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Experts Describe the Gold Standard in Medical

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Experts Describe the Gold Standard in Medical Christopher Zachary, MBBS, FRCP Experts describe the gold standard in Professor and Chair Department of Dermatology medical and aesthetic laser therapy, University of California-Irvine sharing their experiences using clinically- effective, time-proven technologies. asers have without question revolutionized the practice Expanding the Level of Service and ® of dermatology, permitting clinicians to treat conditions Patient Satisfaction with Gemini for which no medical therapies exist or offering results Efficient Management of Rosacea and Photodamage that exceed those of conventional therapeutics. From with the Gemini Laser medical conditions like acne and rosacea to cosmetic Lrejuvenation, laser systems can address a variety of the most Photorejuvenation in Asian Skin Tones: common presentations that bring patients to the dermatolo- Role of the Gemini Laser gist’s office. Gemini for Photorejuvenation: Given their remarkable utility, well-designed and manufac- A Cornerstone of the Cosmetic Practice tured lasers can be a tremendous asset to dermatologists. Yet, often physicians are overwhelmed by the prospect of incorpo- Targeting Patients’ Aesthetic Goals with the VariLite™ rating laser procedures into practice. Technology is costly, and there may be a tremendous sense of pressure to attract The VariLite for Fundamental Cosmetic Applications patients and, as important, provide treatment that meets their VariLite: A Reliable, Predictable Tool for Vascular and goals. There may also be a learning curve, as residency pro- Pigmented Lesions grams currently offer little training in aesthetic dermatology, Continued on page 3 Expert Contributors William Baugh, MD C. William Hanke, MD, MPH Assistant Clinical Professor, Visiting Professor of Dermatology, Western School of Medicine University of Iowa, Carver College of Medicine Medical Director Clinical Professor of Otolaryngology Head and Full Spectrum Dermatology, Neck Surgery, Fullerton, CA Indiana University School of Medicine Carmel, IN Henry H. Lin Chan, MD, PhD Arielle N. B. Kauvar, MD Hon. Professor, Li Ka Shing Faculty of Medicine, Clinical Associate Professor of Dermatology, University of Hong Kong NYU School of Medicine Hon. Consultant Dermatologist, Director, New York Laser & Skin Care Queen Mary Hospital New York, NY HKSAR Visiting Scientist, Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston Additional titles: USAMBBS (London), FRCP (London, Edinburgh, Glasgow), FHKCP, FHKAM (Medicine) Jerome Garden, MD E. Victor Ross, MD Professor of Clinical Dermatology Director, Scripps Clinic Laser and Cosmetic and Biomedical Engineering, Dermatology Center, Northwestern University, Chicago, IL Carmel Valley, CA Private Practice, Chicago, IL Past President of the American Society for Laser Medicine and Surgery (ASLMS) Member of the Board of the American Society of Dermatologic Surgery David J. Goldberg, MD, JD Christopher Zachary, MBBS, FRCP Clinical Professor of Dermatology, Professor and Chair, Department of Dermatology Director of Laser Research, Department of University of California-Irvine Dermatology, Mount Sinai School of Medicine Irvine, CA Director, Skin Laser & Surgery Specialists of New York and New Jersey New York, NY 2 | June 2010 | Supplement to Practical Dermatology Photoaging, Vascular Lesions, and Pigmentation: The Cornerstone of Any Cosmetic Laser Practice Continued from page 1 and such training was virtually non-existent even 10 practice development standpoint, it comes down to years ago. weighing the costs—upfront and ongoing/financial and Clinicians seeking to initiate or expand a laser der- timewise—against the likely returns. It rarely makes matology practice must assess their own interests and sense for a physician to take a gamble on costly new skills, patient demand, and the key considerations that technologies with uncertain efficacy and appeal, when guide device selection and purchase. tried and true systems can be Many dermatologists find success by focusing on acquired (often for less). medical as well as cosmetic indications, such as acne Alternatively, low-priced and rosacea, dyschromia, erythema, telangiectases, and systems can appeal to fine wrinkling. With this broader approach, the clinician the frugal practice, “As thousands of is able to keep her or his practice flexible. Many of the but if a system is best-respected names in aesthetic medicine will tell you underpriced, it physicians have learned, that a portion of their practice remains focused on tradi- probably under- success in laser tional medical dermatology. A flexible approach may performs. medicine is built on suit the clinician’s interest, and it likely reflects the level The initial of demand for service on the local level. investment in a a strong foundation of Selecting a laser system can be a challenge. Key to system purchase tried-and-true procedures success is to disregard the hype. Many lasers have is an important using tried-and-true come to the market backed with flashy campaigns to consideration, but the public and the medical community, making exag- it doesn’t account laser systems.” gerated claims of efficacy and applicability. From a for everything. How much time do proce- Contents dures take? How many Expanding the Level of Service and patients can be treated in a Patient Satisfaction with Gemini . 