Skin Rejuvenation & Tightening Skin Tightening & Non-Ablative Skin Rejuvenation Using a Novel 650microsecond Pulsed Nd:YAG 1064nm Laser Lori Schaen, MD
 Dunwoody Dermatology Atlanta, GA This study was conducted to evaluate the use of a 650 microsecond pulsed Nd:YAG 1064nm laser for skin tightening and non-ablative skin rejuvenation in two treatment sessions. 10 female subjects with skin types I- III and ages 45-69 were enrolled for two sessions of treatment. Nine out of ten subjects reported little or no treatment discomfort and a pleasant warming sensation with a feeling of tightness of the skin immediately following the treatment, and rated their satisfaction as High to Very High. Combining Injectables with Laser Skin Rejuvenation in a Single Treatment Session, Using a Novel 0.65 millisecond Pulsed Nd: YAG 1064nm Laser A Clinical Report by Yelena Kipervas, DO, & Tatyana Martinho, Bartonsville, PA, June 2011 This study was conducted to evaluate the safety of the use of a novel 0.65 millisecond pulsed Nd: YAG 1064nm laser for skin rejuvenation, when used in combination with injectables in a single treatment session. Seven subjects were enrolled and were treated with the laser first, then were given injections afterwards. It was observed that there was a reduction in the pain, bruising and swelling from the injections with the use of the laser prior to the injections. Patient satisfaction was High or Very High in all cases. The use of this laser and this protocol has the potential to increase client retention and to attract new clients who prefer less treatment discomfort and who prefer a single visit rather than two for skin rejuvenation. Skin Tightening After Substantial Weight Loss, Using a Novel 0.65 millisecond Pulsed Nd:YAG 1064nm Laser A Clinical Report by Pam Bennett, Douglas, GA, July 2012 A female patient presented with skin laxity in various anatomical sites, after losing 86 lbs over a 12-month period through diet and exercise. The patient initially received skin tightening treatments in the facial areas and arms with a 0.65msec pulsed Nd:YAG 1064nm laser (LightPod Neo, Aerolase, Tarrytown, NY); she was highly satisfied and then inquired about receiving the same treatment for skin tightening in the buttocks area. The laser treatment was well tolerated without any anesthesia or any form of skin cooling; the patient reported no treatment discomfort and no complications were observed. Mild erythema either didn’t appear at all, or

resolved within a few hours after treatment. The effect of the laser treatments produced positive outcomes in terms of a noticeable reduction in the laxity of treated skin; the patient rated her satisfaction as Very High.

Vascular Lesions Successful Treatment of Facial Telangiectasias Using a Micropulse 1,064-nm Neodymium-Doped Yttrium Aluminum Garnet Laser AMY E. ROSE, MD, AND DAVID J. GOLDBERG, MD, Dermatol Surg 2013;39:1062–1066 OBJECTIVES: To evaluate the safety and efficacy of a microsecond 1,064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser for the treatment of facial telangiectasias. METHODS: Subjects ages 35–70 with Fitzpatrick skin types I to III and facial telangiectasias underwent two treatments with a micropulse (0.65 ms) 1,064-nm Nd:YAG laser. Treatments were spaced 30 days apart, with a final evaluation 60 days after the second treatment. Evaluation included digital photography and an assessment of the degree of improvement on a scale from 1 to 5 by the subject and a nontreating investigator. RESULTS: Twenty subjects (18 women, two men) with Fitzpatrick skin type II and III completed the study. The nontreating investigator rated the objective clinical response as total clearance (100% clear) in 10% (n = 2) of subjects, significant clearance ( over 50% clear) in 75% (n = 15), and some clearance (0–49% clear) in 15% (n = 3). None of the subjects was rated as having no clearance or worsening. In terms of subjective clearance reported by subjects, 80% (n = 16) reported significant clearance, with the remainder reporting some clearance. No adverse events were reported. CONCLUSION: The micropulse 1,064-nm Nd:YAG successfully treated facial telangiectasias with a high degree of patient satisfaction, minimal discomfort, and no adverse events. Treatment of Infantile Hemangiomas Using a Novel 650-microsecond Pulsed Nd:YAG 1064nm Laser David Goldberg, MD, Gulia Kasimova, MD Skin Laser & Surgery Specialists, Hillsborough, NJ; Laser Medicine and Cosmetic Clinic, Kirov, Russia Presented at the American Society of Lasers for Medicine and Surgery Annual Conference 2016 Background: This study was conducted to evaluate the safety and clinical

