Lumenis Ultrapulse fractional CO2 Laser Treatments

Quick Facts

  • The Lumenis Ultrapulse fractional carbon dioxide laser uses tiny columns of laser energy to resurface skin.  Unlike traditional carbon dioxide lasers,  only small columns of skin are treated and some intact skin is left in between these columns that helps to speed recovery and reduce the risk of the procedure
  • It can be used to treat wrinkles, acne scarring, other types of scarring, skin pigmentation and skin sallowness and helps to tighten skin. It can also be used to treat off-face areas such as the hands, neck and decolletage.
  • Treatments with this laser can be done with the Active Fx hand piece, Deep Fx hand piece, or both hand pieces (Total Fx) depending on the type of problem that needs to be treated
  • Treatments can be done at various energy levels to tailor the results and downtime accordingly
  • The Lumenis Ultrapulse fractional carbon dioxide lasers is the most powerful fractional carbon dioxide machine available, and has distinct advantages over other fractional laser devices.



What is the Lumenis Ultrapulse fractional carbon dioxide laser?

Carbon dioxide lasers have been used for many years to resurface skin. Despite the dramatic results, there are many downsides to treatment with traditional carbon dioxide lasers as they remove the entire skin surface. The risk of traditional carbon dioxide laser treatment  include prolonged recovery periods, gradual loss of skin pigmentation, and a relatively high risk of scarring. The Lumenis Ultrapulse laser however is a carbon dioxide laser that uses fractional laser technology to resurface skin effectively without the risks and prolonged downtime associated with traditional carbon dioxide lasers.  

 

What is fractional laser technology?

Fractional laser technology means that only small columns of laser are fired into the skin, ranging in size from 0.15mm to 1.3mm in diameter, leaving untreated/intact skin in between. Traditional unfractionated carbon dioxide lasers remove all of the treated area which prolongs recovery time and increases the risks of laser resufacing, including scarring and pigmentary changes, significantly.

Because with fractional laser technology, only columns of skin are treated, the laser is able to penetrate deeper into the skin without causing scarring. The laser energy both ablates (vapourises) and heats a small column of tissue which leads to new collagen production and skin tightening.

In summary, the main differences are;

Traditional carbon dioxide laser

Lumenis Ultrapulse fractional carbon dioxide laser

Fully ablates skin in the treatment area

Fires columns of laser energy into the skin, leaving intact healthy skin adjacent to these columns

Shallow penetration into the skin

Deeper penetration into the skin

Prolonged recovery periods

Shorter recovery periods

May require dressings to be applied

No dressings required

Higher risk of scarring

Low risk of scarring

Progressive hypopigmentation (over-whitening of skin)

No hypopigmentation problems

 
In summary, fractional laser technology is a balance to achieve the best results possible whilst reducing potential complications and recovery time. For those who have severe/deep wrinkling, the laser can also be set to fully ablative ie the entire skin is treated and the laser is unfractionated. This may yield better results, but may have significantly prolonged recovery times and increased risk.

What can be treated? 

Laser resurfacing with fractional carbon dioxide lasers can treat a number of skin concerns. It can be used to improve skin texture, reduce wrinkles, soften acne scars and other scars, reduce sun-induced skin pigmentation, and to reduce skin sallowness. It can also help to tighten skin.


Case study

This 57 year old female presented to The Victorian Cosmetic Institute with concerns about her skin texture, wrinkles, and skin pigmentation. She had a high energy Total Fx treatment (see below) with the Lumenis Ultrapulse CO2 laser. This was done under light intravenous sedation and local anaesthetic. The recovering picture shows the patient's face after 2 days. The total downtime was approximately 10 days in this case.

She also had dermal fillers and anti-wrinkle injections in addition to the laser.

 

 

 

What is Active Fx, Deep Fx, and Total Fx?

Active Fx and Deep Fx are the names of the two hand pieces that can be utilised with the Lumenis Ultrapulse laser. 

The difference between the two hand pieces is primarily in the size and depth of the columns of laser fired. The Active Fx hand piece emits laser columns with a diameter of 1.3mm and a depth of up to 0.2mm. The density or percentage of area covered by the laser ranges from 50 to 100%. Therefore, the Active Fx hand piece is used for the treatment of more superficial skin problems such as fine wrinkles, superficial sun damage, pigmentation, and skin sallowness.

The Deep Fx hand piece emits laser columns with a diameter of 0.15mm but these penetrate to a depth of up to 2mm. The density or percentage of area covered by this laser is much less, and ranges from 5 to 25%. This hand piece is therefore used for the treatment of deeper problems within the skin such as deep wrinkles, and acne (indented) scarring. The depth of penetration also induces significant skin tightening which is good for the treatment of the skin around the mouth and eyes.

Total Fx is simply the sequential use of the Active and Deep Fx hand pieces on the same areas of skin in one session. By utilising both hand pieces on one area, you can combine the benefits of both hand pieces and achieve results better than treating with one hand piece alone. The recovery period however is prolonged in comparison to treatment with a single hand piece.

 

Am I suitable for treatment with the Lumenis Ultrapulse fractional carbon dioxide laser?

