Rex MoultonRex MoultonRex Moulton---Barrett, MDBarrett, MDBarrett, MDLisa Derita, RNLisa Derita, RNLisa Derita, RN

Alameda & Brentwood CAAlameda & Brentwood CAAlameda & Brentwood CAAlameda & Brentwood, CAAlameda & Brentwood, CAAlameda & Brentwood, CA

2007

ScitonSciton ProfileProfile

Broad Band Light: BBLBroad Band Light: BBLgg

BBL – BroadBand Light

TwinTwin--Lamp TechnologyLamp Technology

•• LampLamp--life decrease as driven to higher energieslife decrease as driven to higher energiespp g gg g

•• BBL uses two lamps supplying half of the energy BBL uses two lamps supplying half of the energy neededneededneeded. needed.

•• Unlimited shots under warranty. Unlimited shots under warranty.

Lamps

BBL™BBL™Large 15 X 45mm treatment area& smaller 15 X 15mm adapter> 300,000 Pulses/ dual-lamp 7 FiltersIntegrated Skin CoolingHigh Power - up to 30 J/cm2

Wide pulse width range - to 200msRapid TreatmentAvailability

Module for Profile110V Tabletop BBLs

BBL Interchangeable FiltersBBL Interchangeable Filters

7 Filters (nm)7 Filters (nm)–– 420 420 -- Blue lightBlue light–– 515 515 -- PigmentPigment–– 560 560 -- VascularVascular & Pigment& Pigmentgg–– 590 590 -- VascularVascular && HairHair–– 640 640 -- VascularVascular && HairHair

695695 HairHair–– 695 695 -- HairHair–– ST ST -- Collagen RemodelCollagen Remodel

ProceduresProceduresProceduresProcedures

•• Skin TighteningSkin Tightening•• Hair Removal Hair Removal •• Epidermal Pigmented LesionsEpidermal Pigmented Lesions•• Junctional Pigmented LesionsJunctional Pigmented LesionsJunctional Pigmented LesionsJunctional Pigmented Lesions•• Dermal Pigmented Lesions Dermal Pigmented Lesions •• Vascular LesionsVascular Lesions•• Vascular LesionsVascular Lesions•• PhotorejuventationPhotorejuventation••Acne Photodynamic therapyAcne Photodynamic therapy

Controlled Cooling By DegreeControlled Cooling By Degree

•• Cold sapphire crystal maintains cool treatment zoneCold sapphire crystal maintains cool treatment zone

•• S t t l t t f 0ºC t 30ºCS t t l t t f 0ºC t 30ºC•• System accurately sets temp. from 0ºC to 30ºC System accurately sets temp. from 0ºC to 30ºC –– Skin surface temperature changes of 4ºC can cause immediate Skin surface temperature changes of 4ºC can cause immediate

differences in the clinical responsedifferences in the clinical response

•• Temperature delivery is consistent = safety & comfortTemperature delivery is consistent = safety & comfort

560 nm filter 12 J/cm2 applied for 10 ms

no treatment

BBL TreatmentBBL Treatment

after 1txbefore after 1txbefore

Photos courtesy of Michael Gold, MD

BBL TreatmentBBL Treatment

BBL TreatmentBBL TreatmentBBL TreatmentBBL Treatment

BBL TreatmentBBL TreatmentBBL TreatmentBBL Treatment

BBL TreatmentBBL TreatmentBBL TreatmentBBL Treatment

SkinTyteSkinTyteTMTM FDA ClearanceFDA Clearance

•• selective photocoagulation of soft tissueselective photocoagulation of soft tissueselective photocoagulation of soft tissue selective photocoagulation of soft tissue •• with a integral thermowith a integral thermo--electric coolerelectric cooler•• cooling epidermis prior to during andcooling epidermis prior to during and•• cooling epidermis prior to, during and cooling epidermis prior to, during and

after treatment reduces discomfortafter treatment reduces discomfort•• minimizes thermal injury to nonminimizes thermal injury to non--targettargetminimizes thermal injury to nonminimizes thermal injury to non target target

skin and skin structures.skin and skin structures.

Collagen Remodeling & ContractionCollagen Remodeling & Contraction

•• Thermally injure a dermal region Thermally injure a dermal region

•• Initiates wound healing responseInitiates wound healing response

•• Stimulates fibroblast activityStimulates fibroblast activityStimulates fibroblast activityStimulates fibroblast activity

•• Denatured collagen leads to contractionDenatured collagen leads to contraction

•• Create collagen remodel or replacementCreate collagen remodel or replacement

Treatment ExpectationsTreatment ExpectationsTreatment ExpectationsTreatment Expectations

•• Expect subtle changes that can vary Expect subtle changes that can vary from immediate improvement to from immediate improvement to subtle resultssubtle results

•• Variable FactorsVariable Factors––TechniqueTechnique––Patient’s Degree of LaxityPatient’s Degree of Laxity––Patient s Degree of LaxityPatient s Degree of Laxity

Sciton SkinTyteSciton SkinTyte

Skin is cooler at the surface.

