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Rex Moulton-Barrett, MD
    Moulton-
    Lisa Derita, RN
   Alameda & Brentwood CA
             Brentwood,

                 2007




     Sciton Profile

Broad Band Light: BBL
             g
BBL – BroadBand Light
Twin-Lamp Technology

• Lamp-life decrease as driven to higher energies
  Lamp-
      p                             g        g
• BBL uses two lamps supplying half of the energy
  needed.
  needed
• Unlimited shots under warranty.


   Lamps
BBL™
Large 15 X 45mm treatment area
& smaller 15 X 15mm adapter
> 300,000 Pulses/ dual-lamp
7 Filters
Integrated Skin Cooling
High Power - up to 30 J/cm2
Wide pulse width range - to 200ms
Rapid Treatment
Availability
   Module for Profile
   110V Tabletop BBLs
BBL Interchangeable Filters


                7 Filters (nm)
                    – 420 - Blue light
                    – 515 - Pigment
                    – 560 - Vascular & Pigment
                                         g
                    – 590 - Vascular & Hair
                    – 640 - Vascular & Hair
                    – 695 - Hair
                    – ST - Collagen Remodel
Procedures
• Skin Tightening
• Hair Removal
• Epidermal Pigmented Lesions
• Junctional Pigmented Lesions
• Dermal Pigmented Lesions
• Vascular Lesions
• Photorejuventation
• Acne Photodynamic therapy
Controlled Cooling By Degree
• Cold sapphire crystal maintains cool treatment zone
• S t
  System accurately sets temp. from 0ºC to 30ºC
                t l    t t      f         t
  – Skin surface temperature changes of 4ºC can cause immediate
    differences in the clinical response
• Temperature delivery is consistent = safety & comfort

             560 nm filter 12 J/cm2 applied for 10 ms


                                    no
                                treatment
BBL Treatment




  before                           after 1tx

     Photos courtesy of Michael Gold, MD
BBL Treatment
BBL Treatment
BBL Treatment
BBL Treatment
SkinTyteTM FDA Clearance

• selective photocoagulation of soft tissue
• with a integral thermo-electric cooler
                  thermo-
• cooling epidermis prior to, during and
                          to
   after treatment reduces discomfort
• minimizes thermal injury to non-target
                              non-
   skin and skin structures.
Collagen Remodeling & Contraction

• Thermally injure a dermal region
• Initiates wound healing response
• Stimulates fibroblast activity
• Denatured collagen leads to contraction
• Create collagen remodel or replacement
Treatment Expectations

• Expect subtle changes that can vary
  from immediate improvement to
  subtle results
• Variable Factors
   –Technique
   –Patient’s Degree of Laxity
    Patient s
Sciton SkinTyte
      Using a controlled thermal profile

Skin is cooler at the surface.
Its temperature depends on the environment.


                                              Room temperature
                       28°C - 32°C
Epidermis

Dermis



                          37°C

                                              Body temperature
Sciton SkinTyte


 Chilled Sapphire Plate
                                                     12°C
            Epidermis

             Dermis



                                       37°C
                     The plate temperature setting
                    BBL s
                    BBL’s Sapphire Chilling plate precisely
                     determines the new thermal gradient
                    fixes the surface temperature.
Sciton SkinTyte


Chilled Sapphire Plate
                                                       12°C
           Epidermis

            Dermis
                                       55°C



                       A subsurface layer is briefly heated
                       Then is cooled.
                               cooled                heated.
                       SkinTyte elevates subsurface temperature
                                                      temperature.
Sciton SkinTyte
• Denatures collagen causing immediate contraction
• Activates collagen generating fibroblasts leading to
  long-term remodeling



Epidermis

Dermis
Treatment Guidelines
• Multiple Passes: Up to 5
• Moderate fluences : 40 – 45 J/cm2
• Pulse Width: 5 seconds
• Cooling : 12°C
            12°
• Post Cooling: 2 seconds
• Treating to a visible, immediate
  endpoint
      p
•     Immediate tightening
•     Erythema
SkinTyte treatment




Pre     before              Postx’s at 1 month intervals
                             3 x’3tx
          Photos courtesy of Jason Pozner, MD
SkinTyte treatment




  before               after 3 monthly treatments

     Photos courtesy of Jason Pozner, MD
SkinTyte treatment
     y




Before      Immediately After
SkinTyte treatment




 Before      Immediately After
SkinTyte treatment
      y
Untreated hand   Immediately After Treatment
Spot Size Comparisons




Sciton SkinTyte       -A-         -T-         -C-         -S-
  15 X 45mm       16 X 40mm   17 X 17mm   10 X 15mm   8 X 12mm
    6.75cm2         6.4cm2      30 2
                                3.0cm       1.5cm2      1.0cm2
Treatment Time Comparisons
           Spot Size     Cycle Time     Handpiece         Passes        Total Tx Time for
            (cm2)          (sec)        placement                            400cm2
                                                                              (min)
                                           (sec)


Sciton       6.75            6.0            1.0            4                  27.7
                                                        (Website)

 -A-         6.40            10             1.0             4
                                                          (Derm
                                                                              45.8
                                                       Times, March
                                                          2006)

