V Review of Energy-Based Treatments Adapting to Millennial Patients IMCAS 2018 Preview. isionary Company Commits to Global Technology Leadership

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1 V page Review of Energy-Based Treatments Adapting to Millennial Patients IMCAS 2018 Preview 2017 Volume 15 Circulation 25,000 isionary Company Commits to Global Technology Leadership 3

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3 Lutronic Commits to Global Technology Leadership By Jeffrey Frentzen, Executive Editor With 20 years of success as one of the leading laser and energybased device manufacturers, Lutronic Corp. (Boston, Massachusetts, U.S.) is continuing to expand globally into Europe and the U.S., with a clear objective of leaping ahead of competing top tier companies. Lutronic s solid plan to grow its R&D capabilities will ensure the continued delivery of innovative technologies to practices that are eager to adopt its ever-widening range of aesthetic devices. According to Lutronic s CEO, Haelyung Hwang, the company has been reinvesting approximately 20% of its revenues in technology development efforts in order to deliver better products to their customers. Among our peers in the industry we have one of the top in-house technology development teams in the world. And although we have been very conservative about offering our products globally, we now feel that we can make this bold move and increase not only our presence, but also our product offerings. We have a broad range of excellent product lines, as well as highly-qualified managers who can make this growth happen quickly. As a whole, the company s energy-based systems are designed to address practically any indication. Having already cornered the Asia-Pacific markets, Lutronic has the momentum to overcome the competition with next-generation laser, radiofrequency (RF) and other light-based technologies. Lutronic is one of the best hidden secrets in the aesthetic industry, expressed Omar Ibrahimi, M.D., Ph.D., founder and medical director of the Connecticut Skin Institute in Stamford, Connecticut, U.S. Their systems are well built and reliable. I think the company is committed to building faster and more powerful devices across a wide spectrum of technology platforms. They are seeking to advance virtually every product they have and I am impressed with this ambitious desire to continually improve. With the purchase of a Lutronic device comes the real golden egg, which is the company itself and the service support, expressed Gilly S. Munavalli, M.D., M.H.S., F.A.C.M.S., founder and medical director of Dermatology, Laser & Vein Specialists of the Carolinas (Charlotte, North Carolina, U.S.). I ve found in the years I ve been using these devices, I don t really need a lot on the maintenance side, but in terms of setting them up, the training, the updates, the ability to speak to Lutronic s marketing representatives, and even at a technical level, my experience has been unparalleled. Any time my staff or I have questions about using the devices, they are always available. I think that s so important when purchasing a device. Haelyung Hwang CEO Lutronic Boston, MA, USA Gilly S. Munavalli, M.D., M.H.S., F.A.C.M.S. Founder and Medical Director Dermatology, Laser & Vein Specialists of the Carolinas Charlotte, NC, USA Steven Weiner, M.D. Facial Plastic Surgeon Destin, FL, USA Tatjana Pavicic, M.D. Dermatologist Munich, Germany Omar Ibrahimi, M.D., Ph.D. Founder and Medical Director Connecticut Skin Institute Stamford, CT, USA Saleem Loghdey, M.B.Ch.B. (U.C.T.), F.C. Derm (SA), C.C.S.T. (U.K.), F.A.C.D. Dermatologist and Mohs Surgeon Miranda, New South Wales, Australia Bettina Rümmelein, M.D. Dermatologist Owner House of Skin and Laser Medicine Zurich, Switzerland Laurence Imhof, M.D. Head of the Division of Esthetic Dermatology, Laser Medicine and Photodermatology University Hospital Zurich Zurich, Switzerland THE European Aesthetic Guide Volume

4 THE European 2017 Volume 15 Features 54 IMCAS 2018 Preview 76 Energy-Based Treatments for Top Indications 88 Adapting to Millennial Patients 54 Comparison Charts 105 Skin Rejuvenation 109 Hair Removal 112 Vascular Technologies 115 Emerging Technologies Acne Tx Devices 118 Body Shaping Technologies 120 Fractional Technologies 122 Dermal Fillers 88 Directory 100 Aesthetic Company Directory 4 THE European Aesthetic Guide Volume 15