Using a controlled thermal profile

Its temperature depends on the environment.

Room temperature

Epidermis28°C - 32°C

Room temperature

Dermis

37°C

Body temperature

Sciton SkinTyteSciton SkinTyteSciton SkinTyteSciton SkinTyte

Chilled Sapphire Plate

Epidermis

Chilled Sapphire Plate12°C

Dermis

BBL’s Sapphire Chilling plate preciselyThe plate temperature setting

37°C

BBL s Sapphire Chilling plate precisely fixes the surface temperature.The plate temperature settingdetermines the new thermal gradient

Sciton SkinTyteSciton SkinTyteSciton SkinTyteSciton SkinTyte

Chilled Sapphire Plate

Epidermis

Chilled Sapphire Plate12°C

Dermis

55°C

SkinTyte elevates subsurface temperatureA subsurface layer is briefly heatedThen is cooledSkinTyte elevates subsurface temperature.A subsurface layer is briefly heated.Then is cooled.

Sciton SkinTyteSciton SkinTyte• Denatures collagen causing immediate contraction

Sciton SkinTyteSciton SkinTyteDenatures collagen causing immediate contraction

• Activates collagen generating fibroblasts leading to long-term remodeling

Epidermis

Dermis

Treatment GuidelinesTreatment GuidelinesTreatment GuidelinesTreatment Guidelines

•• Multiple Passes: Up to 5Multiple Passes: Up to 5•• Multiple Passes: Up to 5Multiple Passes: Up to 5•• Moderate fluences : 40 Moderate fluences : 40 –– 45 J/cm45 J/cm22

•• Pulse Width: 5 secondsPulse Width: 5 seconds•• Pulse Width: 5 secondsPulse Width: 5 seconds•• Cooling : 12Cooling : 12°°CC•• Post Cooling: 2 secondsPost Cooling: 2 seconds•• Post Cooling: 2 secondsPost Cooling: 2 seconds•• Treating to a visible, immediate Treating to a visible, immediate

endpointendpointpp•• Immediate tighteningImmediate tightening•• ErythemaErythema

SkinTyteSkinTyte treatmenttreatment

Post 3txPre

Photos courtesy of Jason Pozner, MD

3 x3 x’’s at 1 month intervalss at 1 month intervalsbefore

SkinTyteSkinTyte treatmenttreatment

Photos courtesy of Jason Pozner, MD

before after 3 monthly treatments

SkinTyteSkinTyte treatmenttreatmentyy

Before Immediately After

SkinTyteSkinTyte treatmenttreatmentSkinTyteSkinTyte treatmenttreatment

Before Immediately After

SkinTyteSkinTyte treatmenttreatmentUntreated hand Immediately After Treatment

yy

Spot Size ComparisonsSpot Size ComparisonsSpot Size ComparisonsSpot Size Comparisons

Sciton SkinTyte15 X 45mm

-C-10 X 15mm

-T-17 X 17mm

3 0 2

-A-16 X 40mm

-S-8 X 12mm

6.75cm2 1.5cm23.0cm26.4cm2 1.0cm2

Treatment Time ComparisonsTreatment Time ComparisonsSpot SizeSpot Size Cycle TimeCycle Time Handpiece Handpiece PassesPasses Total Tx Time forTotal Tx Time for

(cm(cm22)) (sec)(sec) placementplacement(sec)(sec)

400cm400cm22(min)(min)

ScitonSciton 6.756.75 6.06.0 1.01.0 44(Website)(Website)

27.727.7

--AA-- 6.406.40 1010 1.01.0 44(Derm(Derm

45.845.8(Derm (Derm

Times, March Times, March 2006) 2006)

--TT-- 3.03.0 1.91.9 1.01.0 55(Consensus (Consensus

32.232.2(Co se sus(Co se susGuidelines)Guidelines)

--CC-- 1.51.5 8.08.0 1.01.0 44(Bunin White(Bunin White

160.0160.0(Bunin White (Bunin White

Paper)Paper)

--SS-- 1.01.0 0.830.83 1.01.0 44(Sleightholm(Sleightholmwhite paper)white paper)

97.6*97.6*

white paper)white paper)

*Accounts for recommended 50% overlap. Ref: Syneron webinar: 7-06