efficacy of a 650-microsecond Short Pulsed Nd:YAG 1064nm Laser for treatment of Infantile Hemangiomas. Study: A total of 250 subjects with infantile hemangiomas were treated over a study period of 5 years, mostly aged 1-4 months, 60% female, skin types I-II. An Nd:YAG 1064nm laser was used with a 2-3 mm spot size, 650-microsecond pulse duration and fluence of 42-64 J/cm2. Consecutive treatments were performed in 1-4 month intervals. Photos were taken before, immediately after, 30 and 180 days after each treatment session. Results: 100% of the subjects exhibited substantial improvement after just on treatment. Treatment time was fast and did not exceed 3-5 minutes for treatment of areas up to 3 cm2. Patients tolerated the treatment very well with the youngest subjects appearing to tolerate it best. Parents were highly satisfied with the treatment results. No complications were observed. Conclusion: A 650-Microsecond Pulsed Nd:YAG 1064nm Laser delivers a high rate of clearance of infantile hemangiomas with no adverse skin effects. Treatment of Leg Telangiectasias Using a 650-microsecond Pulsed Nd:YAG 1064nm Laser James Newman, MD, Natalia Geraskova, MD Center for Facial Plastic Surgery, San Mateo, CA; Laser Cosmetic Clinic “Loreksiniya”, Dubna, Russia Presented at the American Society of Lasers for Medicine and Surgery Annual Conference 2016 Background and Objectives:
 Nd Yag Lasers with 20-30 millisecond pulse widths are traditionally used to treat cosmetic leg veins, with well documented side effects of bruising and discomfort particularly with large areas treated. This study was conducted to evaluate the safety and clinical efficacy of a novel short pulsed, 650 microsecond pulsed 1064nm NdYag laser for the treatment of lower extremity telangiectasias. Study Design and Methods: Adult female subjects with Fitzpatrick Skin types I-III with leg telangiectasias 0.2-3mm in diameter covering at least 20cm2 were selected for individual laser treatment sessions at 4 week intervals until satisfactory clinical clearance was observed. Laser treatment parameters varied depending on the size, quantity, and density of vessels as follows
 Vessels with less than 1mm diameter- Spot size of 2mm, Fluence 127J/cm2, pulse width of 650microseconds
 Vessels with

diameter 1-3mm-Spot size 2-3mm, Fluence 159-223J/cm2, pulse width of 650 microseconds. Ice pack was used for precooling for 20-30 seconds prior to laser.
 The vessels were treated for the full length and observed for clearance. Adverse events of discomfort, blistering, crusts, scars and duration of erythema were monitored for the first 4 weeks after treatment. Photos were taken before and immediately after treatment and at 4 weeks and 12 weeks after treatment. Follow up continued for 12 months to evaluate for recurrence. Results: 22 female subjects were treated on the lower extremities. 72% of subjects showed substantial improvement at 4 weeks after the first treatment. 96% of patients showed substantial improvement 3 months after the third treatment. In all subjects mild erythema appeared immediately after treatment and lasted for 3-24 hours. Small vessels frequently disappeared during the treatment while larger vessels over 1 mm changed color by darkening. 5 patients exhibited light brown crusting along the coagulated vessel which did not leave any permanent marks by the 3 month follow up appointment. There were no burns, scarring or hyperpigmentation observed in any of the patients. Pain was rated as mild during the treatment sessions. Conclusion: Lower extremity telangiectasias ranging from.1-3mm can be treated safely and effectively in skin types I-III with a novel 650 microsecond pulsed Nd Yag Laser with minimal discomfort.

Hair Removal

Efficacy and Safety of a 0.65 Millisecond Pulsed Portable ND:YAG Laser for Hair Removal Khalil A. Khatri, Robert A. Lee, Lynne J. Goldberg, Beejul Khatri & Veronica Garcia, Journal of Cosmetic and Laser Therapy, March 2009 Based upon the thermal relaxation time of the hair follicle (10–50 ms), most lasers and light devices use relatively long pulse widths for hair removal. This study was conducted to evaluate a shorter pulsed, 0.65 ms Nd:YAG laser for hair removal. Methods: One half of each axilla of six female participants was treated and the other half was monitored as a control. The treatment sites were treated with a fluence of either 21 J/cm2 or 36 J/cm2 using an Nd:YAG laser with a wavelength of 1064 nm and a pulse duration of 0.65 ms. A manual hair count was done before treatment and at each follow-up visit. Results: Four months after four monthly

treatments, the hair reduction was graded as 5 (75–100% reduction) on the high fluence side and 4 on the low fluence side (50–75% reduction) by individuals and investigators. The average hair count 4 months after four treatments in the sites treated with a high fluence went from 114 to 28 (76% reduction) and in the low fluence areas from 135 to 38 (72% reduction). Conclusion: This well-controlled study shows that a 0.65 ms Nd:YAG laser is effective and safe for hair removal. The Safety and Efficacy of Laser Hair Removal with a Novel LongPulse Nd:YAG Laser Babar K. Rao, MD Department of Dermatology Cornell, Weill Medical College New York, New York This study was conducted to evaluate the long-term patient satisfaction of permanent hair reduction with a Nd:YAG 1064nm 650-microsecond pulsed laser. Over a two year period of time, 298 patients, primarily of skin phototypes II-IV were treated with a Nd:YAG laser over an anatomical site or their choice. Long-term patient satisfaction resulted in 85% of patients responding as highly satisfied or satisfied with the treatment. This study supports the Nd:YAG 1064nm laser as being a highly efficacious method of permanent laser hair reduction with high patient satisfaction. Long-Term Hair Removal with a Novel 0.65msec Nd:YAG Laser A Clinical Report by David J. Friedman, Jerusalem, Israel, April, 2008 A study was conducted in 2006/2007 to evaluate a pulsed Nd:YAG 1064nm laser for long-term laser hair removal. Unlike conventional lasers and light-based devices in the field, the laser in this evaluation utilizes a unique 0.65 millisecond pulse duration with no skin cooling, gels or anesthetics. Ten female subjects and one male subject with Fitzpatrick Skin Types II through VI were treated and the long-term results indicated >75% clearance in the majority of cases; those treated 5 to 7 times reported 82% clearance on average and as high as 93%. These assessments were made, on average, 8.3 months after the subjects’ final treatment session.

