Laser Tattoo Removal

Laser Tattoo Removal

Laser Tattoo Removal Focus Medical NaturaLase QS Focus Medical, Bethel, CT, USA American Made NaturaLase QS4 2J 2J of energy, 4 wavelengths 1064, 532, 585, 650 NaturaLase QS4 1J 1J energy, 4 wavelengths

Company History Founded by John Lee, January 2000. Former Laser Division of Lorad, Mammography manufacturer in Danbury, CT. Former parent company is now Hologic First systems manufactured entirely by Focus Medical were export sales to Asia, Australia, and Brazil. NaturaLase QS & NaturaLase Er:YAG Established USA distribution, January 2002. Developed NaturaLase LP, Nd:YAG Laser system, January 2004 Developed NaturaLight Pulsed Light System, July 2005 Second generation NaturaLight, August 2007 3 rd Generation NaturaLase QS January 2009 NaturaLase 980 Aug 2010

What is Laser Tattoo Removal? Light energy interacts with the pockets of ink in the skin that comprise the tattoo Light breaks apart the ink into smaller particles, the body then absorbs the ink, repeat 4 8 times for full removal The Light is delivered in nano-seconds and delivers an acoustic pulse Nano-seconds One billionth of a second Photo-acoustic (ns) vs. Photo-thermal (ms) Different wavelengths react with different tattoo ink 1064 - Black, Blue 532 - Red, Orange, Violet 585 - Yellow, Sky Blue 650 - Green

How does a laser remove a tattoo? Light energy interacts with the pockets of ink in the skin that comprise the tattoo Q-switched Light, When it is delivered to the skin becomes photo acoustic energy. Similar to a shockwave. Photo acoustic energy breaks apart the tattoo ink packets into small enough size to be naturally absorbed by the body Think of an old faded tattoo, we are harnessing the power of light to speed up the fading process To remove multiple colors, different wavelengths must be used 1064, 532, 585, 650, 755, 694 are all wavelengths used in tattoo removal The technique is to gradually increase the fluence (j/cm2) after each treatment as tattoo fades Minimize complications Typical 4 to 8 treatments required More or less depending on colors, professional vs amateur, body location, and health/age of patient Goal is to leave skin as it was before the tattoo An aesthetic result!!!

Millisecond vs. Nanosecond is the same as Photothermal vs. Photoacoustic Milliseconds energy is delivered over time to create a PhotoThermal effect that produces heat to damage hair follicles or heat for rejuvenation. Lasers that deliver energy in ms milliseconds or thousandths of second and this sounds fast but in the laser world this is a very long time. Long pulse lasers are millisecond pulsed lasers Nanosecond energy is delivered faster than the thermal relaxation time of cells. Cells cannot tolerate this energy and consequentially burst. Q-switched lasers deliver energy in ns, billionth of a second. Short pulses or nanoseconds are used in Qswitched Lasers

Why Laser Tattoo Removal? They ve got no where else to go!!!

Why Laser Tattoo Removal? No other technological way to remove tattoos Gels, creams don t work What is Wrecking Balm? Low grade chemical peel that will burn off a few layers of skin. Using chemical peels deep enough to reach tattoo ink packets will leave a serious scar. Please google Wrecking Balm, tell me what you read! Other lasers Long Pulse/ IPL/ Other Lasers Will burn the skin and make tattoo more difficult to eventually remove as scar tissue will encapsulate ink packets. CO2 Ablation down to depths of ink packets will leave same scar as chemical peel. Surgical excision is only other way Acceptable for very small tattoos, surgical tattoos.

Popularity of Tattoo Removal Captive Audience Other methods do not work and/or leave awful scars Compare vs. hair removal, skin rejuvenation, vascular How many people/patients do you know with Tattoos? Location to Military Base Nearby Tattoo Artists Great demographics Although, no hard statistics are published on tattoo removal a report by the Food and Drug Administration estimated as many as 45 million Americans have tattoos. This report was based on a Harris Interactive Poll in 2003, that also found 17 percent of tattooed Americans regretted their tattoos About 20 percent of tattoo wearers are dissatisfied with their body art, and about 6 percent have it removed, according to recent article in Archives of Dermatology Women are more likely than men to have tattoos removed, according to the journal article. In the survey of 196 individuals who visited clinics for tattoo removal, 69 percent were female. Participants also were more likely to be white, single, college educated and between the ages of 24 and 39.

Laser Tattoo Removal Technology Highest power Q-Switched Nd:YAG 2J per pulse highest worldwide Used in prominent Dermatology, Plastic Surgery, Aesthetic offices worldwide Establishes new standard in tattoo removal New features allow for four different wavelengths 1064, 532, 585, 650 Black, Blue, Red, Orange, Green, Yellow, and Violet ink removal.

