TattooStar Family - Q-switched Ruby & Nd:YAG Laser - Technology - - PowerPoint PPT Presentation

TattooStar Family

• Q-switched Ruby & Nd:YAG Laser -

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For more than 35 years, Asclepion has been operating on the medical laser

• market. As the company is based in Jena, famous through the world as the

global center of the optics industry since 1846, the company owes it success to the steady development of new technologies and the active collaboration with researchers from German universities and industries.

• More than 35 years experience in the aesthetic laser medicine and surgery
• Development, production, service & training center in Jena
• TOP100 of the most innovative medium-sized businesses in Germany

Technology „Made in Germany“

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The first Q-switched laser from Asclepion was launched in

• 1998. Now we present the

latest generation of Q-switched laser for the aesthetic laser medicine, where you can have up to 4 different wavelengths (532, 585, 694, 1064 nm) in

• ne system:

TattooStar Effect COMBO.

RubyStar RubyStar+ TattooStar Y Milestones of product introduction of Q-switched laser systems

The new dimension of Q-switched lasers

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Laser: Q-switched Nd:YAG laser (Y), class 4 Q-Switched ruby laser (R), class 4 Q-switched ruby and Nd:YAG laser (COMBO), class 4 Wavelength: 694 nm (R) 532, 1064 nm (Y) 585 nm (Dye) Energy: Up to 1.5 J (Y), 1.2 J (R) Pulse duration:

• Approx. 8 ns (Y), 40 ns (R), 300 µs free running mode (Y)

Frequency: Up to 10 Hz (Y), 2 Hz (R) Fluence: 1064 nm: Max. 37 J/cm² (Q-Switch: 20 J/cm²) 694 nm: Max. 20 J/cm² 532 nm: Max. 10 J/cm² 585 nm: Max. 5 J/cm2 Spot sizes: 2 – 2,5 – 4 – 5,5 mm (Y), optional 7 mm (free running mode) 2,5 – 4 – 5 mm, TattooStar: optional 6 mm (R) TattooStar Effect: optional 7mm (R) 7x7 mm with MicroSpot handpiece (R) (Fractional, 196 MicroSpots with Ø 300 µm, 30% cover rate)

All specifications are subject to change without notice.

TattooStar R TattooStar Effect R TattooStar Effect Y TattooStar Effect COMBO

Specifications

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Clinical success

• 1998: The RubyStar is one of the most

successful Q-switched lasers in Germany with over 100 systems in the market.

• The hundreds of satisfied customers in

Germany and worldwide and their feedbacks had influence in the development of the latest generations.

• More than 12 years experience.

USPs

• Up to 4 different wavelengths in one system
• Microlens array technology
• Application without gaps due to square shaped spots
• MicroSpot technology
• Very homogeneous beam profile
• Automatic spot size detection
• Intuitive operation
• Sterilizable distance holder
• Reliability

Clinical success and USPs

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 state-of-the-art technology Microlens array patented EP1112524  homogeneous spot at every size and fluence  sterilizable distance holder  automatic spot size detection

Microlens array Homogeneous spot Distance holder for different spots (including corresponding optics)

Standard handpiece

Standard handpiece

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Handpiece (fractional for ruby laser) with MicroSpot technology  use of highly reliable microlens arrays  flexible adjustment of Fluence and Speed  optimal coverage for the treatment Spot size 7,1 x 7,1 mm Numbers of spots 196 (14 x 14) MicroSpot Ø 300 µm Gap 200 µm Coverage

• Approx. 30 %

Energy & Fluence

• Max. Energy

1.13 J  8.0 J/cm2

• Min. Energy

0.31 J  2.5 J/cm2

MicroSpot handpiece Homogeneous spot fractional

MicroSpot handpiece

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• worldwide first and only Ruby laser with fractional technique
• very homogenous spots
• clearly more mild treatment  very gentle method
• normally no down time, sun cream and make up can be applied
• side effects even less compared to ablative fractional laser treatments
• therefore: new applications

pigment removal of large areas as the whole face

• painless treatments without anesthesia
• quick treatment procedure for the today‘s busy clients
• reliable technology by Microlens array

Advantages of fractional Q-Switched ruby laser

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Treatment flexibility  The wavelength of the Q-switched Nd:YAG laser can be set to frequency doubled 532nm (green light).  By means of a special dye this green light can be transferred to yellow light (wavelength of 585nm).  This principle is realized with the Dye handpiece of the TattooStar Effect Y.  With the yellow light of 585 nm, e.g. sky-blue tattoos can effectively be treated.