Acne

Neo for Acne Relief Shorter pulse durations and a 1064nm wavelength make the LightPod Neo an effective and pain-free option for acne sufferers.

Published by Michael Gold, MD, Nashville, TN, MedEsthetics Magazine, September 2015 Acne is one of the most common and challenging skin diseases for patients and skincare specialists. Treatment typically requires a multimodal approach involving the use of topical and oral medications to help reduce breakouts and prevent long-term scarring. As the healthcare industry as a whole works to expand antibiotic stewardship programs and isotretinoin—the most effective non-antibiotic oral medication for acne patients— remains heavily regulated, laser and light sources are again generating interest as alternative acne treatment tools. The main impedance to incorporating laser and light treatments is that they are not reimbursable, which places a significant financial burden on patients. But for those who wish to stop oral medication and for those patients who are not experiencing significant results with current treatment modalities, laser procedures provide welcome relief. In addition, newer, more affordable technologies that deliver effective wavelengths at shorter pulse durations allow practices to treat a wider range of skin types with little to no discomfort. I have been treating my acne patients with the LightPod Neo (Aerolase), a 1064nm laser with a 650μs pulse duration. This wavelength allows us to treat all skin types. In the past, we had only long-pulsed (3ms to 15ms) 1064nm lasers, which were too painful for acne treatment. Thanks to the shorter pulse duration, we can deliver enough energy to make this work without the pain. Treatment of Active Acne and Acne Scars With a Single Laser Modality, Using a Novel 0.65 millisecond Pulsed Nd: YAG 1064nm Laser A Clinical Report by Yelena Kipervas, DO, & Tatyana Martinho, Bartonsville, PA, December 2011 This study was conducted to evaluate the use of a single laser modality to treat two skin conditions simultaneously: clearance of active acne, and reduction of acne scars. A novel Nd: YAG 1064nm laser with 0.65 millisecond pulse duration and a peak power of more than 15,000 watts per pulse was used. 10 subjects with skin type I-IV and an average age of 30 – 5 males and 5 females – were enrolled for the series of 3 treatments 2-3 weeks apart. The laser treatment was well tolerated with no anesthesia or any form of skin cooling. No complications were observed; subjects reported little or no treatment discomfort and a pleasant warming sensation as a result of the laser treatment. Of the 10 subjects, 8 rated their

satisfaction as High and 2 rated it as Very High.

Treatment of Acute and Chronic Acne & Acne Scars, Using the LightPod Neo 650-Microsecond Nd:YAG 1064nm Laser Dr.Godfrey Raj-Kumar
 Clinical Director TULIP, The Ultrasound and Laser Integrated Practice, Republic of Trinidad and Tobago A female patient presented with acute on chronic acne vulgaris was successfully treated three times with each treatment at monthly interval by means of laser therapy alone. Patient was very satisfied that both her acute and chronic lesions have been removed by laser therapy and recognizes that continuation of her oral and topical medication are necessary. Treatment of Moderate to Severe Acne With a 650-microsecond Pulsed Nd:YAG 1064nm Laser Using High Fluences and Stacked Pulses at a Low Repetition Rate Natalja Geraskova, MD
 Cosmetology & Dermatology Dubna & Moscow, Russia Khalil Khatri, MD Skin and Laser Surgery Center of New England Nashua NH & Boston, MA This study was conducted to evaluate the safety and efficacy of a 650 microsecond pulsed Nd:YAG 1064nm laser for the treatment of moderate to severe acne using high laser fluences and stacked pulses at a low repetition rate. No complications were observed, including hyperpigmentation, burns, blisters, scars or increase in acne. All subjects reported high satisfaction from the treatment due to the rapid and aesthetically pleasing results.

Skin of Color

A Novel 0.65 Millisecond Pulsed 1064 nm Laser to Treat Skin of Color Without Skin Cooling or Anesthetics Fran Cook-Bolden, MD, Journal of Drugs in Dermatology, December 2011 The Nd:YAG 1064 nm has become the gold standard laser modality for safely treating all skin types and specifically skin of color. The 1064 nm laser technologies with ultra long pulse durations generally require anesthetics as well as skin cooling in order for patients to tolerate the treatment. The use of anesthetics and gels can involve considerable time,

