At present, CO2 laser fractional facial rejuvenation technology - fractional photothermolysis - has been favored by many patients and specialists. There are a large number of devices on the market for these purposes at various price points. Massive advertising, attractive appearance, incomplete information about the technical characteristics of laser devices (or deliberately silent about them) often lead buyers to analyze the technical capabilities of laser equipment, withoutthe final outcome of the process depends on it.
In this article, we will try to find out the technical characteristics that should be paid special attention to when choosing a CO2 Laser device for fractional skin rejuvenation.
Fractional skin rejuvenation method
The essence of fractional skin rejuvenation is the formation of micromolecules on the skin by laser, in which the process of biological thread ablation occurs.
The rejuvenating effect of the procedure is determined by the following factors:
- reduction in the area of the skin (scar tissue) due to the location density of the microparticles and their size (diameter);
- Due to the controlled depth of the microzone, which reaches the dermis and deep, and the controlled dose of heat (heating) on the dermis and deep, fibroblast activity is stimulated, leading to over-activation. regeneration process ;
- activation of cell renewal by stimulating fibroblast activity due to controlled depth of ozone, reaching the dermis and deep layers, and a controlled dose of heat exposure (heating) to the layerdermis and deep;
- recirculation of the treated area (microvascular destruction), combined with aseptic inflammatory processes, promotes the formation of young collagen and elastin fibers.
Furthermore, the durability and severity of the results of the procedure are directly proportional to the depth of the microzone.
The microparticles have the same diameter (determined by the diameter of the focused laser beam). This diameter should be at least 100 microns and no more than 250 microns (minimizing the risk of complications).
The density of micromolecules on the skin is ensured by the design of a special accessory - a scanner for fractional ablation.
Since the depth of the micro-area determines the effectiveness of the final outcome of rejuvenation, it should be adjusted depending on the rejuvenation task.
The biofiber suppression (microzone formation) is provided by the CO2 laser pulse. The resulting microzone includes a number of laser impact zones: - ablation zone, coagulation zone, thermal diffusion zone.
Also, as noted above, the depth of the ablation area affects the effectiveness of the technique. Areas of coagulation and thermal expansion (diffusion) should be minimized, because exposure to extreme heat increases rehabilitation time and can cause complications.
In other words, fractional CO2 laser vaginal rejuvenation requires:
- removal (excision) of a micro-area of biological tissue (skin) to a certain depth;
- provide a controlled, minimally sufficient coagulation zone;
- minimal overheating of biological tissues around the ablation zone - the minimum zone of thermal diffusion;
- The distance between the resection areas can be adjusted.
The depth at which biological tissue ablation occurs depends on the strength of the pulse and the duration of its impact.
The width of the coagulation and thermal diffusion zones mainly depends on the contact time, i. e. pulse duration. Since partition rejuvenation technology requires shrinking these regions, the ideal pulse parameters aremaximum power in minimum short pulse. . .
Furthermore, if the pulse duration is lower or comparable to the thermal relaxation time of the skin (250 - 500 μs), the heat diffusion area will be minimal, but sufficient to heat the middle and deep layers of the dermis. , providing a rejuvenating effect. Here we turn to the parameters of the laser device, which determine the efficiency of the fractionation process:
- pulse electricity;
- pulse duration range.
Modern CO2 laser devices can operate in continuous, cyclic (pulsed) and super pulsed operating modes.
The fractionation method is performed only in the CO2 laser super pulse or super pulse operating mode.
In pulse mode, you can adjust the pulse power and pulse duration. The power can be adjusted to a maximum device power value of 30 - 40 W. The minimum duration of such pulses is limited to 1-10 ms (milliseconds - 10-3 s). .
Super pulse mode- a special mode of operation of the laser, in which the pulse power is not adjusted, but reaches a maximum value, which is 2 - 2. 5 times higher than the maximum value of the device power and is 75 -100 W (at rated power the device is in continuous mode 30-40 W). The duration of the superpulse can be adjusted in the range of 10 to 1000 μs (microsecond -10-6 s).
