Progression and Results for Fraxel Dual Treatments - Available at Total Dermatology in Irvine, Ca

1. Introducing
Fraxel re:store®
Potential side effects include prolonged redness, swelling, blistering, scarring, infection, pigmentary changes (hyperpigmentation), herpes reactivation and
acne flare-up.
FDA indications include skin resurfacing procedures and the treatment of periorbital wrinkles, acne scars, surgical scars, dyschromia and pigmented lesions,
such as age spots, sun spots, actinic keratosis and melasma.
© 2009 Solta Medical, Inc. All rights reserved. Fraxel re:store are trademarks or registered trademarks of Solta Medical, Inc. and its subsidiaries.

2. Training Physician
The doctor you choose for laser treatments is
as important as the laser itself.
Dr. Nissan Pilest is a training physician for
lasers and has particular expertise with Fraxel.
Trust your skin to a doctor who knows which
laser is best for your skin.

3. Healing Sequence
Photos
“What to expect”

4. Subject SSK63 One Week Healing Sequence
1927nm, TL-7, 50% Coverage, 10mJ, 8 passes

5. Days 3-4 Post Treatment - SSK63
Right Side - SSK63 1927nm, TL-7, 10mJ
Baseline 1week Post Treatment

6. Left Side - SSK63 1927nm, TL-7, 10mJ
Baseline 1week Post Treatment

7. Baseline and Post Treatment - SSK63
1927nm, TL-7, 10mJ

8. Days 1-2 Post Treatment - SSK63
1927nm, TL-7, 10mJ

9. Days 3-4 Post Treatment - SSK63
1927nm, TL-7, 10mJ

10. Subject SSK64 One Week Healing Sequence
1927nm, TL-7, 50% Coverage, 10mJ, 8 passes

11. Right Side - SSK64 1927nm, TL-7, 10mJ Baseline
& 1 week Post Treatment

12. Left Side - SSK64 1927nm, TL-7, 10mJ Baseline
& 1 week Post Treatment

13. Baseline & Post Treatment - SSK64
1927nm, TL-7, 10mJ

14. Days 1 & 2 Post Treatment - SSK64
1927nm, TL-7, 10mJ

15. Days 3-4 Post Treatment - SSK64
1927nm, TL-7, 10mJ

16. Days 5 & 7 Post Treatment - SSK64
1927nm, TL-7, 10mJ

17. Patient Results
Fraxel re:store®
DUAL

18. Before Immediately Post 1 Treatment
Fraxel re:store®
DUAL Laser
Healing Progression
Courtesy of the Solta Medical Aesthetic Clinic

19. 1 Day Post 1 Treatment 2 Days Post 1 Treatment
Fraxel re:store®
DUAL Laser
Healing Progression
Courtesy of the Solta Medical Aesthetic Clinic

20. 3 Days Post 1 Treatment 1 Week Post 1 Treatment
Fraxel re:store®
DUAL Laser
Healing Progression
Courtesy of the Solta Medical Aesthetic Clinic

21. Fraxel re:store®
DUAL Laser
Healing Progression
10 Days Post 1 Treatment 2 Weeks Post 1 Treatment
Courtesy of the Solta Medical Aesthetic Clinic

22. Fraxel re:store®
DUAL Laser Treatment
Before 2 Weeks Post 2 Treatments
Courtesy of the Solta Medical Aesthetic Clinic

23. Fraxel re:store®
DUAL Laser Treatment
Blue Channel
Photography
Before 2 Weeks Post 2 Treatments
Courtesy of the Solta Medical Aesthetic Clinic

24. Fraxel re:store®
DUAL Laser Treatment
Before 1 Month Post 1 Treatment
Courtesy of the Solta Medical Aesthetic Clinic

25. Fraxel re:store®
DUAL Laser Treatment
Before 1 Month Post 1 Treatment
Courtesy of the Solta Medical Aesthetic Clinic

26. Baseline 1 Month Post 1st
Treatment
Courtesy of the Solta Medical Aesthetic Clinic
Fraxel re:store®
DUAL Laser Treatment

27. Fraxel re:store®
DUAL Laser Treatment
Before 2 Weeks Post 1 Treatment
Courtesy of the Solta Medical Aesthetic Clinic

28. Fraxel re:store®
DUAL Laser Treatment
Before Post 3 Treatments
Courtesy of the Solta Medical Aesthetic Clinic

29. Fraxel re:store®
DUAL Laser Treatment
Before 2 Weeks Post 3 Treatments
Courtesy of the Solta Medical Aesthetic Clinic

30. Fraxel re:store®
DUAL Laser Treatment
Melasma
Before 4 Months Post 1 Treatment
Courtesy of the Solta Medical Aesthetic Clinic

31. Fraxel re:store®
DUAL Laser Treatment
Before 1 Week Post 1st
Treatment
Courtesy of the Roy Geronemus, M.D.

32. Total Dermatology
Irvine, Ca 92618
Total Dermatology is directed by
Nissan Pilest, a board certified
dermatologist since 1979.
Dr. Pilest was affiliated with the
world famous Beckman Laser
Institute at the University of
California Irvine and continues as
an Associate Professor in
Dermatology.
For additional information
on Fraxel DUAL, see our website.
Acne scar treatment by Nissan Pilest, M.D.