cost and mess. The development of a new 1064 nm laser technology with a unique 0.65 msec pulse duration now enables virtually pain-free treatment of skin of color, with no need for skin cooling or anesthetics and no skin contact during treatment by the handpiece. This uniquely gentle, sanitary, and effective laser treatment experience for patients of color can increase the likelihood that they will return for follow-up treatment sessions and also recommend the treatment to others. Laser Treatment of Pseudofolliculitis Barbae Dr. Arusha Campbell-Chambers, Jamaica, W.I., American Journal of Aesthetic Medicine, May 2015 Although traditional lasers and light devices use relatively long pulse durations for hair removal, a novel short pulsed 0.65ms portable Nd:YAG laser has been found to be safe and effective for hair removal.38 In addition, it carries the added benefit of gentler yet efficacious treatment,39 requiring no gels, no skin contact with the laser, no anesthesia and often no cooling. There have been a number of studies on the efficacy of various laser systems for hair removal and PFB treatment. Some studies suffer from small sample sizes and follow-up is at times inadequate. Most studies use mean lesion count and percentage hair reduction as their measure of outcome. In a small study using the 0.65ms Nd:YAG laser, one half of each axilla of six female patients was treated and the other side was monitored as a control.38 The treatment sides were treated with a fluence of either 21 J/cm2 or 36 J/ cm2 and a manual hair count was done before treatment and at each follow-up visit. Four months after four monthly treatments, the hair reduction was graded as five (75%-100% reduction) on the high fluence side and four (50%-75% reduction) on the low fluence end by individuals and investigators. On the high fluence side, the average hair count went from 114 to 28 (76% reduction) and in the low fluence areas from 135 to 38 (72% reduction). TREATMENT OF PFB (PSEUDOFOLLICULITIS BARBAE) WITH A 650μs PULSED Nd:YAG 1064nm LASER. Arthur J. Sumrall, Indianapolis, IN, Published at the 2006 Annual Meeting of the American Academy of Dermatology 16 female patients aged 25-69 and 6 males aged 34-58 were treated on the beard, anterior neck and chin areas. A portable MicroPulse™ 650μs Nd:YAG 1064nm laser was used. During treatment one pass was applied over the affected area. A fluence of 20-25 j/cm2 was used with a pulse

duration of 650μs, spot size of 6mm and a repetition rate of 1Hz. 6 males with skin type VI were treated with a fluence of 25 j/cm2, while 10 females with skin type V and 6 females with skin type VI were treated with a fluence of 25 j/cm2.be safe and effective in removing PFB on patients of Fitzpatrick skin types V and VI. The device is portable and easy to use. The treatment is quick and practically painless. Treatment of Pseudofolliculitis Barbae with a Compact Nd:YAG 1064nm Laser Using 650µsec Technology Michael H. Gold, MD, Gold Skin Care Center & The Laser and Rejuvenation Center, Nashville, TN Pseudofolliculitis barbae (PFB) is a foreign body inflammatory reaction caused by ingrown hairs. PFB occurs most frequently in the beard areas of 45% to 83% of African-American men who shave.1 When coarse curled hair is shaved, the tips become pointed. These sharp tips, by either extrafollicular or transfollicular penetration, grow into the skin and lead to the formation of painful, pruritic pustules and papules.1, 2 In extrafollicular penetration, the sharp hair tip curves backward toward the skin and pierces the epidermis close to the hair follicle,3 then continues downward to the dermis. Inflammatory reactions occur in both the epidermis and dermis. Transfollicular penetration occurs when shaving is against the grain and the pointed hair tip grows downward and pierces the follicular wall, resulting in inflammatory papules.4 A variety of therapies are available for the treat- ment of PFB. Surgical depilation is associated with high morbidity,5 topical agents (corticosteroids, retinoids, and antibiotics) seldom clear all papules and pustules,6 chemical depilatories may irritate the skin,6 and electrolysis is labor-intensive.5 Alpha-hydroxy acid and chemical peels have been useful in some patients.1 Lasers, including the long- pulsed alexandrite,7 Qswitched Nd:YAG,8 ruby,9 and 800-nm diode5,10,11 have also been used to treat PFB. Traditional laser procedures, though effective, are limited by patient discomfort and prolonged healing times, both due to heat-induced skin damage. This report presents two of four case studies describing the use of a new compact Nd:YAG 1064-nm laser using micropulse technology for the treatment of PFB.

Nails

Laser Treatment of Onychomycosis Using a Novel 0.65-millisecond

Pulsed Nd:YAG 1064-nm Laser Lisa G. Hochman, Journal of Cosmetic and Laser Therapy, January 2011 Onychomycosis is a common disorder of the nails. Treatment modalities include oral and topical antifungals, surgical treat- ment or a combination of these therapies. Cure rates remain low with relatively high relapse rates seen after successful treatment. The purpose of this study was to evaluate the treatment of onychomycosis using a novel 0.65-millisecond (ms) pulsed 1064-nm laser. Eight subjects were treated over two to three sessions spaced at least 3 weeks apart. Of the eight subjects evaluated, seven had negative post-treatment cultures after the second or third session. Treatments were well toler- ated by all subjects. These data suggest that treatment of onychomycosis with a 0.65-ms pulsed Nd:YAG 1064-nm laser should be studied further to determine the long-term clinical and microbiologic effect. The optimal number of treatment sessions for each patient needs to be determined. A New Protocol for the Clearance of Onychomycosis with Laser, Using a Novel 650-microsecond Pulsed Nd:YAG 1064nm Laser
 Jeffrey Adler, DPM, Adler Footcare of Greater New York White Plains and New York City, NY Abstract A new protocol for the treatment of Onychomycosis with laser irradiation was developed and used on 192 subjects with multiple nails affected by Onychomycosis, as confirmed by PAS, KOH and culture tests. A novel Nd:YAG 1064nm laser with a 650 microsecond pulse duration and a peak power of 318 joules/cm2 or 15,385 watts per pulse was used at two clinical sites over a period of 18 months. The protocol included two laser treatment sessions spaced approximately 4 weeks apart. Then, at a point 3 months after the second laser treatment session, each subject was again administered the PAS, KOH and culture tests, and 178 or 92.7% tested negative for the fungus. The two-treatment laser protocol was repeated on the 14 remaining subjects and 11 of them were clear of all fungal infection after two additional laser treatments. Therefore, 98.4% of all subjects have shown negative culture 3 months after completion of their laser treatment course. Toes were pre-cooled with ice and all subjects reported the laser treatment as either painless or highly tolerable with an occasional sensation of heat. There were no side effects of treatment, and all subjects were satisfied with the results. This clinical study demonstrates that Onychomycosis can be effectively and safely treated with a 650 microsecond Pulsed Nd: YAG 1064nm Laser. Complete Restoration of a Toenail Compromised by Onychomycosis, Using a Novel 0.65 millisecond Pulsed Nd:YAG 1064nm Laser