The advantage of using the super pulse mode over the pulse mode is that to achieve the same effect on the skin we can use a shorter duration (compared to the pulse active mode), which minimizes the areadiffuses heat (while maintaining the effectiveness of heat in heating the dermis) and thus reduces recovery time and greatly reduces the possibility of possible complications.
At the same time, the power of the super pulse is 2. 5 times higher than that of the conventional pulse, which helps to achieve the required depth of ablation, providing a rejuvenating effect with minimal contact time.
However, if we compare the skin effects of a supervessel and a conventional pulse of the same energy, then in both cases the same microregional depth will be achieved, however, the widthof the coagulation and heat diffusion regions when exposed to a common pulse is much wider than when exposed to an overlapping substance. The width of the microregion itself after exposure to a typical pulse is wider due to the longer pulse duration, and this also increases recovery time and creates an additional risk of complications.
On more exposure - the formation of a neighboring microzone, in the pulsed mode, the overlapping of the heat diffusion zones and the formation of heat accumulation zones can lead to significant overheating of the skin tissues andincreases the risk of complications. In overlapping mode, this overlap does not occur.
For some purposes (eg, scar reconstruction), the ablation depth of a single pulse may not be sufficient, and then the single-point repeat pulse technique is used. At the same time, the use of superfluid with a shorter duration than the thermal expansion time of the skin also has a significant advantage, as the repeated pulse does not lead to heat accumulation and increases the heat diffusion area, providing a deeper cutremove necessary. In a pulsed mode, such accumulation occurs and is added to heat from neighboring micromolecules, resulting in significant superheating of the surrounding biological tissues and increased recovery time.
Fractional skin rejuvenation in some cases requires the use of a super-attractant longer than the thermal expansion time of the skin, despite a significant heat load. For example, treating hypertrophic scars, smoothing out deep wrinkles requires deep skin rejuvenation, ie. Coagulation-heat effect on all layers of the dermis (using pulses with duration 800 - 1000 μs). Thus, a wide range of timing adjustments of the super pulse greatly expands the functionality of the device, allowing you to effectively impact different layers of the skin, depending on the rejuvenation task.
Requirements for laser devices for partial skin rejuvenation
All of the above allows us to describe the requirements that the device must meet for effective partial skin rejuvenation:
- The maximum power of the CO2 laser device in continuous mode should be at least 30 W.
- The device's super-pulse operating mode is required. Let me remind you that the power in super pulse mode is not adjusted and reaches its peak value.
The interface of some models of devices allows you to adjust the average power in super pulse mode, but the value of this power does not exceed 15 W (for devices, the power is 30 W). Furthermore, the regulation of average power in the superpulse mode is provided due to the duration of the super pulses and the pause between them. That is, if you have such a device in front of you, then by varying the mean power of the supercharger you will see a change in the time of the supercharger and the pause between them. If you don't see this, or the power of the super pulser can be set to the maximum power of the device (30W), then you have a regular pulse mode declared by the seller as a super pulse mode.
- In superpulse mode, the regulation of superpulse time should be provided over a wide range, including values of 250-500 μs (skin thermal expansion time).
In some device models, you can set the energy per pulse (value in J or mJ), equal to the product of the pulse power and duration. With this parameter setting, it is recommended that you view the value of the pulse width to understand the laser's ability to operate at a pulse duration close to the thermal relaxation time of the skin.
- The scanner for fractional skin rejuvenation must adjust the position density of the micropoints and adjust the number of pulses at each contact point.
CO2 laser sellers often emphasize scanning speed and size of scans as advantages of the device presented. These characteristics are determined to a greater extent by the design of the nozzle - the scanner. Of course, these parameters affect the speed of the procedure, which is certainly fascinating. But nevertheless, it is the parameters of the laser device that affect the efficiency of the process - the power, the presence of the supercharger mode, the range of the superaccumulation interval. Keep this in mind when choosing a laser machine.