5 Advertisers Index Adoderm 93 Aesthetic Forum THE Aesthetic Industry Awards 98 THE Aesthetic Show , Aesthetic TV BTL Industries 131 Canfield Scientific 17 Classys 27 cocoon medical 79 Croma-Pharma 83 Cutera 35 Cynosure 47 DEKA 63 Ellipse 37 Eunsung Global 85 Fotona 33 Contact Information Hironic The HydraFacial Company 87 IBSA Farmaceutici 69 Ilooda 23 InMode 81 Michael Moretti Editor-in-Chief / Group Publisher mmoretti@miinews.com Leah Morvant Publisher lmorvant@miinews.com Medical Insight 36 Discovery, Suite 170 Irvine, CA USA IMCAS 28 Jeisys Medical 67 Lutronic 11 Merz Aesthetics 2, 13, 132 mesoestetic Pharma Group 73 Novavision Group 45 PerfAction Technologies 49 Quanta System 61 Sciton 53 Sinclair Pharma 95, 97, 99 Jeffrey Frentzen Executive Editor jeff@miinews.com Editorial Staff Erin Velardo Senior Editor erin@miinews.com Telephone: Facsimile: Subscriptions: info@miinews.com Skin Tech Pharma Group 91 STORZ MEDICAL 29 Syneron Candela 15, 59 Ulthera, a Division of Merz, Inc. 25 Laboratoires VIVACY 57 Niamh Cahill Contributing Editor William T. Kelley Senior Editor, International Anthony J. Varro Contributing Editor Kevin A. Wilson Contributing Editor Advertising Inquiries: sales@miinews.com Viveve 39 WONIK 51 ZELTIQ Aesthetics 43 Zimmer MedizinSysteme 65 Correction of errors: Medical Insight assumes no liability for the information contained in this publication. Every effort has been taken to ensure the accuracy of this information by contacting sources believed to be reliable. Errors, when discovered, will be promptly corrected. Copyright: This publication is protected by U.S. Copyright Law; 2017 Medical Insight Unauthorized reproduction is strictly forbidden by law, the penalty for violation is $100,000 per occurance. THE European Aesthetic Guide is a trademark of Medical Insight THE European Aesthetic Guide Volume

6 For Saleem Loghdey, M.B.Ch.B. (U.C.T), F.C. Derm (SA), C.C.S.T. (U.K.), F.A.C.D., a dermatologist and Mohs surgeon in Miranda, New South Wales, Australia, This is a company I m very happy to deal with, especially in the non-surgical rejuvenation area. A lot of the bases are covered with Lutronic systems. Aesthetics is a growing market and I believe most practices will want to be a part of it. I think Lutronic is the way to go in terms of acquiring these types of systems for your practice. system s Hollywood Peel is a very quick, no downtime procedure to rejuvenate the face using a proprietary carbon-based lotion that is placed on the patient and penetrates the skin to several microns. Then you apply the laser, which pulls off around 7 to 10 microns of skin and makes the skin glow. As well, the Clarity is an exceptional hair removal system, which has an Alexandrite and a 1064 nm wavelength. The Alexandrite wavelength is used to address pigmentary problems, Dr. Weiner continued. Additionally, the company s Healite LED-based system promotes faster healing and decreased inflammation. Popular systems include the INFINI fractional RF-based device, which features a unique method of delivering RF energy. The eco2 laser-based platform incorporates Lutronic s patented Controlled Chaos Technology (CCT), which delivers multiple arrays of randomized microscopic laser beams to the skin for a more natural, uniform treatment that prevents bulk thermal damage caused by conventional linear delivery methods. Clarity is a versatile, dual wavelength Alexandrite and Nd:YAG laser for hair removal, pigmentation, vascular lesions and more. Also, the Spectra provides a dual mode Q-switched Nd:YAG laser that offers customizable parameters, built-in safety and minimized downtime using four distinct Q-switched mode wavelengths (1064 nm, 532 nm, 585 nm and 650 nm). The entire product line is very well priced in comparison to other manufacturers, as well, noted Steven Weiner, M.D., a facial plastic surgeon in Destin, Florida, U.S. It is a little known fact that the Spectra is the biggest selling laser system in the world. It does everything from treating tattoos, pigmentation, all types of congenital nevi and more, he said. Additionally, the Before and six months after one INFINI full face treatment Photos courtesy of Edmond Griffin, M.D. Before and after INFINI full face treatment Photos courtesy of Gilly S. Munavalli, M.D., M.H.S., F.A.C.M.S. Acne scars before and after INFINI treatment Photos courtesy of Swapnil Shah, M.D. 6 THE European Aesthetic Guide Volume 15