This laser treatment is for those people wanting skin resurfacing for the face, neck or body. Most commonly, the face, neck, decolletage, and hands are treated.

We recommend those who are pregnant, breast-feeding, are prone to keloid scars, and those who have taken isotretinoin (Accutane, Roaccutane) in the past 6 months to avoid treatment.

The laser can also be used on most skin types from fair to dark, however, darker skin types may not be able to be treated with as aggressive settings as the fairer skin types due to the increased chance of darker skin types to have pigmentary disturbances post-laser.



What does treatment involve?

The first step of treatment invovles preparing the skin for laser treatment. A good skin care regime with medical grade ingredients, especially topical retinoids, before laser can help improve the results achieved from laser as well as reduce the potential side effects. Topical retinoids can help to improve skin turnover and have been shown, if used for at least two weeks prior to laser resurfacing, to reduce the time of re-epithelialisation (regeneration and reformation of skin). For those with darker or olive skin types, preparation with a topical lightening agent such as hydroquinone may help to reduce complications such as post-inflammatory hyperpigmentation (darkening of the skin in the treated areas as a result of treatment).

In some cases, a test patch may be done to help determine the level of energy to be used as well as the possible skin response to the laser. This is usually done in more olive or darker skin types to help predict the possible outcomes. It is also performed in an inconspicuous area if possible.

Especially for heavier treatments, anti-viral medications or antibiotics may need to be taken prior to the procedure to prevent infections.

The anaesthesia for the treatment will depend on the level of treatment and the hand pieces used. For lighter treatments, a topical anaesthetic agent may be used without any other forms of anaesthesia. This will need to be applied at least 30 minutes prior to the onset of the procedure. For stronger treatments, it may be necessary to use topical anaesthetic agents in conjunction with nerve blocks/injectable anaesthesia. Deep Fx treatments tend to require more anaesthesia or stronger forms of anaesthesia in comparison to the Active Fx treatments. Intravenous sedation is also a good option for stronger treatments, and this can help to reduce any discomfort of the procedure. It is also possible to use sedation with lighter treatments for those who would prefer the least possible discomfort. 

The treatment with the laser takes approximately 30 minutes (not including anaesthetic) for a full face or neck/decolletage . The area is systematically covered  by the laser. Both or either of the Active Fx or Deep Fx hand pieces can be used. During the treatment your eyes will be covered with gauze, and for treatments within the orbital rim (within the bone surrounding the eyes), corneal shields may need to be inserted under the eyelids to protect the eyes.

The treated areas appear red and swollen after the treatment, and the small columns of laser can be seen on the face in a grid-like pattern of dots. The treated areas also feel quite hot after the procedure. To reduce this, we offer you a Zimmer cooler, a machine which blows cold air through a hose that can be directed at the areas to be treated.

What happens after treatment? 

Full recovery takes from 4 to 14 days approximately depending on the level of energy used in the treatment (this can be tailored to your requirements). Off-face areas usually take longer to heal, and usually only lower energy levels can be used for these areas.

There is a period where the skin appears quite red. Usually this subsides within 1 week in lower energy level treatments, but may take up to one month to fade for more aggressive treatments. Swelling of the face/eyes may occur for a few days, and sleeping on a 45 degree angle or greater can help to reduce this. There may be a mild acne-like break out (small white pustules) on the face after 3 days as the skin regenerates. The skin may scab, peel and flake and this occurs over one week.

Vaseline or Rescue Balm (Cosmedix) needs to be applied post treatment until the skin peels, and then a normal moisturiser can be used. Sun avoidance is important post procedure to help reduce the chance of pigmentation changes post treatment, or more specifically, darkening of the treated areas.

Anti-viral medications or antibiotics may need to be taken post-treatment, depending on the depth of your treatment, and we closely monitor you for any signs of infection.

Generally the post-treatment recovery period will depend purely on the level of the treatment, and therefore we are able to tailor the recovery time to match the time you can afford to take off your normal activities.

 

What is the difference between the Fraxel, Pearl fractional other fractional lasers, and the Lumenis Ultrapulse laser?

There are other fractional carbon dioxide lasers from other manufacturers, however, at 60 watts, the Lumenis Ultrapulse is the most powerful. There are other fractional carbon dioxide lasers including the Deka Smartxide, the Medart 610 laser, Ellipse Juvia, and the Fraxel re:pair laser. However, we have chosen the Lumenis Ultrapulse because of its superior flexibility and power to the other fractional carbon dioxide lasers.

The Fraxel laser is a fractional laser, but not a carbon dioxide laser. Instead this laser emits laser energy at 1550 nanometres. At this wavelength, no tissue is actually ablated (vapourised) and only tissue heating occurs. This can help with problems such as acne scarring, but tends to be a less effective treatment than fractional carbon dioxide laser which both ablate and heat tissue to maximise the results.

Pearl fractional (2790 nanometres) and Pixel (2940nm) are also both fractional lasers, but again are not carbon dioxide lasers. The laser wavelengths of these two machines tend to ablate columns of skin, but unlike fractional carbon dioxide lasers, do not heat the skin to any large extent. As it is the heating which causes collagen contraction/skin tightening, these two lasers are limited as they do not cause much skin heating.