DYE handpiece

DYE Handpiece (for Q-switched Nd:YAG)

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X

Round spot no overlap -> gaps Overlap -> more treatment time Non homogeneous Spot by Gaussian profile

X

Square spot no overlap necessary Homogeneous spot by Flat Top Profile

Homogeneous, square Spot for a safe and effective treatment! TattooStar Other lasers

X X

Beam profile and spot shapes

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TattooStar Flat Top Pulse Q-Switch Nd:YAG traditional Gaussian Pulse q-Switched Nd:YAG

By courtesy of Prof. Dr. D. Cassuto, Milan, Italy

Comparison beam profile

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Display TattooStar Effect

• detachable 12“ high resolution display
• pre & post treatment pictures and videos
• patient library and list of indications with

treatment parameters

• treatment suggestions and procedure
• about Asclepion

Display TattooStar R

• easy use by touch screen
• fluence and speed adjustable directly
• display of energy in the Work Screen
• patient library

User interface

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0.0001 0.001 0.01 0.1 1 10 100 1000 10000 100000

100 1000 10000

Wavelength [nm] Absorption Coefficient [cm-1]

4000 3000 2000 5000 500 400 300 200

Melanin Protein Water Scattering Desoxy-Hemoglobin Oxy-Hemoglobin

HIGH ABSORPTION in the Melanin of pigmented lesions and in the ink of tattoos. Pigments are fragmented by the Q-Switch pulse and reabsorbed by the lymphatic system. Ruby laser: LOW ABSORPTION in blood and water. Side effects in blood vessels and other tissue are marginally. Nd:YAG laser: LESS ABSORPTION in Melanin. More safe for dark skin.

Selective absorption

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• (benign) Lentigines
• Epidermal naevi
• Naevus Ota/ Ito
• Tattoo

* besides sun protection before and after treatment, it is always necessary,

• therwise recurrent lesions have to be treated once more

Indication

694nm 532nm 1064nm 585nm

Technology Ruby Nd:YAG Nd:YAG DYE Benign pigmented lesions yes yes (superficial) yes (dark and/or deep) yes (superficial, lighter) Tattoo Permanent make-up Black, blue, green Red Black, blue Light blue Dirt tattoos yes no yes no Melasma/Chloasma* yes (MicroSpot FRx) no no no

By courtesy of Dr. Paul Wood, Proderma, Bad Homburg, Germany

Indications

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Laser treatment is the only, almost bloodless and efficient treatment method.

• no scars
• fast and painless treatment
• usually no anesthesia required
• after the treatment the patient

can carry on as normal.

Indications | Removal of tattoos

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composition of professional Tattoo inks (University Regensburg, Dr. Bäumler, Prof. Landthaler, BASF Research)

• nly 16 main substances
• 41 colorants
• contain of organic pigments
• main component Aluminum
• basic substance: car paint
• 85% dark colors
• substances are toxic

Indications | Removal of tattoos

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• E. Richter et al:

In vivo analysis of solar Lentigines by reflectance confocal microscopy before and after Q-switched Ruby laser treatment Acta Derm Venerol 2011; 91: 164 – 168

By courtesy of Dr. Patricia Steiner, Germany

immediately after the treatment, the skin color is typically white-gray

Clinical end point: Immediate reaction: whitening at the skin Caused by:

• extremely fast heating of pigments

and vaporizing of the tissue water

• formation of vacuoles

Indications | Removal of tattoos

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By courtesy of Dr. Said Hilton & Heike Heise, Dusseldorf, Germany

Indications | Removal of tattoos

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By courtesy of Dr. Patricia Steiner, Germany

after 6 treatments (Ruby Q-switched), red part can not be removed with ruby laser

Indications | Removal of tattoos

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By courtesy of Prof. Dr. D. Cassuto, Milan, Italy

after 5 treatments (Nd:YAG Q-switched 1064 nm, 8 J/cm2, 2.5 mm spot)

Indications | Removal of tattoos

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By courtesy of Dr. Patricia Steiner, Germany

before after 4 treatments (Ruby Q-switched) after 8 treatments (Ruby Q-switched): nearly complete repigmentation

Indications | Removal of tattoos

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By courtesy of Dr. Patricia Steiner, Germany

before after 2-3 treatments (Ruby Q-switched)

Indications | Removal of tattoos

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By courtesy of Dr. Patricia Steiner, Germany

before after 14 treatments (Ruby Q-switched)

Indications | Removal of tattoos

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By courtesy of Prof. Dr. D. Cassuto, Milan, Italy

after 1 treatment (Nd:YAG Q-switched 532 nm, 3,5 J/cm2, 2 mm spot) ATTENTION: During treatment of tattoos/ permanent make-up color change is possible. Test treatment!

Indications | Removal of permanent Make-Up

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before color change after

By courtesy of Dr. Said Hilton & Heike Heise, Dusseldorf, Germany

Indications | Removal of permanent Make-Up

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Laser treatment is the only, almost bloodless and efficient treatment method.