7 According to Bettina Rümmelein, M.D., a dermatlogist and owner of House of Skin and Laser Medicine (Zurich, Switzerland), I saw my first Lutronic device, the eco2, at a congress. Each system I ve acquired has had a very positive influence in my clinic Spectra for tattoos; the extremely versatile Clarity; and the INFINI system, which is an outstanding device, and unique in the market. Not only are the Lutronic devices exceptionally versatile, but they are built with care. What I like most about Lutronic systems is their design, they are very easy to move and they always work. I use all my devices every day, and I perform about 40 treatments per day. They are very reliable systems. Before and after one LaseMD treatment Photos courtesy of Gilly S. Munavalli, M.D., M.H.S., F.A.C.M.S. Lutronic s new vaginal rejuvenation application, the Action II is a multipurpose fractional Erbium:YAG laser that received CE mark clearance for treatment of vaginal relaxation syndrome and stress urinary incontinence. The treatment is non-surgical, non-invasive and easy to perform, allowing practitioners to effectively treat a wide-range of vulvovaginal symptoms and conditions, stated Dr. Weiner. I think we are just scratching the surface with this device, because it can also work well for ablative skin resurfacing. On the vaginal rejuvenation side, it offers a quicker process that is very well tolerated by patients and achieves better results than competing systems. There are also potential combination therapies that use the INFINI and the Erbium laser. Other newer systems include the novel LaseMD, a Thulium laser that is changing the way the world thinks about non-ablative technology. This device is an advanced laser system that is designed to Before and after three LaseMD treatments Photos courtesy of Steven Swangel, M.D. work in concert with specially formulated cosmeceutical compounds, which are delivered into the skin via micro-wounds that are created by the LaseMD laser. The LaseMD creates a great niche for Lutronic, said Dr. Weiner. While the Spectra and INFINI have been solid systems for some time, Lutronic has done a great job with technology development efforts, such as laser resurfacing with the introduction of the LaseMD, without using topical anesthesia. Tatjana Pavicic, M.D., a dermatologist in Munich, Germany, utilizes the LaseMD system practically every day, Because it does not need any preparation time and has almost no patient downtime, she said. Due to its non-invasive treatment and the ability to interact with cosmeceuticals, you can use it on any skin type and patients of all ages. It also works well for different indications, from pigmentary problems to anti-aging and even treating superficial wrinkles. I also use the eco2 laser, which is effective for skin resurfacing and tightening, as well as treating acne scars. Adding body sculpting to the company s lineup of products, the new encurve device features an advanced form of RF-based energy that utilizes a specialized frequency (27.12 MHz) to selectively target and heat adipocytes to the optimal temperature to cause denaturation of cells, thus leading to adipocyte death. THE European Aesthetic Guide Volume

