The State of Aesthetic IPLs & Lasers

In the last few years there's been an explosion of new IPLs and cosmetic lasers.

While that's generally good for clinics - inducing some competition and pricing/sales pressure - it can be a problem trying to find the right system to invest in.

READ: Cosmetic IPL & Laser Reviews & Comparisons Forums

In 2011, Dermatologist Dr. Goldman wrote a journal article about using what kind of laser should be used for the practice. In the present, there are devices that have multiple modalities and treatment options, you can have a single laser device instead of two or more. These devices are now made convenient for physicians and practitioners.

Lasers are steadily gaining traction in the aesthetic field. Many aesthetic devices have been launched, and various companies continue to upgrade their devices or create breakthroughs. Physicians are able to choose devices, which is suitable for their practice, as there are many ranging from skin rejuvenation to fat melting to even vaginal rejuvenation. At the same time, not everything has been met with praise, as lasers have its downsides for the patients or the physicians or practice itself. Thus, it is best that physicians and practitoners practice laser treatments with care.

Multiple treatments are common in many practices. More and more aesthetic companies are making more integrated systems with multiple modalities. Alma, Sciton, and Cutera are some of the aesthetic laser companies that have begun or launched a multiple modality device for one’s practice. No studies have been made about the efficacy of using multi-modality systems, but the technology is promising.

Having multiple modalities could mean multiple or combination treatment options. Effectiveness has been proven in several studies. Prior to multiple modality in a single device, physicians have been combining treatments.

Findings:

• In a dermatologic setting, treatment of non-melamona skin cancer with laser and photodynamic therapy was proven successful and effective. Er:YAG and ALA-PDT had the most efficacy rate with 98.97%
• Goldberg, 2012 suggests that IPL is better at removing hair considering it will be done with multiple sessions
• As for skin rejuvenation, an alternative to fillers would be repeated Erbium:YAG laser mini-peels (El-Domyati et al., 2013), leaving patients with an average of 88% satisfaction rate after the treatment.

Lasers remain to have some controversy over lawsuits filed by patients and complications brought about by its usage. One common issue faced by practices is negligence or mishandling by a non-physician administering the laser procedure. Several state laws allow non-physician practitioners, so long as the doctor is present in the practice. However, unhappy patients experieince some adverse side effects possibly due to poor handling and patient screening.

Training is important to avoid any of this concerns to rise and be the cause of lawsuits. According to E. Victor Ross, dermatologist, vigilance is key when administering laser treatment.

In 2016, a study was published by Dr. Gary Chuang, noting that fumes were present in a laser hair removal system. There are 13 carcinogenic compounds present in the laser hair removal plume. It is a cause for alarm as it could affect the respiratory systems of those performing the procedure and those receiving it. The researchers suggest that better ventilation systems and protection would help prevent any further issues.

Aside from this finding, Laser Service Solutions provides us with a list of common issues with laser devices. Technical issues like LCD screens and circuit boards should not be taken lightly. Other problems include: water issues, calibration, and handpieces.

It is expected that despite issues and problems, aesthetic laser procedures will still rise according to several market research reports.

REFERENCES:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3390232/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3376014/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4632833/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3100114/

http://dermatologytimes.modernmedicine.com/dermatology-times/news/laser-fundamentals?page=0%2C1

http://jamanetwork.com/journals/jamadermatology/article-abstract/2532614

https://www.laserservicesolutions.com/most-common-aesthetic-laser-issues/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3390232/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3376014/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4632833/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3100114/http://dermatologytimes.modernmedicine.com/dermatology-times/news/laser-fundamentals?page=0%2C1http://jamanetwork.com/journals/jamadermatology/article-abstract/2532614https://www.laserservicesolutions.com/most-common-aesthetic-laser-issues/

Dr. Beatriz Porras, Skin Diagnostics Laser & Rejuvenation

Beatriz H. Porras MD, Skin Diagnostics Laser & Rejuvenation

Physician: Dr. Beatriz H. Porras
Location: Cincinnati, Ohio
Website: CincinnatiSkinLaser.com
That's interesting: Dr. Porras is the owner of a patent for a wound healing compound to treat chronic ulcers.

