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Aesthetic Dermatology Laser
Figure 3: PS02 Treatment Regimes properties. This enables the practitioner to perform all nine basic
VSP Er:YAG ablative treatments and the smooth treatment with fully
Light fractional Medium fractional
clinically proven and tested laser parameters. The only difference is
No peel
Deep fractional
peel peel peel
that the skin is treated with pixelated Er:YAG laser beams. Other
Cold
fractional technologies use focused beams with modified pulse
fluences in the fractional spots and therefore with modified and
relatively uncontrolled thermal treatment modalities. PST ensures
that the laser fluence in each pixel is exactly as it would be with a
Warm
standard Er:YAG laser handpiece.
Smooth mode
PST treatments can be delivered using two distinct handpieces
Hot
to provide different fractional effects. Delivered through the
PS01 handpiece, a ‘soft fractional’ effect is created, while
The PS02 treatment regimes are, in principle, the same as the basic variable square pulse
delivered through the PS02 handpiece, a ‘sharp fractional effect’
(VSP) erbium:yttrium–aluminum–garnet (Er:YAG) treatment regimes, but through pixellation
they are less invasive and have shorter downtimes.
can be observed.
Figure 4: Removal of Lentigo Senilis Using Fotona’s Pixel
PS01 Fractional Laser Handpiece
Screen Technology Fractional Ablative Er:YAG Laser The PS01 handpiece is a soft fractional treatment modality in which
Before (A) and One Week After (B) a Single Session
fluence within each pixel gradually diminishes from the centre of
the pixel to its edge through an exclusive optical solution.
A B
Therefore, transitions from the areas of high to low light intensity on
the skin are soft and gradual. This modality is especially suited for
minimally ablative and non-ablative fractional treatments at larger
spot sizes (7–12mm).
The PS01 handpiece is a variable handpiece that allows the
practitioner to change the number of pixels, the size of the pixels
and the total laser spotsize. The number of pixels can be adjusted
Er:YAG = erbium:yttrium–aluminium–garnet.
Courtesy of Dr L Volovec.
20 in the range of seven to 75 pixels by adjusting the pixel level from
one to five. For a fixed pixel level (from one to five) the number of
Figure 5: Reduction of Peri-ocular Wrinkles Using the
pixels is fixed, and the pixel size and pattern can be varied by
Fotona Smooth Er:YAG Laser Before (A) and 60 Days
After (B) a Single Session (Three Passes)
changing the spotsize to provide quick and large area coverage.
PS02 Fractional Laser Handpiece
A B
Fotona’s PS02 handpiece provides ‘sharp fractional’ effects; sharp
signifies that the laser energy is contained within the pixels and
that the laser beam quality and parameters within the pixels remain
unchanged compared with the original beam’s properties. This
modality allows the practitioner to perform all nine basic VSP
ablative and smooth treatments at fully clinically tested laser
parameters. The only difference is that the skin is treated with
pixelated Er:YAG laser beams (see Figure 3)
Er:YAG = erbium:yttrium–aluminium–garnet.
With the PS02 sharp fractional modality, a fixed number of 37 pixels
Courtesy of Dr C Pidal.
24
within a laser spot is generated, providing approximately 11%
nominal coverage regardless of the selected spot size. The PS02
the smooth treatment the epidermis remains intact, protecting the handpiece is a fixed-pixel-number handpiece.
area from infection. Superficial layers peel off 12–72 hours folowing
the treatment, when recovery has already started. Smooth When very large ablation depths are desired, the ablation depth
treatment can be considered as a delayed ablative procedure, but can be increased by using turbo mode. This mode allows the
with less pronounced clinical results than ablative resurfacing. practitioner to determine the treatment depth by selecting
the fluence and the number of pulses to be stacked on the same
Fotona Fractional Pixel Screen treatment area. As always in ablative modes, the coagulation depth
Technology Er:YAG Treatments is determined by pulsewidth. Fotona’s turbo mode allows VSP
To provide fractional treatments, Fotona offers a unique pixel Er:YAG laser fractional treatments greater flexibility. It allows
screen technology (PST) solution that divides the original Er:YAG fractional treatments to be accomplished from the keratinous layer
treatment beam into parallel beam pixels. The advantage of this to depths the practitioner deems necessary to achieve the
method compared with other fractional technologies is that it desired clinical end-point of the treatment. Turbo mode can be
allows the laser beam quality and parameters within the pixels to used to reach deeper into the dermis than traditional (non-
remain unchanged compared with the original laser beam’s fractional) resurfacing.
60 EUROPEAN DERMATOLOGY
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