After researching fractional laser resurfacing devices, Sydney plastic surgeon Dr Kourosh Tavakoli chose the one he believes delivers the best results with the least fuss. Gillian Samuel reports.

The fractional laser has opened a new era in laser resurfacing primarily because it has taken away the down time once associated with laser treatments,’ says Sydney plastic surgeon Dr Kourosh Tavakoli.

‘The fractionated laser is designed to prevent damage to the surrounding skin and because of this the redness and swelling normally associated with traditional laser resurfacing treatments is considerably reduced,’ he says.

Dr Tavakoli spent some time researching fractionated laser devices before opting for the Palomar Starlux to use for skin resurfacing and anti-ageing treatments in his practice. ‘I chose the Palomar primarily because it is a renowned laser company with over 30 years experience in cosmetic laser devices.’

Palomar’s Starlux 1540 nanometre erbium glass laser handpiece uses tiny individually focused lenses that divide a laser beam into a number of tiny beams. The main advantage of fractional technology is that it removes the bulk heating effect of conventional lasers by fragmenting the heat effect into small zones. These coagulated micro treatment zones (MTZs) achieve an effective result with much less collateral damage and no bleeding.

Fractional lasers use wavelengths of 1540/1550nm that attract water well but also can penetrate deeply into the dermis. These wavelengths enable new and better
treatments for skin conditions including melasma and scarring, and a more gentle way to treat wrinkles.

Dr Tavakoli underwent trial treatments himself so he could evaluate the experience firsthand. ‘I found the Palomar significantly less painful than other laser resurfacing devices and that’s a major positive.’ In addition to not requiring numbing creams or medication, he says the treatment allows for a very quick turnaround time. ‘There’s a very low down time in terms of swelling and redness, in the vicinity of 24 hours for most patients.’

He says the Starlux’s flexibility was another decisive factor. ‘I needed a machine that performed a number of functions and the Starlux also allows you to add on an Intense Pulsed Light (IPL) handpiece for hair removal so you don’t have to buy a second machine, which is not only a positive in terms of economy but also clinical floor space.’

Apart from the IPL handpiece, other dedicated function add-ons include the Lux1540 for treating melasma, wrinkles and for scar revision; the Lux2940 for skin resurfacing; LuxIR-IPL 825nm to 1350nm for skin tightening and a new model, the Lux2780, is soon to be released.

According to Dr Tavakoli another plus is its running costs. ‘They are the best for a fractionated laser because you get more mileage with the disposable head than with
the main competitor in the field.’

He has been using the Starlux for scar revision, ‘in the treatment of acute and chronic scars such as old acne scars or new surgical scars that are red and raised’. He says the laser treatment significantly improves scar colour, texture and evenness and that he has been getting excellent results with mild to moderate acnes scars.

‘It is a widely held belief that fractionated laser treatments for acne scars yield better results’

It is a widely held belief that fractionated laser treatments for acne scars yield better results than with any other modality. The Starlux handpieces also allow for close proximity of micro treatment zones. Each MTZ is only microns wide with around a millimetre between them (this measurement is called the pitch). One head has 100 MTZs
in a 10mm diameter area and another has 320 in a 15mm area. Clearly the pitch is smaller on the 15mm head, allowing for a more intensive skin rejuvenating effect.

The reduction of fine line wrinkles is another important clinical use for the Starlux in Dr Tavakoli’s practice. ‘The Starlux gives fantastic results for correcting fine wrinkles
when used in conjunction with other treatments such as Botox. The Botox paralyses the muscle and then I can use the fractionated laser to smooth the wrinkle out.’ He says he has stopped using chemical peels for all his facial patients and is using laser resurfacing instead. Chemical peels carry a minor but significant risk of white patches developing on the skins of some patients.

Dr Tavakoli says treatments usually take half an hour to one and a half hours in an in-office procedure. Laser resurfacing with the Starlux requires no anaesthetic and
involves just one day off work for most patients.

He stresses that a course of four to five treatments is usually needed to obtain the desired results. ‘The laser gives an equal result but there is no risk of hypopigmentation, making it extremely attractive for Asian patients and patients with darker complexions.’