We got togetether with Dr. Beatriz Porras, physician owner of Skin Diagnostics Laser & Rejuvenation in Cincinnati, Ohio as part of our new series of interviews with doctors who are running successful medical spas and laser centers. You can find more in the Medical Spa MD Physician Report.

Can you tell us a little bit about you and how you got started in cosmetic medicine?

I am a Dermatopathologist with extensive training and experience in skin diseases, cosmetic dermatology and laser medicine. I practice cosmetic and general dermatology in Cincinnati OH. 

I got interested in cosmetic medicine many years ago because of all the wonderful results that can be achieved with Lasers, fillers and Toxins.  Also because I can help people improve their self esteem.

Question:  Can you tell us more about your clinic?

My clinic is Skin Diagnostic Laser & Rejuvenation in Cincinnati OH.  We have a condo office in a beautiful neighborhood called Montgomery. My office is very relaxing, we have painted mural of Tuscany and a water fountain in the waiting room. We offer cosmetic and general dermatology. We offer ablative and non ablative laser, Botox, fillers, treatments for acne, scars, wrinkles, sun damage, cellulite, hyperpigmentation etc. My patient population is 55% women 45% men.  I see Whites, African Americans, Hispanics and Asians.

Can you give us some insight into how you hire, motiviate, and manage your staff?

Hiring and firing personal is one of the most challenging parts of running a cosmetic practice.  Before, I had my office manager do that and it was a disaster. Now I do the hiring. I hire people that are personable, friendly and happy. I pay basic salary because I travel a lot and my personal need to get paid consistently. I also give bonuses according to performance, free treatments and products. I tend to hire people that other people have recommended. Before, I used agencies but that was a disaster. I found it is a very bad idea to use people from agencies.

What IPL or laser technologies are you using? 

I use an IPL by Cutera, I love it. I have the entire Cutera Plataform that is non ablative. It is a great laser. I also have a Sciton Erbium laser that is more ablative, it is also excellent. I think the key is choosing the right treatment for the right patient.

How do you market your clinic?

For external advertisement we do TV and Billboards. I also write for 2 magazines. I don’t believe in radio since what I do is visual. I try to be in every event possible so people get to see me.  I also give contributions to several charities and try to be present for their events. I also have my website. We have a big open house every year, we invite many people and we are very successful with this event. 

For internal marketing to existing patients, we send postcards and call patients. We also give referral rewards.

What treatments or services are most profitable for you?

Lasers are the most profitable... once you have paid off the lasers. Botox and fillers don’t have nearly as good margins. I have my own skin care line and that is very profitable. People love my products.

I would like to start doing cool sculpting. (If anyone has any thoughs on cool sculpting please leve them in the comments.)

What have you learned about practicing cosmetic medicine? 

I have learned doing cosmetic medicine that it's importent to never do what the patient wants and what is going to fit their needs (results, price, etc.), rather than what I want or would prefer to do. Everybody’s needs are different and it is very important to listen. I just think cosmetic medicine is very rewarding.  It is very important to be honest and to choose the treatments that will most benefit your patient.

About: Beatriz H. Porras, M.D. is the medical director of Skin Diagnostics Laser & Rejuvenation. She is board certified dermatologist.

Dr. Porras graduated from Medical School from Norte University in Colombia; subsequently she did a surgical internship and fellowship in Plastic Surgery at Washington University School of Medicine in St Louis MO. She completed her Dermatopathology training at UT Southwestern at Parkland Memorial Hospital in Dallas TX, where she trained with one of the best dermatologist in the world, and former president of the American Academy of Dermatology (Dr. Clay J. Cockerell). Dr. Porras was a professor of Biology at Washington University School of Medicine in St Louis, MO. and currently is the president of SKIN DIAGNOSTICS INC, where she serves other physicians by diagnosing skin diseases.

Dr. Porras has extensive research experience, twenty years ago she helped in the research and development of growth factors to promote wound healing, today growth factors are used in several medications and skin products to promote skin regeneration and rejuvenation. She has authored over 30 peer-reviewed papers in leading medical scientific journals and she has contributed several chapters in major dermatology, dermatopathology and plastic surgery textbooks. Dr. Porras is also trained in Laser Medicine and is Laser Certified.

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