter system MCL EN * compared to the previous model MCL30 Dermablate 7

8 VarioTEAM handpiece VarioTEAM handpiece (Ablation) with TEAM-Technology (Total Evacuation of Ablated Material) very effective smoke evacuation lowest smell nuisance no assistance necessary cost reduction patents: US DE with VarioSpot-Technology spot size from 1 to 6 mm adjustable in 1mm steps spot size from 8 to 12 mm adjustable in 2mm steps automatic spot size detection automatic fluence adaption VarioTEAM handpiece with variable spot size MCL EN 8

9 MicroSpot handpiece MicroSpot handpiece (Fractional) with MicroSpot-Technology use of stable and precise microlens array technology integrated smoke evacuation (TEAM-Technology) air cooling adaptable (e.g. cooling from Zimmer) very flexible adjustment of ablation depth through fluence very flexible adjustment of cover rate through variable coverage of 10 to 25% controlled thermal effect with selectable pulse duration Micro-lens array Laser beam input MicroSpot output EPIDERMIS MAZ* MAZ* MAZ* DERMIS MCL EN * MAZ = Microscopic ablation zone by Dr. Bettina A. Buhren & Dr. Peter A. Gerber, Clinic of Dermatology, Dusseldorf, Germany 9

10 Beam profile Flat-Top beam profile most homogeneous spot Ablation Fractional MCL EN 10

11 Ablation vs. Fractional Classical Skin Resurfacing with VarioTEAM handpiece Almost 100% of the epidermal layer will be completely removed (Depth of ablation is variable). -> accordingly long wound healing Fractional treatment with MicroSpot handpiece Only 10-25% of the epidermal layer will be completely removed (depth of ablation is variable). -> fast wound healing, supported by the untreated skin MCL EN 11

12 Ablation in µm Ablation vs. Coagulation Ablation vs. Fluence - different mechanism of Er:YAG - Linear correlation constant ablation depth of 5 µm per 1 J/cm² (above ablation threshold) The higher the FLUENCE, the more skin will be removed. Thermal Mode Specs: 1 J/cm², 20 Hz, N = 5... coagulation zone up to 400 µm depth (with single impulse up to 40 µm) Fluence in J/cm 2 MCL EN 12

13 Ablation vs. Coagulation Coagulation depth µm as function of pulse length µs Ablation: increased visibility in the treatment area, thanks to less bleeding Fractional: thermal effect for skin tightening MCL EN 13

14 Ablation vs. Coagulation MicroSpot: Flexibility combined with effectiveness unique results thanks to variability of the cover rate and pulse length Setting E10% N10% N25% C10% W25% Mode Expert Normal Normal Cold Warm Spot number 169 Size pattern 13 x 13 mm 2 Energy per pulse (J) 1.6 J 0.8 J 2.0 J 0.6 J 2.0 J Fluence per pulse Cover rate 10% 10% 25% 10% 25% Pulse length (µs) ,000 Recommended pulses MCL EN 14

15 Display Easy to use clear menu navigation touch-sensitive display different background colors selectable Modes Settings Purpose Ablation Fluence, pulse length, Frequency, spot size* Ablation Therm Fluence, pulse number, time between pulses (interval), spot size* Thermal MicroSpot Fluence, pulse length, time between pulses (interval), coverage** Fractional TOOLS Pilot beam brightness, background colors, pulse rate, filter usage etc. Defaults * Spot size is set directly on the handpiece ** Coverage is set directly on the handpiece MCL EN 15

16 Design Modern design elegant mobile space saving ergonomic handpieces balanced spring articulated mirror arm articulated mirror arm with a long range (110cm)* footswitch for adjusting the fluence MCL EN * Arm about 25% longer than the previous model MCL30 Dermablate 16

17 Selective absorption High absorption in water Low absorption in melanin and hemoglobin Selective thermolysis (effective targeting and low side effects) Absorption Coefficient [cm -1 ] Protein Desoxy-Hemoglobin Oxy-Hemoglobin Melanin Water Scattering Wavelength [nm] MCL EN 17