8 The encurve is an interesting device that completes Lutronic s portfolio with a body contouring system, said Dr. Weiner. And it is quite powerful, as well. In Dr. Loghdey s experience, the encurve is becoming more popular with people. This will be a system to watch. It is a new technology that patients are just starting to learn about. encurve fills a very real need because a lot of patients are looking for noninvasive treatments to address body shape, size and weight. No other system is as effective when talking about this particular type of RF. The encurve is efficacious, with minimal downtime. Another new product, the Picoplus picosecond laser system, perhaps best epitomizes the company s approach to taking aesthetic technology to the next level. The Picoplus is more powerful than any other picosecond laser on the market, stated Dr. Weiner. It has four wavelengths, a variety of spot sizes and a fractional component for skin rejuvenation. It is good for Asian skin rejuvenation, which is a difficult skin type to treat, but Lutronic perfected treatments on darker skin types. It is clear that this has both pico and nano technologies built into a single platform. For Dr. Loghdey, Picoplus is his favorite device. It is a picosecond laser that really addresses a multitude of problems, he reported. Initially it performs tattoo removal, which is a growing market. We can remove them in one-third to one-half of the time that it took in the past. The cost is much better for our patients, as well as the efficacy. Laurence Imhof, M.D., head of the division of Esthetic Dermatology, Laser Medicine and Photodermatology at University Hospital Zurich, recounted a story about one of her Picoplus patients. I had a young patient who had accidental tattooing on his face due to an explosion in Afghanistan, whom I treated successfully with the Picoplus. Overall my patients are really happy with their results. In addition, the system offers many other benefits, including pigment removal, rejuvenation and laser facial toning, Dr. Loghdey expressed. The user interface Before and after encurve treatment Photos courtesy of Michelle Gueseloff, M.D. Before and after Clarity treatment Photos courtesy of Bettina Rümmelein, M.D. Ephelides before and after one Picoplus treatment Photos courtesy of G.S. Lee, M.D. is very friendly and comes with a toggle function for adjusting fluence energy settings very easily. Settings can be adjusted at any stage of treatment and the warm up time is very quick. For treating pigmentary problems, the Picoplus is safe on all skin types. This is very important, added Dr. Loghdey. I also use it to perform a lunchtime facial where patients get a quick treatment with no downtime, so they can go back to work an hour later. 8 THE European Aesthetic Guide Volume 15

9 In particular, the Picoplus has been very helpful in treating melasma, Dr. Loghdey continued. This is an extremely difficult condition to treat that often comes back, he said. With other laser systems I would find that there would be an initial improvement, but then at some point the condition would rebound. With the Picoplus system, we are able to stay on top of this condition, so it has been a bonus having it in our practice. Tattoo previously treated with nano and pico lasers before and after three Picoplus treatments Photos courtesy of G.S. Lee, M.D. Overall, Lutronic systems have had a very positive impact on Dr. Pavicic s clinic. I recently opened another clinic and added new Lutronic devices, she said. They always work well and are ready to use almost immediately. I don t have to wait five minutes for them to start like some other systems I ve used. But most importantly, they are safe and I can manage any risks very efficiently. As a result, patients proactively ask for these procedures and we see increased patient satisfaction, as well as better turnover and conversion rates. Satisfaction has been very high and we ve not had any serious adverse events. That makes me confident. In order to meet what is seen as a growing demand for its systems, Lutronic has boosted its technical support capabilities. As stated by Dr. Weiner, With picosecond lasers you have to make sure that the company is reliable and they have good service because picosecond lasers can be finicky. I have no problem working with Lutronic s technical support, though there really are very few problems that I have encountered with their devices. The highly trained technicians respond quickly and fix any issues in a single visit. That has to be factored into the cost equation when you purchase a laser-based device. Before and after Picoplus treatment Photos courtesy of G.S. Lee, M.D. According to Dr. Ibrahimi, Having more options available to individual practices is a winning scenario. Lutronic s wonderful portfolio of products will also raise the bar