A Clinical Report by Boris Raginsky, DPM, Fair Lawn, NJ, June 2012 A male patient aged 74 presented with a toenail on the left foot that was affected by Onychomycosis and fully compromised. Laser therapy was selected because previous treatments by other modalities were not effective. The 1064nm laser modality has been proven to be effective in clearing Onychomycosis, as long as the pulse duration is in the submillisecond range and the fluence is at least 40-50 joules per square centimeter. Such a submillisecond Nd:YAG laser (the LightPod Forte laser from Aerolase, Tarrytown, NY) was used to treat this patient. The nail bed was cleaned and dried, and laser energy was applied at a spot size of 5mm, fluence of 41 j/cm2 and 0.6 millisecond pulse duration, with two complete passes applied to the full nail bed including the nail matrix area and surrounding skin. Two treatments were performed, spaced three months apart. A new, healthy and clear toenail grew in within 6 months after the first treatment session. No side effects were observed. New Laser Technology Enhances a Podiatry Practice Marc Garfield, DPM, Podiatry Management, April 2012 Laser therapy is not new to podiatry, but new technology is providing versatility and power that brings this type of therapy to a new level. Patients are increasingly attuned to the availability and popularity of laser treatments in general, and I have found it increasingly easy to attract patients for laser therapy. When I do, I always review oral, topical and laser treatment options with them in terms of risk and benefits, and the laser option fills a niche for an astounding number of patients that do not want pharmaceuticals or have failed oral and topical treatments in the past.

Skin Resurfacing

Laser Skin Resurfacing with a Novel Portable Erbium:YAG Laser Khalil A. Khatri, James Gordon & Lalitha Garamela, Journal of Cosmetic and Laser Therapy, April 2006 Background and objective: The erbium:YAG laser is a popular modality for laser skin resurfacing (LSR). This study was performed to evaluate the safety and efficacy of a new portable Er:YAG laser in the treatment of photo-damaged skin. Methods: Nine patients with skin types I–IV were treated for rhytides, large pores, pigmented lesions, lentigines and photodamage. Small facial areas such as the periorbital area, nose, cheeks, and upper lip were treated with one to six passes at 5–6 J/cm2 with a new portable Er:YAG laser. Topical and local anesthesia was used.

Results: All treated areas showed improvement and, depending upon the number of passes, re-epithelialization was complete within 2–7 days. The intense erythema resolved within 7 days and there was blending of treated and untreated areas within 2 weeks. Conclusion: The technique of applying a tailored number of 5–6 J/cm2, 300 ms pulses of a new portable Er:YAG laser to small areas appears to be safe and effective. There was minimal discomfort and a high level of patient satisfaction after a relatively short recovery time. Skin Rejuvenation on Skin Types I to V Using a 300 Microsecond Pulsed Er:YAG 2940nm Laser in Sub Ablative Mode Khalil A. Khatri, MD Skin & Laser Surgery Center of New England Nashua NH & Boston, MA Viktor Moiseev, MD This study is to evaluate the use of an Erbium:YAG laser in a “subablative” mode where there is a heating of the surface tissue with no ablation. In this multi-center study 35 subjects were treated with 3 passes in a sub-ablative mode. The treatments were repeated 2-4 times. No topical anesthesia or skin cooling was required. Subjects tolerated the procedure well. Partial-Face Laser Resurfacing with a 300-microsecond Pulsed Er:YAG 2940nm Laser Allen Rosen, MD Medical Director, The Plastic Surgery Group Assistant Clinical Professor,
 University of Medicine and Dentistry of New Jersey This study was conducted to evaluate the effect of 300 microsecond pulsed Er:YAG 2940nm laser resurfacing on periocular lines, treated as a functional unit based on static and dynamic rhytid anatomy as opposed to standard cosmetic anatomic landmarks. Over a three year period of time, 14 female patients, with Fitzpatrick skin type II-III were treated with Erbium laser resurfacing to the periocular area based on a pattern consistent with their static and dynamic “crow’s feet” lines versus standard anatomic units. Improvement in periocular rhytids was achieved efficiently using Erbium laser resurfacing based on functional landmarks without the need to treat adjacent uninvolved areas within the aesthetic unit based on anatomical landmarks alone. Erbium:YAG Laser Resurfacing Using a Novel Portable Device James Gordon, MD, Misbah H. Khan, MD, Khalil A. Khatri, MD, Facial Plastic Surgery Clinics of North America, May 2007 Laser resurfacing of facial rhytids has become a popular treatment option for many patients who have wrinkles, photodamage, and acne scarring.