33. Patient’s Diary - Day 1
• The numbing gel really works, I’m totally numb and glad that I am numb
• The procedure was completely painless and actually felt nice with the cooling air that sort of
felt like cool mist. I had no pain whatsoever.
• My face started to tingle about 10 minutes after the procedure but the numbing gel was still
working, which felt a bit weird with the effects of the treatment, sort of like I couldn’t move my
face
• When the numbing gel wore off my face felt hot and very tingly, like a “fresh” sunburn, this
lasted about an hour.
• Later in the afternoon, my face feels sunburned but not unbearable, just tight. The
moisturizer (Aussie) helps and so does ibuprofen. I am not touching my face but am
wondering how it will feel when I go to sleep tonight, if the pillow hitting it will make it a bit
uncomfortable. We’ll see.
• Overall not that bad, but I am super pigmented, my freckles are very brown and my face is
bronzy red. I expected this since I had seen others, I wouldn’t go out for drinks with this look,
that is for sure.
• 8:00 pm, my face is feeling pretty good especially after washing with my usual product
Cetaphil and then I switched to the Aquaphor and it feels really soothing. The other product
is fine but Aquaphor feels cooling (more). I'm a little tight feeling but not super
uncomfortable. I took another ibuprofen and I think that really does help. I'm turning more
bronzy in color still quite a bit of color to my face but not quite as red. Very pigmented! So
far so good!
SSK64

34. Patient’s Diary - Day 2
• I slept fine, not uncomfortable at all. I washed with Cetaphil®
and noticed that I have a slight
bleed on my right side, upper cheek bone but it just looks like a little scrape. I had a couple of
white (almost look like whiteheads) pop out but after washing they are gone. Without
moisturizer my skin feels like “fine” sandpaper, feels better once the moisturizer is on.
• I’m a little itchy but really not too bad, will probably get worse but for now very tolerable. Lots of
pigmentation showing.
• I’m wearing the SPF 30 moisturizer plus the clear 45 SPF zinc.
• Still just slightly itchy but I can feel the skin tightening up, contracting almost. But not
uncomfortable. I dream of being able to use a washcloth next week. 
• 5:00 pm, I’m getting itchier and the cream is harder to absorb into my skin when I first put it on,
it stings a little too: MD Forte SPF 30. One thing that is really bugging me is somehow the
cream is irritating my contact lenses, really bugging me, can’t wait to take them out.
• Tues pm: I can now see the slight "track" of the laser with small dots that are accentuated by
the "browning" of my skin. I'm not worried about it because this is what will be peeling off. I
can't get enough moisturizer on my face. Very dry feeling. My eyes were itching a lot so I
switched to putting a little dab of vaseline at corners and that seems to help.
SSK64

35. Patient’s Diary - Days 3 - 4
Day 3
• I'm pretty brown, skin very dry, light sandpaper like feeling. I'm a little itchy but I'm not
scratching, it's easy to avoid so not at all unbearable. Vaseline®
works better around the
eyes.
• I was very itchy later today, I didn’t scratch but just dealt with the itch. It felt like I had a pore
minimizer mask on, that I couldn’t take off, tight. The moisturizer with sunscreen wasn’t
penetrating anymore, just drying out my face so I switched back to Aquaphor®
which felt
much better.
• I went home and washed my face immediately with Cetaphil®
and put on Aquaphor and it felt
much better. At about 9:00 pm, I saw the first signs of peeling and a small reddish (scrape
like) abrasion on the bridge of my nose (I swear I didn’t pick or rub) I am so happy to have
the peeling begin.
• I felt a little itchy during the night and could feel my skin touching the pillow, I would rub a
little but not scratch. I slept fine.
Day 4
• WOW, I am officially peeling! And it feels so much better, such a relief! It is peeling from the
middle of my face outward, which is kind of weird. In the shower, by just gently rubbing, it
comes off. The sides of my face look like I have dirt smudged on . It’s slightly itchy but not
as tight feeling, so am happy for that. The new skin that I can see looks so nice! No
pigmentation, nice and healthy and smooth. I’m so psyched to see it all peeled off.
• Thursday evening I washed my face and more sloughing occurred, the only part remaining
are the outer portions of my face and forehead and the bridge of my nose. Looks good! I’m
using the Aquaphor to keep moisturized.
SSK64

36. Patient’s Diary - Topical Regime
Products I recommend based on my personal skin type and experience with the
procedure.
• Day of procedure: Aquaphor®
really seems to be the best moisturizer all around. It
penetrates and is non irritating and has a cooling effect. I then would put the clear zinc
on for protection (Aussie 45 SPF). I took 4 ibuprofen, two about an hour after the
procedure to ease the sunburn feel, which worked and two more before I went to bed and
also helped.
• Day 2 and 3: Aquaphor again works the best for moisturizing, penetrating along with
Vaseline around the eyes. I tried the Aussie moisturizers and they just didn’t penetrate or
feel as good as the Aquaphor. If you have Benadryl®
or Claritin®
, I would recommend
taking to ease a bit of the itch. I did not take any and it was totally bearable, but
everyone is different
• Still using Aquaphor to moisturize and now Neutrogena®
SPF 75 for face which is very
creamy and penetrates well.
• I used Cetaphil®
to wash with every day and night, it’s a great product, won’t irritate and
feels good.
SSK64