and force other companies to improve their product offerings, which will ultimately increase the quality available to individual practices. I ve been working with Lutronic for over five years and have been impressed with their growth trajectory. I attribute this to their wonderful products and great customer service. As Mr. Hwang asserted, prospects for Lutronic s global push are extremely bright. We have more than 10,000 customers worldwide who have found a home with us. In addition, we have the stable financial structure and funding that will make this continued expansion a success. This very strong financial ability and dedication to technology advancements will bring us closer to our customers, he said. Dr. Weiner concluded, This is a solid manufacturer and they are financially very sound, and that is something you need to evaluate when you buy aesthetic devices. In an environment where larger players are acquiring so many energybased device suppliers, a big concern for practitioners is; what does the future hold for these companies? Is the research going to continue? Will the product lines be upgraded and will there be new products created that offer the latest technology advancements? In the case of Lutronic, the answer is a definite yes. THE European Aesthetic Guide Volume

10 SCIENTIFIC ADVISORY BOARD Maurice Adatto, M.D. Medical Director Skinpulse Dermatology & Laser Center Geneva, Switzerland Daniel Cassuto, M.D. Professor of Plastic Surgery University of Catania Catania, Italy Doris J. Day, M.D. Clinical Assistant Professor of Dermatology NYU Langone Medical Center Director Day Dermatology and Aesthetics New York, NY, USA Macrene Alexiades-Armenakas, M.D., Ph.D., F.A.A.D. Assistant Clinical Professor Yale University School of Medicine New Haven, CT, USA Director Dermatology and Laser Surgery New York, NY, USA Henry Chan, M.D., Ph.D., M.B.B.S., F.R.C.P., F.H.K.C.P., F.H.K.A.M. Dermatologist Honorary Professor Li Ka Shing Faculty of Medicine University of Hong Kong Hong Kong, China Koenraad De Boulle, M.D. Director Aalst Dermatology Group Aalst, Belgium Red M. Alinsod, M.D., F.A.C.O.G., A.C.G.E. Urogynecologist and Pelvic Reconstructive Surgeon Laguna Beach, CA, USA Gregory W. Chernoff, M.D., F.R.C.S. Plastic Surgeon Medical Director Chernoff Cosmetic Surgery Indianapolis, IN and Santa Rosa, CA, USA Jason B. Diamond, M.D., F.A.C.S. Diplomate American Board of Facial Plastic and Reconstructive Surgery Los Angeles, CA, USA Tina Alster, M.D. Washington Institute of Dermatologic Laser Surgery Washington, D.C., USA Suneel Chilukuri, M.D., F.A.A.D., F.A.C.M.S. Cosmetic and Dermatologic Surgeon Houston, TX, USA Barry DiBernardo, M.D., F.A.C.S. New Jersey Plastic Surgery Montclair, NJ, USA Benjamin Ascher, M.D. Plastic Surgeon Clinique IENA Lecturer and Clinical Assistant Paris Academy Paris, France Hong-Kyu Cho, M.D. Plastic Surgeon NB Plastic Surgery Clinic Seoul, Korea Christine Dierickx, M.D. Medical Director Skinperium Boom, Belgium Peter Bjerring, M.D., Ph.D. Professor of Dermatology Aarhus University Hospital Vejle, Denmark Joon-Yong Choi, M.D. Chief Plastic Surgeon Dream Plastic Surgery Group Seoul, Korea Jason Emer, M.D., F.A.A.D. Board Certified Dermatologist Beverly Hills, CA, USA Kevin Brenner, M.D., F.A.C.S. Board Certified Plastic and Reconstructive Surgeon ROX Center Beverly Hills, CA, USA Steven R. Cohen, M.D., F.A.C.S. Medical Director FACES+ Plastic Surgery Skin and Laser Center Clinical Professor of Plastic Surgery University of California, San Diego La Jolla, CA, USA Sabrina Fabi, M.D. Board Certified Dermatologist Goldman, Butterwick, Fitzpatrick, Groff & Fabi Cosmetic Laser Dermatology San Diego, CA, USA Gregory Buford, M.D., F.A.C.S. Board Certified Plastic Surgeon Beauty by Buford Englewood, CO, USA Angelo Cuzalina, M.D., D.D.S. Past President American Academy of Cosmetic Surgery, 2011 Diplomate American Board of Cosmetic Surgery Tulsa, OK, USA Klaus Fritz, M.D. Director, Dermatology and Laser Centers Landau, Germany Associate Professor Carol Davila University of Medicine and Pharmacy Bucharest, Romania President, European Society of Laser Dermatology 10 THE European Aesthetic Guide Volume 15