Laser wavelength, pulse duration, and newer techniques continue to shorten the healing phase associated with laser skin resurfacing while maintaining clinical efficacy. Erbium:YAG laser resurfacing has emerged as one of the safer, more effective methods of facial rejuvenation compared with other modalities, such as carbon dioxide laser, with shorter recovery time and better treatment outcome. The increasing popularity among physicians to use the Erbium:YAG laser for resurfacing has led to its widespread use; however, size and high initial and maintenance cost are among the problems with currently available laser devices. Additionally, because many cosmetic laser surgeons practice at more than one location, they are therefore faced with the challenge of using their laser devices at more than one office. The LightPod portable Erbium:YAG laser from Aerolase offers a new paradigm for more cost effective means of performing ablative resurfacing with reduced initial and maintenance cost and the ease of portability with significantly reduced size and weight. Clinical Efficacy and Patient Satisfaction in Laser Scar Revision using a 300-Microsecond Pulsed Er:YAG 2940nm Laser Khalil A. Khatri, MD, Viktor Moiseev, MD Skin & Laser Surgery Center of New England, Nashua, NH; General Director and Head Doctor of Cosmetic Clinic “Sasha”, Ryazan, Russian Federation Presented at the American Society of Lasers for Medicine and Surgery Annual Conference 2016 Objective and Background: A 300-Microsecond Pulsed Er:YAG 2940nm Laser at a fluence of 5 J/cm2 allows ablation of scar tissue without significant residual thermal damage. Based on the fact that Er:YAG laser is most effective in hydrated tissue, which corresponds to the early stages of scar formation (10-14 days after injury), we hypothesized that laser scar treatment would be most effective during this period. Materials and Methods: 11 male and 21 female subjects with skin type II-III were recruited, 25 with post mechanical trauma scars, 6 with acne scars and 1 with a chemical burn scar. The subjects were divided into two groups; first group (11) had subjects with scars in their early stages (14 days) and the second group (21) had subjects with scars over a year old. Treatment was performed with a 300-Microsecond Pulsed Er:YAG 2940nm Laser (Aerolase, USA) with a spot size of 6mm, a fluence of 5 J/cm2 and a rep rate of 1.5 HZ. Treatments were performed at 14 days interval. The total number of treatments were 114 and treatments were performed until a physical leveling of the scar was observed. Each subject had an average

of 3.6 treatments. Results: In the first group, the physical leveling of the scar was observed immediately after the first treatment whereas it took two treatments in the second group. The first group had a total of 29 treatments (mean 2.6) and the second group had a total 85 treatments (mean 4). 94% of the subjects completed the study. No complications observed. 30% rated the results as excellent, 50% as good, and 20% as satisfactory. Conclusion: A 300-Microsecond Pulsed Er:YAG 2940nm Laser is a safe and effective to revise scars. Results are quicker, well tolerated and better with relatively fresh scars as compared to older scars. Combining blepharoplasty and skin resurfacing with a portable 300 μsec Er:YAG laser James Gordon, White Plains, NY, and Khalil Khatri, Chelmsford, MA, Published at the 2006 Annual Meeting of the American Society of Ophthalmic Plastic and Reconstructive Surgery The use of a portable 300 microsecond Erbium:YAG 2940nm laser for skin resurfacing, immediately following both bilateral upper and four eyelid blepharoplasty, was evaluated. Sixteen patients between the ages of 28 and 74 were treated for varying degrees of dermatochalasis and photodamaged skin in the periorbital region. Eleven females and five males with Fitzpatrick Skin Types I-III were treated. Local anesthesia was administered on all patients Without sedation. All patients demonstrated dramatic improvement in the Appearance of ‘hoods’,‘bags’ and photodamaged skin. Patients recovered from Ecchymosis and erythema within 14 days. The combination of blepharoplasty and skin resurfacing with a portable 300 microsecond Erbium:YAG laser appears to be a highly effective, patient-satisfying and safe modality to treat dermatochalasis and photo-damage. The additional 10-20 minutes of surgical time required for the skin resurfacing substantially enhances the outcome of the blepharoplasty.

Pigmented Lesions A Novel 650µsec Pulsed Nd:YAG 1064nm Laser for Removal of Pigmented Lesions Yelena Kipervas, DO & Tatyana Marthino Comprehensive Family Practice, Laser & Cosmetic Center, Bartonsville,

PA Six females with skin types II-IV and an average age of 64.7 were enrolled for treatment of pigmented lesions due to sun damage on the hands as well as some facial areas including cheek, forehead, nose and upper lip. Subjects had hairs in the treatment areas shaved immediately prior to treatment and all makeup and lotions were removed; one subject had microdermabrasion treatment both before and after the two laser sessions. One subject was treated once and all others were treated two times with the laser, with treatment sessions spaced approximately one month apart. In each session, subjects were treated using one pass at fluences of 21-28 J/cm2 on a 6mm spot size, followed by one pass at fluences of 159-223 J/cm2 on a 2mm spot size. No cooling, gel or lotion was used; moisturizing cream was applied after treatment. A 1064nm Nd:YAG laser, LightPod NeoTM (Aerolase, Tarrytown, NY) with a 650μsec pulse was used to perform all treatments. All subjects were asked to rate their satisfaction with the procedure after the final treatment, on a scale of Low, Moderate, High or Very High. Also, these were older patients who exhibited chronic joint and muscle pain in their hands and because they all received treatment on the hands, and since the laser used for the pigmented lesion removal is also known to reduce joint and muscle pain, subjects were asked to rate their level of pain both before and after the course of treatments. Clearance of Melasma Using a Novel 650-microsecond Pulsed Nd:YAG 1064nm Laser Yelena Kipervas, DO & Tatyana Marthino Comprehensive Family Practice, Laser & Cosmetic Center, Bartonsville, PA Seven female subjects with skin types II-V and an average age of 45.6 were enrolled for a single treatment of laser for Melasma. Treatment areas included cheeks and upper lip areas. All subjects confirmed that they were not using Accutane or other photosensitizing medications, and were not pregnant; subjects had all makeup and lotions removed immediately prior to treatment. No anesthetics, cooling, gel or lotions were used regardless of skin type, as the laser does not require any numbing or skin cooling at all. Laser treatment was performed as follows: (a) two passes at fluences of 18-24 joules/cm2 on a 6mm spot size, in a painting motion across treatment areas; and on skin types II-IV only, one pass at fluences of 159191 joules/cm2 on a 2mm spot size. All laser treatments were performed using a 1064nm Nd:YAG laser, LightPod Neo (Aerolase, Tarrytown, NY) with a novel 650 microsecond pulse duration. The treated areas were kept moist post-op and the subjects were advised