What is the price of treatment with the Lumenis Ultrapulse laser?

Note the definition of peri-orbital is the area around the eyes, including the upper lid, lower lid, and crows feet area. The definition of peri-oral is the area around the mouth) 

Medicare rebates may apply to to erbium and fully ablative (non-fractional) co2 only for the treatment of scarring, including acne scarring.  Safety net rebates may apply if over the Medicare safety net threshold.

All prices include the cost of any follow up treatments.

High energy treatments

 

Full face high energy skin resurfacing - fractional (Active Fx / Deep Fx / Total Fx treatments) or fully ablative carbon dioxide laser. Inclusive of sedation, full face local anaesthetic infiltration, limosine transfer to and from home.

8500


High energy Perioral resurfacing. Fractional Deep Fx/ Active Fx/  Total Fx / or fully ablative carbon dioxide laser. Not inclusive of sedation or transport

2500


High energy Periorbital resurfacing. Fractional Deep Fx/ Active Fx/ Total Fx/ or fully ablative carbon dioxide laser. Not inclusive of sedation or transport

 2750

High energy Periorbital and peri-oral resurfacing. Fractional Deep Fx/ Active Fx/ Total Fx/ or fully ablative carbon dioxide laser. Not inclusive of sedation or transport

4500

High energy forehead resurfacing. Fractional Deep Fx/Active Fx/ Total Fx / or fully ablative carbon dioxide laser. Not inclusive of sedation or transport


2500

High energy Cheek & nose resurfacing. Does not include crows feet or upper lip. Fractional Deep Fx/ Active Fx/Total Fx / or fully ablative carbon dioxide laser. Not inclusive of sedation or transport.


4500

 Low energy treatments


Low level* Fractional carbon dioxide laser - Active Fx or Deep Fx (not Total Fx) of full face. Not inclusive of sedation or transport. For 1st, 2nd and 3rd/subsequent treatments respectively

 2500 , 2000, 1500

Low level* Fractional carbon dioxide laser - Active Fx or Deep Fx (but not Total Fx) of peri-oral area. Not inclusive of sedation or transport. For 1st, 2nd and 3rd/subsequent treatments respectively

1200, 1000, 800

Low level*  Fractional carbon dioxide laser - Active Fx or Deep Fx (but not Total Fx) of peri-orbital area. Not inclusive of sedation or transport. For 1st, 2nd and 3rd/subsequent treatments respectively

1200, 1000, 800

Low level* Fractional carbon dioxide laser - Active Fx or Deep Fx (but not Total Fx) of cheeks. Not inclusive of sedation or transport. For 1st, 2nd and 3rd/subsequent treatments respectively

2150, 1750, 1350

Low level* Fractional carbon dioxide laser - Active Fx or Deep Fx (but not Total Fx) of neck only. Not inclusive of sedation or transport. For 1st, 2nd and 3rd/subsequent treatments respectively

2150, 1750, 1350

Low level*  Fractional carbon dioxide laser - Active Fx or Deep Fx (but not Total Fx) of décolletage only. Not inclusive of sedation or transport. For 1st, 2nd and 3rd/subsequent treatments respectively

2500, 2000, 1500

Low level* Fractional carbon dioxide laser - Active Fx or Deep Fx (but not Total Fx) of neck and décolletage. Not inclusive of sedation or transport. For 1st, 2nd and 3rd/subsequent treatments respectively

3500, 2800, 2100

Mixed energy treatments

 

Low level* Fractional carbon dioxide laser - Active Fx or Deep Fx (not Total Fx) of full face. High energy (including Total Fx) treatment to peri-oral AND peri-orbital areas. Inclusive of sedation or transport. 

6500


Low level* Fractional carbon dioxide laser - Active Fx or Deep Fx (not Total Fx) of full face. High energy (including Total Fx) treatment to peri-oral OR peri-orbital areas. Not inclusive of sedation or transport. 


4500

NB

*Low level Active Fx treatments are less than or equal to 100mJ, 125 Hz, density 3

*Low level Deep Fx treatments are less than or equal to 20mJ, 600 Hz, Density 20%

*Total Fx treatments are all classified as high energy level treatment   



 

Why should I choose The Victorian Cosmetic Institute as my provide of laser treatments?

With a large number of lasers available, our doctors are able to choose the best laser to suit your requirements. Our doctors specialise in laser treatments and will be able to advise you on what is best for your skin.

The first step is simply contacting us for your initial laser consultation, where we will discuss with you what is a realistic and achievable outcome, and what to expect from your treatment.    

Making that first phone call about any cosmetic procedure can be a confronting task - many of our patients have preferred filling out our online enquiry form. We can then contact you with an understanding of the results you are hopeful of achieving and ensure the treatment is appropriate.

It's as easy as clicking either of the buttons below and completing the provided form.
Otherwise, you can phone us directly on (03) 8850 0655 (Templestowe branch), or (03) 9707 0888 (Berwick branch).

 




 

 

 




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