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12 SCIENTIFIC ADVISORY BOARD Takahiro Fujimoto, M.D., Ph.D. Medical Director Clinic F Laser and Skin Centre Tokyo, Japan Pearl E. Grimes, M.D. Director Vitiligo and Pigmentation Institute VPI Cosmetic Center Los Angeles, CA, USA Chang-Hun Huh, M.D., Ph.D. Clinical Assistant Professor Department of Dermatology Seoul National University Budang Hospital Gyeonggi, Korea Ma. Teresita G. Gabriel, M.D., F.P.D.S. Chair Department of Dermatology Research Institute for Tropical Medicine Alabang, Muntinlupa City, Philippines Sanjay Grover, M.D., F.A.C.S. Diplomate American Board of Plastic Surgery Newport Beach, CA, USA Christopher Inglefield, B.Sc., M.B.B.S., F.R.C.S.(Plast) Medical Director London Bridge Plastic Surgery & Aesthetic Clinic London, UK Dore J. Gilbert, M.D. Dermatologist Newport Dermatology & Laser Associates Newport Beach, CA, USA Ka-lam Hau, M.B.Ch.B., M.R.C.P., F.H.K.A.M., F.H.K.C.P., D.C.H. Dermatology Specialist Hong Kong SAR, China Garo Kassabian, M.D., F.A.C.S. Dual Board Certified Plastic and General Surgeon Founder and Medical Director Lift MD Aesthetics Beverly Hills, CA, USA Chee-Leok Goh, M.D., M.B.B.S., M.Med., M.R.C.P., F.R.C.P.E., F.A.M.S. Clinical Professor National University of Singapore Adj. Professor Duke-NUS Graduate School Sr. Consultant Dermatologist National Skin Centre, Singapore Per Hedén, M.D., Ph.D. Associate Professor of Plastic Surgery Karolinska Institutet Founder and Chairman Akademikliniken Private Hospital Group Stockholm, Sweden Bruce Katz, M.D. Clinical Professor of Dermatology Mount Sinai School of Medicine New York, NY, USA Michael H. Gold, M.D. Gold Skin Care Ctr. Tennessee Clinical Research Ctr. Clinical Assistant Professor Vanderbilt University School of Medicine Nashville, TN, USA Gangaram Hemandas, M.B.B.S., M.R.C.P., F.R.C.P., M.Med., F.A.A.M. Head and Consultant Dermatologist Department of Dermatology Prince Court Medical Center Consultant Dermatologist Tropicana Medical Center Petaling Jaya and Kuala Lampur, Malaysia Arielle Kauvar, M.D. Clinical Associate Professor of Dermatology New York University School of Medicine New York, NY, USA David J. Goldberg, M.D. Clinical Professor of Dermatology Mount Sinai School of Medicine New York, NY, USA Alberto Goldman, M.D. Board Certified Plastic Surgeon Clinica Goldman Porto Alegre, Brazil Chanyeong Heo, M.D., Ph.D. Assistant Professor Department of Plastic Surgery School of Medicine Seoul National University Chairman and Chief of the Department of Plastic Surgery Seoul National University Budang Hospital Seoul and Gyeonggi-do, Korea Sindy Hu, M.D. Department of Dermatology Chang Gung Memorial Hospital Taipei, Taiwan Suzanne Kilmer, M.D. The Skin Surgery Center of Northern California Sacramento, CA, USA Beom-Joon Kim, M.D., Ph.D. Dermatologist Head Professor and Chairman Department of Dermatology College of Medicine, Chung-Ang University Seoul, Korea Miles Graivier, M.D., F.A.C.S. Plastic and Reconstructive Surgeon North Atlanta Plastic and Reconstructive Surgery Roswell, GA, USA Peter Huang, M.D. Plastic and Cosmetic Surgeon Director Rebecca Cosmetic Institute Taipei, Taiwan Lorrie Klein, M.D. President Lorrie Klein, M.D. - Dermatology & Laser Center Euro Day Spa, Inc. Laguna Niguel, CA, USA 12 THE European Aesthetic Guide Volume 15

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14 SCIENTIFIC ADVISORY BOARD Malavika Kohli, M.D., D.V.D., D.N.B. Consultant Dermatologist Aesthetic Dermatologist Jaslok Hospital and Research Centre Director Skin Secrets Mumbai, India Joyce Teng Ee Lim, M.B.B.S., F.R.C.P.I., F.A.M.S. Dermatologist Joyce Lim Skin and Laser Clinic Singapore Visiting Consultant National Skin Centre Singapore Rhoda S. Narins, M.D. Clinical Professor of Dermatology NYU Medical Center Medical Director Dermatology Surgery and Laser Center Manhattan and White Plains, NY, USA Taro Kono, M.D. Department of Plastic and Reconstructive Surgery Tokyo Women s Medical University Tokyo, Japan Corey S. Maas, M.D., F.A.C.S. The Maas Clinic for Aesthetic and Facial Plastic Surgery Associate Clinical Professor University of California, San Francisco San Francisco and Lake Tahoe, CA, USA Kei Negishi, M.D., Ph.D. Associate Professor and Chief of Aesthetic