Is PicoWay more effective than PicoSure in regard to treating cafe au Lait Macules?

Thanks for your question.  Unfortunately, your results are dependent of the settings used and the experience of the provider.  It sometimes takes some trial and error to zero in on the best option for your birthmark.  Since you haven't had initial success, we would probably test spot different areas of your birthmark with different lenses and settings on the same visit.  We would use our PicoSure with the FOCUS and Flat lens, plus try an area with the Tattoo Removal handpiece and an IPL test spot.  You should voice your concerns with the supervising physician.  Ask if you can arrange a test spot appointment where you try different modalities to judge which option is the most effective.  I hope this helps.