• straightforward procedure
• fast and efficient treatment
• painless treatment
• no scarring
• impressive results

Indications | Removal of pigmented lesions

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After 10 days

immediately after treatment, the skin color is typically white-gray

Indications | Removal of pigmented lesions

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By courtesy of Dr. Said Hilton & Heike Heise, Dusseldorf, Germany

Indications | Removal of pigmented lesions

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By courtesy of Dr. Patricia Steiner, Germany

after 1 treatment (Ruby Q-switched)

Indications | Removal of pigmented lesions

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By courtesy of Dr. Patricia Steiner, Germany

before 3 months after one treatment (Ruby Q-switched)

Indications | Removal of pigmented lesions

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By courtesy of Center of Biophysics, Ho Chi Minh City, Vietnam

after 4 treatments

Indications | Removal of pigmented lesions

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By courtesy of Center of Biophysics, Ho Chi Minh City, Vietnam

after 4 treatments

Indications | Removal of pigmented lesions

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By courtesy of Dr. med. Said Hilton, Düsseldorf, Germany

Indications | Q-switched ruby fractional

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By courtesy of Dr. med. Said Hilton, Düsseldorf, Germany

Indications | Q-switched ruby fractional

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By courtesy of Dr. med. Said Hilton, Düsseldorf, Germany

Indications | Q-switched ruby fractional

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Clinical results

 „Removal of tattoos with q-switched ruby laser (694 nm) and q-switched Nd:YAG laser (532 nm and 1064 nm)”

by S. Werner et al. (Hautarzt 1999, 50 :174-180) Results: 100% brightening rate in 57% of black and 30% of colored non-professional tattoos and in 50% of black and 33% of colored professional tattoos; brightening rates of 70% to 99% in all

• ther patients. Removal of professional tattoos takes more sessions than removal of non-

professional tattoos. Removal of colored tattoos requires a number of sessions similar to that for removal of black tattoos.

 „Red ink tattoo reactions: successful treatment with the q-switched 532 nm Nd:YAG laser”

by F.C. Anthony et al. (Br J Dermatol 2003 ; 149 : 94-98) Results: Depigmentation of red tattoos after six sessions on average. After six months of follow-up, treated spots were found to be flat and inconspicuous.

 „Comparison of the q-switched Alexandrite (755 nm) and q-switched Nd:YAG (1064 nm) lasers in the treatment of benign melanocytic nevi“ by A. Rosenbach et al. (Dermatol Surg 1997; 23:239-245)

Results: Both lasers yield statistically significant improvement of pigmented lesions, as was confirmed by independent observers. Improvement was more pronounced in the case of the alexandrite laser. (Authors discussed possibility for compensation by selecting other energy densities; study used 6 J/cm² for both lasers.). Reflection measurement showed equally good results for both lasers. A significant reduction in epidermal pigments was histologically verified for both lasers after treatment.

 „Tattoo removal with the q-switched ruby laser and the q-switched Nd:YAG laser: a comparative study”

by V. J. Levine et al. (Cont Med Educ 1995; 55:291-296) Phase 1: In 17 of 49 professional tattoos – equally good brightening of black professional tattoos. 18 cases better @ 694 nm, 4 cases better @ 1064 nm. Ruby laser provides better results, if tattoos is green. Also non-professional tattoos were found to respond better to ruby laser. Phase 2: All red tattoos successfully removed in 1 to 3 sessions using the 532 nm Nd:YAG laser.

Bibliography | Q-switched laser

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Clinical results

 „Fractional mode Q-switched Ruby laser for Melasma”

by Dr. Paisal Rummaneethorn, Thailand (2010) Method: 14 cases of refractory Melasma, Fluence of 2 – 3.5 J/cm2 (in order to prevent photo-thermal reaction, use of EMLA, Indications: Lentigo senilis, Hori‘s melanosis (Hori Nevus), Freckles, Melasma Results:

• grade 1 improvement (0-25%) – 5 patients, no scarring observed
• grade 2/3 improvement (25 -50%, 50 – 75%) – 7 patients, no scarring observed
• 2 patients lost during follow up, 3 cases of post-inflammatory hyper-pigmentation

Conclusion:

• Remarkable improvement after a single treatment
• optimal effective fluencies still to be investigated in further studies (incl. Biopsies)

 „Use of Fractional Q-Switched Ruby Laser Treatment of Facial Lentigines“

by Dr. Ron Moy, Lisa Chipps, UCLA, Los Angeles, USA (2011) Preliminary results: Facial Lentigines, Fitzpatrick type II, 5 patients with excellent outcome, Significant lightening of lesions after 1 or 2 treatments, Dermal lesions on types III – IV, results less convincing, expectation that with 4, 5 or 6 treatments results will improve, PIH, Anesthetic is inadequate for superficial lesions, Very good improvements on Becker Nevus, Rapid healing times, Post treatment care is much easier with the Ruby FRx

 „Efficacy of 694-nm Q-switched Ruby Fractional Laser Treatment of Melasma in Female Korean Patients“

by Dr. Lee, Gowoonsesang Dermatologic Clinic in cooperation with Chung-Ang University, Seoul (2011) Method: 15 Korean female patients aged 29–50 years (mean 39 years) with Melasma Conclusion: Treatments provides convincing improvements on superficial pigmentation, also dermal components of pigmentations (Melasma) respond

Bibliography | Q-switched ruby fractional laser

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