Accent vs. Titan for skin tightening

Fraxel is a great technology, they have come out with a new Fraxel re:pair that is more aggressive and gets even better results with one treatment. Once again it is new, but worth investigating. If safe and effective it will be one of the greatest invovations in facial plastic surgery over the past 10 years (according to one of it's prototype university dermatology professors who annoucned the technology at the American Academy of Dermatology last week, as well as on NBC's Today Show. No matter what treatment that you have, you will likely need some Botox in the future. That is unless you have the procedure (GLX) that destroys the nerves that causes movement, but this tecnology is new and it would probably be wise to wait and look what patients look like longer term. Good Luck.

Fraxel and IPL are not comparable in any way. IPL is meant to minimize and reduce pigmentation issues. As a side benefit, you would see a little bit of wrinkle reduction but that is not it's main goal or result. Fraxel on the other hand, was created to substantially reduce wrinkles, minimize pores, address pigment and tighten all in the one technology. I am an owner of a laser business in the Phoenix area and have performed thousands of these treatments in the last 6 or 7 years. Both of these treatments are a little painful. I use topical numbing for the Fraxel but the IPL doesn't really require it because of the bipolar infrared technology that I use. The results from both is quite dramatic but different and it depends entirely on what you are trying to accomplish. Hope that helps, although you posted this sometime last year so you may have done something already. Christine

This is very hard. You read so much, who do you believe, the only way to figure it out is to try it, but in this case the only thing you could lose is a lot of money. I see you offer Accent in your practice, so I question your good words. I wish more than anything to be able to trust people. I dont mind spending the money, I just want to receive the product/service i have paid for. I dont think that is to much to ask

Hi Dizzy, I'd be dizzy too if I had to go by all of the confusion out there. I'm sorry for it, but the reality is that everyone is trying to make themselves money, and unfortunately not everyone cares if they are giving the best treatment available to their patient. The laser companies want to sell their product, the practitioners want to sell their services to pay for the laser, and the uninformed patient gets stuck with being unsatisfied for their hard earned money. As a physician, it is also dizzying for me to try and decipher which technologies are safe, effective, and not just hype. I do that by attending 4-6 national and international meetings/yr, keeping up on all of the facial plastic, plastic, and dermatological journals, speaking with colleagues whom I trust about their honest opinions on the technologies, "demo"ing the treatments on my own patients, and hearing what patients say about the treatments. I incorporated Accent XL into my practice after five years of investigation. I have a twenty-two year reputation and am not willing to ruin it based on technology that does not satisfy my patients. My patients receiving Accent XL are very happy. I believe that it has to do not only with the Accent XL performs, but how the person applying the treatment does the treatment(I am confident that my patients will see excellent results, but I cannot predict how patients will feel in other offices. The technology works when it is performed properly). I hope that I have eased a bit of your vertigo.

I am 53 with some deep lines beginning to form around the nose and mouth, as well as the neck beginning to look scrawny. I started Accent laser a couple of months ago- have signed up for 6 treatments and have received 4 of them. At first, I began to see small differences, after the second treatment I got very excited that this would be the best thing since sliced bread. However, after the 3rd, it seemed to begin to reverse and lines began reappearing. After the 4th it got worse. I am afraid that if I continue with the last 2 treatments I will be back where I started. Is this unusual? The treatments are administered by a technician in a plastic surgery office in Boca Raton, who is an excellent physician with a great reputation. I would like an unbiased opinion as to whether a sort of reversal of beneficial effects is encountered in your practice at all. Thank you!

I usually advise that for "skin tightening," it is best to wait at least 1 month in between treatments, otherwise the collagen you are trying to stimulate is being re- broken down before it has had the opportunity to strengthen the integrity as a whole. I would wait and do the last two treatments about 6-8 weeks apart. It will help.

You made the following statement a month ago(Feb. 7, 2008)on your website: "Alma laser has a device called Accent XL™ that has the potential for tightening areas of unwanted fullness. Antedotically (speaking to two physicians and one nurse at different meetings) I have heard that there is some success, but that it takes a lot of physical work with the machine, and/or with vigorous massage after the treatment to get good results. A third respected physician was unable to reproduce the results shown by the company's before and after pictures. Accent XL is similar to Thermage, but not painful." Yet, a month later you state your patients see "excellent" results. Just how many of your own patients have had this procedure; how many have received excellent results, and where are the before/after pictures to prove it? You may want to sit down, while your head spins.