to keep these spots moist with lotion and to use sunblock after treatment; they were also advised to avoid picking at the treatment sites after the treatment session, and were informed to avoid direct sun exposure. All subjects were asked to rate their satisfaction with the procedure after the treatment, on a scale of Low, Moderate, High or Very High.

Decubitus Ulcers

Full Closure of Foot Ulcers Using a Novel 0.65 millisecond Pulsed Nd:YAG 1064nm Laser A Clinical Report by Dr. Juliette Hepburn, Nassau, Bahamas October, 2012 Common modalities for wound healing often fail to achieve full closure of a wound; however, new laser therapy using a novel 0.65msec pulsed Nd:YAG 1064nm laser (LightPod Neo, Aerolase, Tarrytown, NY) has previously demonstrated clinical success achieving closure in wound healing without making any contact to the wound. 1064nm laser energy has been clinically proven to stimulate the formation of new collagen in the dermis of the skin; the heat from a 1064nm laser is also theorized to stimulate bacterial destruction, Nitric Oxide production, and the wound healing cascade. A patient presented with ulcers on the distal areas of the feet, and was treated with the subject laser. The response to treatment was rapid. The patient reported no treatment discomfort at all. Both ulcers complete re-epithelialized in a short period of time (see additional data below). Patient satisfaction was very high. 10-month follow up was conducted on the ulcer that had been treated twice, and it was still fully closed with barely any visible evidence of where the ulcer had been. Wound Healing with a Portable650μsec 1064nm Laser Aletha Tippett, MD Wholistic Healing Cincinnati, OH Assumptions • Existing ‘cold lasers’ were not very effective
 • A low-level 1064nm laser may cause or stimulate: – dermofibroblast synthesis of collagen
 – NO (Nitric Oxide) production
 – alteration of cell membrane w/release of ions & neurotransmitters – wound healing cascade
 – destruction of bacteria LightPod Neo selected for unique set of benefits: 1. 650μsec energy mode: lack of pain compared with traditional long-pulse Nd:YAG lasers

2. LightPod handpiece allows treatment without contacting the wound (quick, easy, sanitary treatment) 3. Ability to dial energy down to low settings for wound healing 4. Gentle treatment of skin, esp. dark skin types 5. Compact, portable design: easy to use in office or take off-site to hospice, etc. 6. Highly versatile – performs many other medical & aesthetic Tx Clinical study by Aletha Tippett, MD in Cincinnati, OH (presented at the April 2006 Symposium on Advanced Wound Care, San Antonio, TX): • 17 subjects treated over 10-week period
 • Subjects ranged in age from 36 to 77
 • Subjects range in Fitzpatrick Skin Type from I to VI • Wound types included burns and various ulcers
 • Concomitant wound care applied to all subjects.

Cutaneous Lesions Ablation of Cutaneous Lesions Using an Er:YAG Laser Khalil A. Khatri, MD, Skin & Laser Surgery Center of New England, Cambridge, MA Erbium:YAG laser has been used for laser skin resurfacing for many years. It is an effective device for resurfacing and has a faster recovery time and fewer side effects when compared to the CO2 laser resurfacing1. There are several published studies demonstrating its effectiveness in laser resurfacing. Er:YAG laser has a wavelength of 2.94μm, which is absorbed by water 16 times more than the CO2 laser2. This property makes it an ideal tool for tissue ablation. Each pass of Er:YAG laser removes a thin layer of skin and the depth of ablation can be controlled by altering the effective fluence. Er:YAG laser has been used for indications other than resurfacing for wrinkle and acne scars3,4,5,6,7. Epidermal lesion can be removed without damaging the dermis, minimizing the risk of scarring. Er:YAG laser can be used to ablate/remove many benign, pre-malignant and malignant cutaneous lesions. It can be used to remove/treat Seborrheic Keratosis, Actinic Keratosis, Lentigines, Epidermal Nevus, Benign Nevi, Xanthelasma, Syringomas, Sebaceous Hyperplasia, Warts, Melasma, Milia, Acrochordons, Dermatosis Papilosa Nigra, Hypertrophic Scars, Rhinophyma, Superficial Basal Cell Carcinoma, Squamous Cell Carcinoma in Situ (Bowen’s Disease), etc. The data presented in this poster was collected to evaluate the safety and effectiveness of erbium:YAG laser in removing cutaneous lesions. Treatment of Verruca Vulgaris with Nd:YAG 1064nm Laser

