Lumenis AcuPulse? Is this a good laser?

Question

Lumenis AcuPulse? Is this a good laser for reducing fine lines? What is the difference between ablative and non ablative? What is the best laser system on the market? Thank you!

Jason Emer, MD · Answer

you need the right doctor not the right laser. without photos nobody can tell you what is best, but if you want co2 you will want ultrapulse with the right physician.  start peels before and after (see link).

at home peels like cosmelan, enlighten and aerify along with dermarolling (EmerageSkin roller with anteage AERIFY MD ampules weekly, see link) should be started now to prevent further aging.

For facial rejuvenation,  I would suggest a combination approach of 
1) skin care with products and PRP/microneedling
2) PDT light therapy few times a month with growth factors
3) laser treatments like clear and brilliant regularly and a few times a year Fraxel/halo Viva, Co2/Erbium
4) Sculptra injections a few times a year for collagen production with fillers like juvederm/restylane/belotero/radiesse/bellafill
5) thermage/ultherapy for yearly skin tightening with or without PDO or cone based instalift threads for lifting
6) botox every 2-3 months to stop movement lines and prevent lines at rest
7) deep microneedling RF like Fractora/morpheus8 for tightening of the skin
8) Vascular laser like vbeam/excel V or BBL forever young treatment every quarter (3-4 months)

Best, Dr. Emer.

Harold J. Kaplan, MD · Answer

Hello Chelsea.  Thanks for your question.  It's quite common for consumers to relate a particular type of laser to a particular outcome.  The challenge is that the technology used in your treatment is but a small part of the potential outcome.  The reason is that lasers do not think for themselves.  In the same way that you and we cannot drive a NASCAR race car at 250 miles an hour in the same way as a race car driver, not all practitioners can use a laser in the same way with the same skill and experience.

The outcome of this discussion is that many lasers use very similar technology (C)2, Erbium, fractional, full field).  What's different is how the procedures are undertaken to get you the best results.   So how to tell who can deliver your results?  Look for before and after photos for patients that have the same issues as you (see link below).  If you find a practitioner that has good before and after photos for patients that had the same concerns as you, schedule a consultation and go from there.  Best of luck.

Shehla Ebrahim, MD · Answer

Thank you for your question. Non-ablative lasers do not vaporize the skin period. The temperature for ablation is about 100°. Non-ablative lasers cause deep dermal heating thereby causing collagen contraction but they do NOT LIFT the skin, nor do they get rid of wrinkles. They may TIGHTEN the skin by improving the elasticity and pore size. 
Ablative laser, on the other hand, vaporizes the skin thereby causing better tissue effects. They can be fractionally ablative which is like aerating the grass or totally ablative which is like mowing the lawn. These lasers are very good for reducing wrinkles and fine lines and would be the treatment of choice if you're able to take time off work. In my opinion, fractionally ablative lasers are very good for wrinkles around the eyes and mouth but require several treatments compared to totally ablative laser's which requires only one treatment but a lot more downtime. It is really important to choose an experienced physician as these lasers in the hands of an experienced person can lead to potential and permanent complications. Good luck!

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