Hi Suspicious, Thanks for visiting my web site and pointing out your confusion. The quote that you have taken out of the context from my article entitled "What's New in Facial Plastic Surgery" was originally written in August 2007 after I had attended The Foundation of Facial Plastic Surgery's Newport Beach Meetings (as stated in the first lines of the article). In August 2007 my interest in Accent XL was piqued at the meeting, and what I wrote (as you quoted) at that time was my initial impression. From August to December 2007 I investigated the Accent XL technology, and was quite fortunate to meet one of the original users of the technology. She has treated well over a thousand patients over the past three years with excellent results. I was so impressed that in January 2008 she began treating patients in my office. The before and after pictures are very nice (over 3 years worth). You are welcome to come to my office to not only look at before and after photos, but also meet and speak to many happy patients. Since January 2008, over twenty five of my patients have been treated and each has been very pleased to date (with their excellent results thus far). As you probably noticed while you were visiting my website, I currently do not have before and after photos of patients. My philosophy about putting before and after photos on the internet may change in the future, and at that time I will not only include photos of Accent XL patients, but also of all of the other cosmetic procedures that I perform, including rhinoplasty, facelifts, blepharoplasty, fat transfer, Fraxel re:store and Fraxel re:pair, Botox, Restylane, Juviderm, and Radiesse. As far as your suspicious mind goes, you can simply return to my web site home page (drpersky.com), click on advice, and then click on "What's New in Facial Plastic Surgery". There you will see the article that you quoted, and see that it was incorporated into my web site back in August 2007. On February 7, 2008, I transferred that article to my blog. I'm sorry the date of the transfer that appears on the blog page confused you, and led you to make false accusations regarding the state of the stability of my head upon my shoulders. I assure you that despite your accusations, I am quite fine and not suffering from any form of vertigo. Be Well, Dr P

I also live in the Boca area and have been trying to decide what treatment to go for the lines & wrinkles. Can you tell me what ps you went to?? Many thanks.

hi Jackster. I just had fraxel re:pair done last Monday...same as you...done on my entire face. So far so good. ;] Dr. Felder in Fort Lauderdale did mine and he does the mini lift you are int. in as well. He teaches/trains other Drs on laser and fillers. I love him.  Cheers, Tara p.s. why did you do just your eyes?

Tara, thank you so much for the info. Actually I am having the repair done on my eyes tomorrow in Miami, Dr. Walder. She felt I didn't need to have my entire face done...I'm sure why, but she felt I would get more benefit with a mini lift that would address my jowling. Maybe I am too old for the repair to tighten enough!!! I called Reliant about a month ago to get the names of some docs in the area for repair and she was the closest to me, (Delray Beach). Hopefully all will go well, but I will definitely look into Dr. Felder for the mini. How are you coming along with the repair? Are you happy with the results thus far? Please keep me posted and thanks again.

Hi, Tara it's me again. I just checked out Dr. Felder's site and he seems to do only injectable (short term) mini lifts. I am looking for a surgical mini lift under local that will last more than a year or so. If you know something that his site doesn't mention, please let me know. Thanks again, and happy healing!

Jack..how are your eyes??? Tara

Very swollen and red, but they seem to get better by the hour. My doc is thrilled with how I am healing. I see her again on Monday and she wants to put some Botox on the sides to facilitate the healing. Hope you are doing well,Tara. Jackster

had accent done at a very reputable office in Beverly hills. Me and my boy friend both received 8 treatment sessions w noooo results! not even 5%! We are both n shape, I am 36 years old and 118 blds and 5'7. So this did not work for either one of us.

i am n ot an expert but i had your problem 1st i had i filler hydrafiil grade i under the eyes to give a bit of padding the i had 3 treatments of teosyk meso injected into the skin under the eye to imprve crepiness and it looks a lot better

Hi Heather, It is very confusing (see the other entries above). For your age and problem I think that I would treat you with Fraxel re: pair, followed possibly by a small amount of Restylane under your eyes. Read other entries here and you will see some problems with loss of volume under the eyes with Thermage (it may have been improperly performed, but I would stay away from it under your eyes). If you would like a referral to someone in your area let me know. Good luck. Dr. P