18 Indications Removal of dermal and epidermal lesions: epidermal naevi, Keratosis seborrhoeic, warts, naevus cell naevus, hypertrophic scars, acne scars, xanthelasma, rhinophyma, wrinkles, Lentigines, actinic Keratosis, Syringomas Full skin resurfacing Soft laser peel Skin refreshing Fractional laser therapy Smoothes fine lines, wrinkles and rhytids; perfectly blends uneven pigmentation; minimizes the size of pores; dramatically clears photo-damaged skin; fills in acne scars MCL EN 18

19 Indications Dermablation MCL EN 19

20 Indications Dermal nevus MCL EN By courtesy of Dr. Said Hilton & Heike Heise, Medical Skin Center, Dr. Hilton & Partners, Dusseldorf, Germany 20

21 Indications Epidermal nevus MCL EN By courtesy of Dr. R. Hartmann, Blaustein, Germany 21

22 Indications Fibro adenoma MCL EN By courtesy of Dr. Klaus-Peter Koch, Harsefeld, Germany 22

23 Indications Xanthelasma Parameters: 2 mm Spot, 18 J/cm 2, 10 Hz MCL EN By courtesy of Dr. Peter Arne Gerber, Clinic of Dermatology, Dusseldorf, Germany 23

24 Indications Xanthelasma Parameters: 2 mm Spot 18 J/cm 2 10 Hz KTP-Laser (532 nm) MCL EN By courtesy of Dr. Peter Arne Gerber, Clinic of Dermatology, Dusseldorf, Germany 24

25 Indications Verruca Seborrhoica Parameters: 2 mm Spot, 18 J/cm 2, 10 Hz MCL EN By courtesy of Dr. Peter Arne Gerber, Clinic of Dermatology, Dusseldorf, Germany 25

26 Indications Lentigo senilis MCL EN By courtesy of Dr. Said Hilton & Heike Heise, Medical Skin Center, Dr. Hilton & Partners, Dusseldorf, Germany 26

27 Indications Keratosis Seborrhoica 3 weeks after treatment MCL EN By courtesy of Dr. Paul Wood, Proderma, Bad Homburg, Germany 27

28 Indications Fibroma MCL EN By courtesy of Dr. Said Hilton & Heike Heise, Medical Skin Center, Dr. Hilton & Partners, Dusseldorf, Germany 28

29 Indications Verruca Seborrhoica Pigmentosa 6 months after treatment MCL EN By courtesy of Dr. W. Petrow, Bonn, Germany 29

30 Indications Verruca Seborrhoica Pigmentosa 6 months after treatment MCL EN By courtesy of Dr. W. Petrow, Bonn, Germany 30

31 Indications Dermal NCN 6 months after treatment MCL EN By courtesy of Dr. W. Petrow, Bonn, Germany 31

32 Indications Milia MCL EN By courtesy of Dr. M. Fuchs, Dr. Samimi-Fard, Germany 32

33 Indications Syringoma MCL EN By courtesy of Dr. R. Hartmann, Blaustein, Germany 33

34 Indications Freckles MCL EN By courtesy of D. Fleming, M.D., Brisbane, Australia 34

35 Indications Full skin resurfacing MCL EN By courtesy of D. Fleming, M.D., Brisbane, Australia 35

36 Indications Fractional laser therapy MCL EN 36

37 Indications Fractional laser therapy immediately after one day after two days after three days after MCL EN By courtesy of Dr. Daniel, Cassuto, Milano, Italy 37

38 Indications Fractional laser therapy MCL EN By courtesy of Dr. Said Hilton & Heike Heise, Medical Skin Center, Dr. Hilton & Partners, Dusseldorf, Germany 38

39 Indications Fractional laser therapy pre op after 4 weeks Acne scars and sun damage MCL EN By courtesy of Dr. Daniel, Cassuto, Milano, Italy 39

40 Indications Fractional laser therapy MCL EN By courtesy of Dr. Daniel, Cassuto, Milano, Italy 40

41 Indications Fractional laser therapy MCL EN By courtesy of Dr. Feller-Heppt, University Hospital, Mannheim, Germany 41

42 Indications Fractional laser therapy Single treatment, 20 J/cm 2, 10 % cover rate, 3 shots on the same fractional spots, 3 and 7 days MCL EN By courtesy of Dr. Feller-Heppt, University Hospital, Mannheim, Germany 42

