What Qualifications Does a Person Need to Perform Total FX?

I am wondering what training or qualifications a person has to have in order to perform a total FX procedure on someone in Texas. I had a total FX treatment completed almost five months ago and have hyperpigmentation. I had no pretest done on me and also no pretreatments. MR

Doctor Answers 5

Seek Credentials and Experience for Safe Laser Treatments

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Dear MR,

Texas state law mandates that only a physician may fire an ablative laser such a Total FX and that the physician may NOT delegate the use of an ablative laser to a non-physician. That being said, for ablative laser surfacing of your face choose a physician who specializes in plastic surgery procedures of the face with board certification and experience in laser procedures to help you achieve optimal results and successfully treat any complications that may arise. Regarding treatment for hyperpigmentation after your laser, there are many options including daily broad spectrum sunblock to prevent further pigmentation, bleaching agents, retinol, chemical peels, steroid creams, microdermabrasion, which can be used in combination to lighten hyperpigmented areas. But the most elements in treating hyperpigmentation are time and patience - as it is a transient and reversible condition.

Best of Luck to you,

Dr.  Ben Bassichis in Dallas

Dallas Facial Plastic Surgeon

Total F/X who to see for treatment

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The first issue of concern is that you are having hyperpigmentation following treatment.  If you haven't already please see the physician who treated you for the laser so they can help you with your recovery and concerns.  If you did not see a physician for your treatment, then you should find a cosmetically oriented board certified dermatologist near you for a consultation regarding your hyperpigmentation as there are likely many options to improve your situation. 

Qualifications vary state by state but in general when seeking this treatment, you want a board certified plastic surgeon or dermatologist who is very familiar with lasers and this device in particular.  The upside with this laser is it can make a dramatic positive impact on wrinkles, unwanted pigmentation and skin tightening especially around the eyes and mouth.  The potential downside is that in the wrong hands it can cause permanent scarring.  Pre-testing is not the norm for use of this laser but occasionally we do perform a test in our office. 

Qualifications to do Total FX

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Thank you for your question. Every state has different regulations, and a body of evaluation of who can do what. I recommend seeing a Board Certified Dermatologist to evaluate how to manage your pigmentation. Sunscreen and a hat are a must. You may need to have hydroquinone , but an evaluation is in order first. I hope this helps!

Vivek Bansal, MD
Danville Plastic Surgeon
4.9 out of 5 stars 26 reviews

Some states require an MD to run a CO2 laser, others allow anyone to do it

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As the other posters have outlined, regulations on who may use a CO2 ablative laser vary from state to state. Even if you get a physician to perform the laser procedure that is no guarantee that the proper evaluation is performed and the best treatment parameters have been selected. The Lumenis Ultrapulse laser that delivers the TotalFX treatments is a very powerful surgical laser. That is why I selected it over other less powerful machines. It is adjustable and can give very mild treatments for cases of minimal skin aging or very powerful treatments for extensive wrinkles that if set too high could scar a patient's skin. The operator has to understand how lasers work, how the skin responds and be able to make a judgment as to what is best for the patient. In my practice we have used the TotalFX for three years. We do no pre-treatment. Everyone should use a sunblock after the procedure and avoid direct sunlight as anyone can develop hyper-pigmentation after the treatment. I hope this helps you.

Ivan Wayne, MD
Oklahoma City Facial Plastic Surgeon
5.0 out of 5 stars 65 reviews

Total FX is a total success

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Hi, I just added a couple of links that might be helpful...

The laws on who can operate lasers vary from state to state.  Physicians with training, experience and ongoing education in lasers will take a detailed skin history, do a careful skin analysis to establish safe treatment settings, and provide pre-treatment guidelines to help avoid adverse outcomes.  Laser test spots are especially useful if you have pigmented or sensitive skin.  Post inflammatory hyperpigmentation can be addressed with a variety of topical treatments(peels, retinoids) and prevention of additional darkening with the use of sunblocks and pigment suppression.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.