 -T-          3.0            1.9            1.0            5                  32.2
                                                       (Consensus
                                                       (Co se sus
                                                       Guidelines)


 -C-          1.5            8.0            1.0             4                 160.0
                                                       (Bunin White
                                                          Paper)

 -S-          1.0           0.83            1.0              4
                                                       (Sleightholm
                                                                              97.6*
                                                       white paper)


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

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Bbl

  • 1. Rex Moulton-Barrett, MD Moulton- Lisa Derita, RN Alameda & Brentwood CA Brentwood, 2007 Sciton Profile Broad Band Light: BBL g
  • 3. Twin-Lamp Technology • Lamp-life decrease as driven to higher energies Lamp- p g g • BBL uses two lamps supplying half of the energy needed. needed • Unlimited shots under warranty. Lamps
  • 4. BBL™ Large 15 X 45mm treatment area & smaller 15 X 15mm adapter > 300,000 Pulses/ dual-lamp 7 Filters Integrated Skin Cooling High Power - up to 30 J/cm2 Wide pulse width range - to 200ms Rapid Treatment Availability Module for Profile 110V Tabletop BBLs
  • 5. BBL Interchangeable Filters 7 Filters (nm) – 420 - Blue light – 515 - Pigment – 560 - Vascular & Pigment g – 590 - Vascular & Hair – 640 - Vascular & Hair – 695 - Hair – ST - Collagen Remodel
  • 6. Procedures • Skin Tightening • Hair Removal • Epidermal Pigmented Lesions • Junctional Pigmented Lesions • Dermal Pigmented Lesions • Vascular Lesions • Photorejuventation • Acne Photodynamic therapy
  • 7. Controlled Cooling By Degree • Cold sapphire crystal maintains cool treatment zone • S t System accurately sets temp. from 0ºC to 30ºC t l t t f t – Skin surface temperature changes of 4ºC can cause immediate differences in the clinical response • Temperature delivery is consistent = safety & comfort 560 nm filter 12 J/cm2 applied for 10 ms no treatment
  • 8. BBL Treatment before after 1tx Photos courtesy of Michael Gold, MD
  • 13. SkinTyteTM FDA Clearance • selective photocoagulation of soft tissue • with a integral thermo-electric cooler thermo- • cooling epidermis prior to, during and to after treatment reduces discomfort • minimizes thermal injury to non-target non- skin and skin structures.
  • 14. Collagen Remodeling & Contraction • Thermally injure a dermal region • Initiates wound healing response • Stimulates fibroblast activity • Denatured collagen leads to contraction • Create collagen remodel or replacement
  • 15. Treatment Expectations • Expect subtle changes that can vary from immediate improvement to subtle results • Variable Factors –Technique –Patient’s Degree of Laxity Patient s
  • 16. Sciton SkinTyte Using a controlled thermal profile Skin is cooler at the surface. Its temperature depends on the environment. Room temperature 28°C - 32°C Epidermis Dermis 37°C Body temperature
  • 17. Sciton SkinTyte Chilled Sapphire Plate 12°C Epidermis Dermis 37°C The plate temperature setting BBL s BBL’s Sapphire Chilling plate precisely determines the new thermal gradient fixes the surface temperature.
  • 18. Sciton SkinTyte Chilled Sapphire Plate 12°C Epidermis Dermis 55°C A subsurface layer is briefly heated Then is cooled. cooled heated. SkinTyte elevates subsurface temperature temperature.
  • 19. Sciton SkinTyte • Denatures collagen causing immediate contraction • Activates collagen generating fibroblasts leading to long-term remodeling Epidermis Dermis
  • 20. Treatment Guidelines • Multiple Passes: Up to 5 • Moderate fluences : 40 – 45 J/cm2 • Pulse Width: 5 seconds • Cooling : 12°C 12° • Post Cooling: 2 seconds • Treating to a visible, immediate endpoint p • Immediate tightening • Erythema
  • 21. SkinTyte treatment Pre before Postx’s at 1 month intervals 3 x’3tx Photos courtesy of Jason Pozner, MD
  • 22. SkinTyte treatment before after 3 monthly treatments Photos courtesy of Jason Pozner, MD
  • 23. SkinTyte treatment y Before Immediately After
  • 24. SkinTyte treatment Before Immediately After
  • 25. SkinTyte treatment y Untreated hand Immediately After Treatment
  • 26. Spot Size Comparisons Sciton SkinTyte -A- -T- -C- -S- 15 X 45mm 16 X 40mm 17 X 17mm 10 X 15mm 8 X 12mm 6.75cm2 6.4cm2 30 2 3.0cm 1.5cm2 1.0cm2
  • 27. Treatment Time Comparisons Spot Size Cycle Time Handpiece Passes Total Tx Time for (cm2) (sec) placement 400cm2 (min) (sec) Sciton 6.75 6.0 1.0 4 27.7 (Website) -A- 6.40 10 1.0 4 (Derm 45.8 Times, March 2006) -T- 3.0 1.9 1.0 5 32.2 (Consensus (Co se sus Guidelines) -C- 1.5 8.0 1.0 4 160.0 (Bunin White Paper) -S- 1.0 0.83 1.0 4 (Sleightholm 97.6* white paper) *Accounts for recommended 50% overlap. Ref: Syneron webinar: 7-06