43 Indications Fractional laser therapy Periorbital treatment only (forehead): single treatment, 20 J/cm 2, 10 % cover rate, 3 shots on the same fractional spots, 3 and 7 days MCL EN By courtesy of Dr. Feller-Heppt, University Hospital, Mannheim, Germany 43

44 Indications Fractional laser therapy Result after 5 treatments MCL EN By courtesy of Dr. Gerd G. Gauglitz, Dermatology of LMU Munich, Germany 44

45 Indications Fractional laser therapy Result after 4 treatments MCL EN By courtesy of Dr. Gerd G. Gauglitz, Dermatology of LMU Munich, Germany 45

46 Indications Fractional laser therapy Striae after 5 treatments MCL EN By courtesy of Dr. Gerd G. Gauglitz, Dermatology of LMU Munich, Germany 46

47 Indications Fractional laser therapy before after 3 treatments MCL EN By courtesy of Prof. Kabir Sardana, Delhi 47

48 Indications Fractional laser therapy before after 2 treatments MCL EN By courtesy of Prof. Kabir Sardana, Delhi 48

49 Indications Fractional laser therapy before after 3 treatments MCL EN By courtesy of Prof. Kabir Sardana, Delhi 49

50 Bibliography Er:YAG-Laser Dermal lesions 1. Khatri KA. Ablation of coetaneous lesions using an Erbium:YAG laser. J Cosmet Laser Ther 2003; 5: Kaufmann R, Beier C. Erbium YAG laser therapy of skin lesions. Med Laser Appl 2001;16: Doi H, Ogawa Y, Hatoko M. Treatment of melanin-induced benign dermal lesions by an Erbium-YAG laser system. J Plast Reprod Surg 2000; 0: Wollina U, Konrad H, Karamfilov T. Treatment of common warts and actinic keratosis by Er:YAG laser. J Cutan Laser Ther 2001;3: Beier C, Kaufmann R. Efficacy of Erbium:YAG laser ablation in Darer disease and Hailey-Hailey disease. Arch Dermatol. 1999; 135(4): Gerd G. Gauglitz, Markus Reinholz, Peter Kaudewitz, Jürgen Schauber, Thomas Ruzicka. Treatment of Striae Distensae Using an Ablative Erbium-Yag Fractional Laser versus a 585-nm Pulsed-Dye Laser. J Cosmet Laser Ther Jun;16(3): doi: / Epub 2013 Nov 18. Aesthetic lesions (Skin Resurfacing) 1. Jasin ME. Achieving superior resurfacing results with the Erbium:YAG laser. Arch Facial Plast Surg 2002; 4: Perez MI, Bank DE. Facial skin resurfacing with the Erbium:YAG laser: new findings. Cosmetic Dermatology 1998;5: Khatri KA, Machado A, Magro C, Davenport S. Laser peel: facial rejuvenation with a superficial Erbium:YAG laser treatment. J Coetaneous Laser Ther 2000;2: Khatri KA, Ross V, Grevelink JM, Magro CM, Andersson RR. Comparison of Erbium:YAG and carbon dioxide lasers in resurfacing of facial rhytids. Arch Dermatol 1999;135(4): Jeffrey S. Orringer, MD, Laure Rittie, PhD, Ted Hamilton, MS, Darius J. Karimipour, MD, John J. Voorhees, MD, FRCP, and Gary J. Fisher, PhD. Intraepidermal Erbium:YAG laser resurfacing: Impact on the dermal matrix 6. Karsai S, Czarnecka A, Jünger M, Raulin C. Ablative Fractional Lasers (CO2 and Er:YAG): A Randomized Controlled Double- Blind Split-Face Trial of the Treatment of Peri-Orbital Rhytids. Lasers Surg Med 2010;42: Karsai S, Raulin C. Comparison of Clinical Outcome Parameters, the Patient Benefit Index (PBI-k) and Patient Satisfaction After Ablative Fractional Laser Treatment of Peri-Orbital Rhytids. Lasers in Surgery and Medicine 42: (2010) 8. Daniel Cassuto, MD, Milan, Italy. Fractional Er:YAG (Dermablate) Histological in vivo study MCL EN 50

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