4 period of time? Will time be wasted on set up? Will consumables and maintenance Efficient Management of Rosacea and Photodamage with the lead to costly bills? Gemini Laser . 6 Dermatologists establishing or growing their laser Photorejuvenation in Asian Skin Tones: practices can benefit significantly from the wisdom of Role of the Gemini Laser . 8 their experienced and successful colleagues. That’s what the following pages provide. Some of the best- Gemini for Photorejuvenation: respected minds in aesthetic dermatology share their A Cornerstone of the Cosmetic Practice . 10 expertise about two laser systems—Gemini® and Targeting Patients’ Aesthetic Goals with the VariLite . 12 VariLite™—from an established market leader in laser The VariLite for Fundamental Cosmetic Applications . 13 aesthetics: IRIDEX. As thousands of physicians have learned, success in laser medicine is built on a strong VariLite: A Reliable, Predictable Tool for Vascular and Pigmented foundation of tried-and-true procedures using tried- Lesions . 14 and-true laser systems. G Supplement to Practical Dermatology | July 2010 | 3 Expanding the Level of Service and Patient Satisfaction with Gemini® By E. Victor Ross, MD Director, Scripps Clinic Laser and Cosmetic Dermatology Center Carmel Valley, CA hotodamage is one of the most common com- Ideal Combination Systems plaints among patients presenting for cosmetic A significant benefit of the Gemini for a cosmetic der- laser therapy. Specifically, patients frequently matology practice is that it combines two different seek treatment for mottled pigmentation, laser systems into one single device. While the notion melasma, lentigines, broken capillaries, telang- of dual-system devices is well-established, the reality Piectases, and surface roughness. Despite anecdotal is that combinations are not always optimal, or they reports of decreased demand in some areas, hair may not be as convenient as they seem upon first con- reduction and leg vein removal continue to be com- sideration. For example, some systems may pair con- mon requests in the cosmetic dermatology clinic, as stituents that have similar indications. As such, the well. combination system may provide clinical utility for Various laser and light sources available on the mar- specific patient presentations but may not permit the ket offer a range of wavelengths and penetration practice to expand the service menu or appeal to a depths necessary to address these various patient con- wider base of patients. By combining the 532nm and cerns. Ranging from intense pulsed light sources (IPLs) the 1064nm wavelengths, the Gemini expands the to fractional resurfacing lasers, the number of treat- number of indications—and likely the ment options has become remarkably wide. Yet to effi- number of patients—the clini- ciently treat a majority of patients presenting with cian can treat. these common complaints, a single system offering With some dual sys- dual wavelengths and a variety of spot sizes, Gemini tems, switching from REEL TALK* (532nm KTP/1064nm Nd:YAG, IRIDEX) may be appro- one wavelength to “There are a lot of new priate. another can be a technologies out there, but Gemini features the long-pulse 532nm KTP laser time-consuming one of the tried-and-true tech- and the 1064nm Nd:YAG, providing the versatility to and difficult nologies is KTP laser and the target a variety of chromophores and enabling the cli- process for the nician to provide up to about 80 percent of the treat- operator. With long-pulse YAG laser. And the ments commonly sought in a typical laser practice. Gemini, the Gemini fits the bill for both of Although other two-in-one systems are available, operator can those wavelengths. So in a sense Gemini is unique in the wavelengths it offers. The quickly and the Gemini is a time-tested prod- shorter 532nm wavelength effectively targets superfi- easily switch uct. It has served us well at our cial red and brown lesions (lentigines, broken capillar- from one wave- ies, mottled pigmentation, melasma), while the longer length to another clinic, both at the Navy and at 1064 wavelength effectively targets deeper vessels in (just a tap on the Scripps Clinic
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