Multiple Wavelengths Multi-colored tattoos 2000 millijoules (mj) of 1064 nm Invisible IR radiation Ideal for black and dark blue ink 900mj of 532 nm Red ink tattoos, pigmented lesions, vascular lesions 500mj of 585 nm Sky blue and yellow ink 450mj of 650 nm Green and yellow ink

Why So Much Power? More energy allows a bigger spot Bigger spot means deeper penetration Deeper penetration means lower intensity Lowering intensity reduces complications Less skin damage Less scarring Less hypo and hyper pigmentation Better results with deeper penetration

Light Penetration Higher power -> Deeper light penetration Penetration to the depth of the pigment Larger spot size with same or greater energy Flat top beam improves results Lower intensity at the surface reduces complications

Energy Thresholds Without enough energy an extra wavelength will not produce results Wavelength Skin damage threshold Min Fluence at Ink 1064 nm 7 J/cm2 1.5 J/cm2 532 nm 5 J/cm2 1 J/cm2 585 nm 6 J/cm2 2 J/cm2 650 nm 6 J/cm2 2 J/cm2 Tattoos require a minimum amount of energy to reach the ink and cause disruption, too much will cause skin disruption.

Highest Beam Quality

Beam Profile NaturaLase QS uses proprietary technology to produce the best beam profile in the industry. Treats evenly to the edge of the spot No HotSpots that can cause complications

Why Beam Quality Matters? More even light penetration Fewer complications No hot spots to cause epidermal damage Uniform results Cone shaped beam will have less energy/results away from center of beam

Before and After 4 Treatments Increasing Fluence 1.5 J/cm 2 to 6 J/cm 2

Before and After

Removal of Amateur Tattoo Before During Immediately After

In Progress Tattoo Can be considered a typical tattoo that is treated for removal. This tattoo will likely only take 4-5 tx, with a charge of $150-200 per tx. 5 minute procedure time, max.

Tattoo Removal from Start to Finish

Tattoo Removal Full removal took 10 tx and 2yrs, this is a very good result. This type of result can only be accomplished with the best technology. Pictures courtesy of Dr. Cyrus Chess, Norwalk, CT

Progression of three treatments Pre-treatment 1 Post-treatment 1 3 hours post 1 24 hours post 1 Pre-treatment 2 Post-treatment 2 1 hour post 2 3 days post 2 17 days post 2

Progression of four treatments Pre-treatment 3 Post-treatment 3 30 min. post 3 hours post 37 days post Pre-treatment 4 3 hours post 53 hours post 90 days post Before

Tattoo Removal Not Bad!

High Revenue Procedure 1 st treatment $750 Follow up treatments $250 each Total revenues for this treatment $1500-2000

On the Skin Energies Laser Product 1064 nm Energy 532 nm Energy 585 nm Energy 650 nm Energy NaturaLase QS 2J 2000 mj 900 mj 500 mj 400 mj NaturaLase QS 1J 1000 mj 500 mj 300 mj 225 mj Conbio RevLight 1600 mj 500 mj 300 mj 200 mj Conbio C6 1000 mj 400 mj 250 mj 150 mj Lutronic 1000 mj 400 mj 225mj 150mj

NaturaLase QS Specifications Wavelength Energy Spot size Fluence 1064 nm 2000 mj 3-10 mm 24 J/cm2 532 nm 900 mj 3-10 mm 18 J/cm2 585 nm 500 mj 3-5 mm 12 J/cm2 650 nm 400 mj 3-5 mm 7.5 J/cm2

Laser Tattoo Removal Takeaways If YOUR patients want to remove their tattoos, only a QSwitched laser can do it! Tattoo shops refer patients for tattoo removal, to fade tattoos before they put on a cover up tattoo and also to remove bad tattoos! The key are some key demographics to target Soccer moms, military/police, people with multiple tattoos Location matters, if you had a tattoo you wanted laser treatment on, how far would you have to drive?

NaturaLase QS 2J Not only tattoos Indications: All Tattoo Colors Traumatic Tattoos Amateur Tattoos Melasma Common Naevi Lentigines Café-au-Lait Birthmarks Seborrheic Keratosis Vascular Lesions

New Standard of Care Higher energy allows bigger spots Bigger spots produce higher fluences in the skin. These effects multiply to produce much lower fluence requirements. Much lower fluence means less skin damage Fewer complications Better results

Please see the supplementary CD for additional information on laser tattoo removal.