Winifred S. Chu, D.O. PGY-II Dermatology Resident, St. John’s Episcopal Hospital Far Rockaway, NY Suzanne Sirota Rozenberg, D.O.
 Program Director, Dermatology Department St.Johns Episcopal Hospital Far Rockaway, NY This study demonstrates the success of utilizing Nd:YAG 1064nm laser in treating a verruca that had failed to respond to standard treatment. Dermatologists should consider using this laser therapy early in the course of treating resistant warts since it is well tolerated by patients and it provides timely, significant results that help to bring disease to remission. Acute Lumbago Treated with a Nd:YAG Laser, Leonardo Longo, MD, C. Romanelli, MD, and D. Longo, PT, Presented at the International Academy Laser Medicine and Surgery, Florence, Italy. Laser Therapy for Chronic Induration Penis Plastic (IPP): 33 Years of Experience, Results and Follow-up Leonardo Longo, MD, Olha Sheykh, MD, Diego Longo, PT, Giulio Cherubini, PT Institute Laser Medicine, Firenze, Italy Presented at the American Society of Lasers for Medicine and Surgery Annual Conference 2016 Background: Our first experience with Laser Therapy for IPP started more than 33 years ago. The results for first 101 treated patients was described in previous reviews. Our purpose was to treat chronic IPP in the shortest possible time, with less number of cycles and less time for each session. Study: In the last three years we enrolled 30 patients, from 25 to 60 years old, with chronic IPP. 15 patients were treated with three different types of laser contemporary: 808, 1064, 10600nm. 15 patients were used as control. Before laser therapy the patients stopped the other therapies. The size of the lesion of the penis was estimated with an echography before the treatment and 40 days after the end of the treatment. Dosage was Nd:YAG 1064nm, PW, spot-size 6mm2, 35 J for spot; 10600nm 36 J/cm2, spot-size 5cm2; 808 12 J/cm2, spot size 3cm2. We performed 20 sessions on each patient, 4 sessions a day. Results: To evaluate the results we observed: presence/absence of clinical features, size of the lesion. Results were positive in the majority of patients. A group of patients had partial results and they required a second cycle of sessions, after two months of interval. Side effects were not noted.

A few patients required a third cycle. Follow-up after 6 months was completely positive. Conclusion: In the chronic forms of IPP the science tried to use laser to remodel the phases of the scar, to make the fibrosis recede. Same mechanisms could be involved in the recovery. We can observe differences between acute and chronic IPP treatment. In conclusion, laser therapy for IPP can be effective in most of the clinical forms, although settings and parameters are subject to improvement. Effects of Laser Therapy and Grimaldi’s Muscle Shortening Maneuver on Motor Control of Subjects with Incomplete Spinal Cord Injuries Diego Longo, PT, Leonardo Longo, MD, Paolo Lippi, PT, Giulio Cherubini, PT, Vanessa Mange, PT Institute Laser Medicine, Firenze, Italy Presented at the American Society of Lasers for Medicine and Surgery Annual Conference 2016 Background: Since 2003 until present we have treated 251 patients with Traumatic Central Nervous System Injuries (TCNSI), using Non-Surgical Laser Therapy (NSLT) obtaining good results in terms of sensibility and movement. To increase muscle strength and to further explore new emerging synergies, we have started to use a physical therapy practice based on the most current knowledge about the motor control, name Grimaldi’s Muscle Shortening Maneuver (MSM). Each TCNSI is different; no two similar exist, for loss of function and response to treatment. For this a reason statistical criterion is relative, as too many variables are involved contemporaneously. The goal of our study is to obtain objective data suggesting the real efficiency of the association between these two treatments. Study: In 2015, 10 patients with incomplete TCNSI, occurred at least one year before laser treatment and documented by NMR, ESSP, and ESMP, were enrolled. At the same time, another 10 patients with the same features were included as a control group. All patients have subtotal sensory and motor paralysis under the level of lesion. Lasers used were 808nm, 10600nm, and 1064nm, applied with a first cycle of 20 sessions, four times a day. Patients were involved in a specific physical therapy training Grimaldi’s MSM two times a day, eight session in total, working selectively on certain joints, muscles and limbs. Before treatment under the level of lesion, muscle activity was tested with EMG system of surface (sEMG). Clinical evaluations included the research of superficial and deep tactile and thermal sensory under the level of lesion. Muscular force at

specific joint angles were assessed by electronic dynamometers and goniometers. This latter type of evaluation was also administered prior to and after each MSM and at the end cycle of laser treatment. Every cycle of both treatments was replicated each month. Controls did not receive any kind of treatment but all the variables have been assessed for the intervention group. Results: Results were regarded as positive if sEMG showed modifications in CNS-muscle conduction spikes, under the level of lesion. Objective assessment of force, trunk’s ROM and balance displayed encouraging results in patients assigned to the intervention group. On subtotal TSCI, after each cycle of 20 sessions, patients showed improvements in motor function and voluntary command shown by the graphic features. Follow-up is positive after 3 months. Conclusion: The association between laser treatment and Grimaldi’s Muscle Shortening Maneuver (MSM) seems to be effective on muscle strength and motor control of patients affected by subtotal SCI compared to a control group.