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Beauty Tech Review: Fractional Resurfacing Devices - Fraxel re:store Dual


Dr. Heidi Waldorf shares her experience with the latest from Solta Medical.

At the recent annual meeting of the American Academy of Dermatology (AAD), American Health & Beauty Editor Keith Veseleny spoke to Dr. Heidi Waldorf, Director of Laser and Cosmetic Dermatology at Mount Sinai Medical Center in New York, New York. Fractional resurfacing devices have flooded the market and probably the most well known is the Fraxel laser from Solta Medical. Their most recently released device is the Fraxel re:store Dual which adds an additional wavelength to the original Fraxel re:store machine.

Dr. Waldorf says, "What's very exciting to me is I've been using the Fraxel re:store for quite some time, and what the Dual adds is an extra layer of efficacy without adding a lot of downtime. And for my patients, they're busy people who have busy lives, socially and work wise and they can't take a lot of downtime." The added benefit of the new wavelength is seen right away. "With the Fraxel re:store, you saw improvement in lines, you saw improvement in texture which increased over multiple treatments... for most patients - to improve pigmentation for example - 2 to 4 treatments to have a significant benefit. With the addition of the other wavelength for the Dual to the traditional re:store wavelengths, you add that extra surface improvement. The patients will have some bronzing afterward, like they would get with a peel, but then by a week their skin is not only tighter, but it's a lot smoother and the pigmentation issues are improved, all in one treatment."

Fraxel re:store Dual Before After
Actual Before and After Results of Dr. Heidi Waldorf, After One Treatment (Note: Lower Lids)

"I think the Fraxel Dual is an ideal piece of equipment, and an ideal treatment, for a patient coming in who is in need of an overall rejuvenation, but they don't need surgery," says Dr. Waldorf. She goes on to say that she believes the Fraxel re:store Dual, "is the ideal procedure for the patient who is a bit younger, maybe their late 30's into their early 50's who has mild to moderate sun damage, mild to moderate lines, and... perhaps some acne scarring and pigmentation issues. They may have freckling, they may have lentigos that they've developed over years, they're starting to get some puffiness and crepeyness around the eyes that their filler and their toxins are not taking care of adequately.... Those patients will see a significant difference."

Physicians must take care with aggressive treatments on those with darker skin, says Dr. Waldorf. "It is a great treatment for patients with light or medium tones skin and can be used carefully in patients with darker toned skin." She refers to the Fitzpatrick scale that classifies skin tone based on its ability to tolerate sunlight. Dr. Waldorf says, "In my practice, I usually limit this to a 4 with the Dual because if I wanted to do a 5 or 6 then I would in general just use re:store." She says that a 4 on the scale would be, "a darker skinned Hispanic, lighter skinned African American or Indian patient. It's somebody who really doesn't burn and they generally tan, but at rest, they do have a light brown pigmentation."

"I would say the most common treatment area for me with the Fraxel Dual is the face and neck," says Dr. Waldorf. She also says that one of the best areas to use this laser is around the eyes, for those patients who are almost ready to have a blepharoplasty. "We've used Botox or Dysport around their eyes so that their mobile, [or] active lines are reduced, however, they've reached the point that at rest those lines are still there. Perhaps they don't need fillers; they don't want to change the contour of their face; or we've used fillers but there are still residual lines going down their cheeks and under the eyes.... With this procedure, you can address some of the pigmentation that makes the under eye circles look dark, and you can tighten and tone that area to get rid of the crepeyness, so that then afterwards they can either go out without makeup or put just a little under cover makeup on and their eyes look refreshed and they can put off having a blepharoplasty."

How much does Fraxel cost? According to Dr. Waldorf, around $1000-$1600 per treatment of the face and neck. The number of treatments needed varies depending on the patient's individual skin needs. "If it's a patient who has been careful in more recent years, hasn't had a lot of weight changes so that their skin is fairly tight, but they're trying to get rid of some of the old sun damage from their twenties and teens, one treatment with the Fraxel Dual may refresh their skin significantly enough that they're happy with that, especially if they're someone who's using a good topical regimen. For the patient who is, let's say in their later 40's, into their 50's, they have some areas that are more significant, perhaps they used to smoke, they were tanning later, they have some acne scarring, then you're talking about more like 3-5 treatments."

dr. heidi waldorf
Dr. Heidi Waldorf
The procedure only requires topical anesthesia and recovery time is short, but does vary depending on the extent of the treatment. "For the patient for whom you're using solely the re:store aspect of the Dual, you will have two days of swelling and by the third day, you might be a little pink or red, you can wear makeup, and the swelling is down. When you add the Dual aspect to it, in addition to those few days of swelling, you're going to have another 3-5 days of some bronzing. That is that surface skin coming off, and that is what's leading to the improvement in the pigmentation. So I tell patients to figure a week of not having any social engagements, but after three days they can go to work, they can go out and about, and really look fine." After graduating magna cum laude from Harvard University, Dr. Heidi Waldorf received her medical degree from the University of Pennsylvania School of Medicine. Dr. Waldorf's extensive professional accreditations include Diplomate of the American Board of Dermatology, Fellow of the American Society of Dermatologic Surgery, Fellow of the American Society for Laser Medicine and Surgery, Member of the American Academy of Cosmetic Surgery, Fellow of the American College of Mohs Micrographic Surgery and Cutaneous Oncology, and Fellow of the American Academy of Dermatology. As Director of Laser and Cosmetic Dermatology at Mount Sinai, Dr. Waldorf is contributing to the advancement of laser treatment in cosmetic dermatology and dermatologic surgery.

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American Health and Beauty, in an effort to provide the most up-to-date information to our readers, presents the Beauty Tech Review. Our first installment in this ongoing series discusses Fractional Resurfacing technology. Join American Health and Beauty editor, Keith Veseleny, as he speaks with leading physicians who share their knowledge on each laser platform.

The Beauty Tech Review: Fractional Resurfacing - will include: Dr. Heidi Waldorf on {!Fraxel Re:store Dual | Fraxel}, Dr. Etai Funk on Matrix IR, Dr. Michael Kaminer on ProFractional, Dr. Janee Steinberg on Sandstone Matrix, Dr. Lori Brightman on eMatrix, Dr. Deborah Sarnoff on SmartSkin, Dr. Christopher Zachary on {!Fraxel Re:pair | Fraxel}, and Dr. Bill Johnson on SmartXide DOT Therapy.