Dermatology Division Aoyama Institute of Women s Medicine Tokyo Women s Medical University Tokyo, Japan Marina Landau, M.D. Dermatology Wolfson Medical Center Holon, Israel Daniel Man, M.D. Plastic Surgeon Boca Raton, FL, USA Joseph Niamtu, III, D.M.D. Cosmetic Facial Surgeon Richmond, VA, USA Moshe Lapidoth, M.D., M.P.H. Head of the Laser Unit Rabin Medical Center Tel Aviv, Israel Woraphong Manuskiatti, M.D. Professor Department of Dermatology Siriraj Hospital, Mahidol University Siriraj Skin Laser Center Bangkok, Thailand Andrew P. Ordon, M.D., F.A.C.S. Plastic Surgeon Host CBS talk show The Doctors Beverly Hills and Rancho Mirage, CA, USA Geun-Soo Lee, M.D., Ph.D. Dermatologist Drs. Woo and Hann s Skin and Laser Center Seoul, Korea David Matlock, M.D., M.B.A., F.A.C.O.G. The Laser Vaginal Rejuvenation Institute of Los Angeles Los Angeles, CA, USA Hsien-Li Peter Peng, M.D. Director Dr. Peng s Dermatological Clinic & Cosmetic Laser Center (P-Skin Clinic) Taiwan, Republic of China Wendy W. Lee, M.D. Assistant Professor of Clinical Ophthalmology, Oculofacial Plastic and Reconstructive Surgery Bascom Palmer Eye Institute, University of Miami Miller School of Medicine Co-Director UM Cosmetic Medicine Miami, FL, USA Tess Mauricio, M.D., F.A.A.D. Founder Scripps Ranch Dermatology and Cosmetic Center San Diego, CA, USA Jorge A. Perez, M.D., F.A.C.S. Plastic and Reconstructive Surgeon Perez Plastic Surgery Ft. Lauderdale, FL, USA Hang Li, M.D. Associate Professor Chief of the Dermatologic Surgery Division Department of Dermatology Peking University First Hospital Beijing, China David McDaniel, M.D. Laser Center of Virginia Virginia Beach, VA, USA Miriam Emily Piansay-Soriano, M.D., F.P.D.S. Davao Doctors Hospital Davao City, Philippines Yuanhong Li, M.D., Ph.D. Associate Professor of Dermatology Vice Chairman No. 1 Hospital of China Medical University Shenyang, China Ronald L. Moy, M.D. Dermatologist and Facial Cosmetic Surgeon Moy, Fincher and Chipps Facial Plastic & Dermatology UCLA Medical School Beverly Hills, CA, USA Jason Pozner, M.D., F.A.C.S. Medical Director Sanctuary Medical Aesthetic Center and Sanctuary Plastic Surgery Boca Raton, FL, USA 14 THE European Aesthetic Guide Volume 15

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16 SCIENTIFIC ADVISORY BOARD Nark-Kyoung Rho, M.D. Clinical Assistant Professor Department of Dermatology Samsung Medical Center Director Leaders Aesthetic Laser & Cosmetic Surgery Center Seoul, Korea Gordon H. Sasaki, M.D., F.A.C.S. Clinical Professor Department of Plastic Surgery Loma Linda Medical University Center Private Practice Pasadena, CA, USA Siak-Khim Tan, M.D., B.S. Medical Director The DRx Clinic Singapore Alexander Z. Rivkin, M.D. Facial Cosmetic Surgeon Founder Westside Aesthetics Los Angeles, CA, USA Gerhard Sattler, M.D. Founder and Medical Director Rosenpark Klinik Darmstadt, Germany Mark B. Taylor, M.D., F.A.A.D. Director Gateway Aesthetic Institute and Laser Center Salt Lake City, UT, USA Leif Rogers, M.D., F.A.C.S. Plastic and Reconstructive Surgeon Leif Rogers, M.D. Reconstructive and Cosmetic Plastic Surgery Beverly Hills, CA, USA Kyle Koo-Il Seo, M.D., Ph.D. Clinical Associate Professor BOTOX Clinic Department of Dermatology Seoul National University Hospital Director Modelo Clinic Seoul, Korea William Philip Werschler, M.D., F.A.A.D., F.A.A.C.S. Assistant Clinical Professor of Medicine/Dermatology University of Washington School of Medicine Seattle, WA, USA E. Victor Ross, M.D. Director Cosmetic and Laser Dermatology Unit Scripps Clinic San Diego, CA, USA Ava Shamban, M.D. Laser Institute for Dermatology Santa Monica, CA, USA Assistant Clinical Professor of Dermatology University of California, Los Angeles Los Angeles, CA, USA ChongHyun Won, M.D. Assistant Professor Department of Dermatology Ulsan University School of Medicine Seoul, Korea Mark G. Rubin, M.D. Assistant Clinical Professor of Dermatology University of California, San Diego Private Practice Beverly Hills, CA, USA W. Grant Stevens, M.D., F.A.C.S. Plastic Surgeon Marina Plastic Surgery Clinical Professor of Surgery University of Southern California Marina Del Rey, CA, USA Woffles Wu, M.B.B.S., F.R.C.S., F.A.M.S. Plastic Surgeon Woffles Wu Aesthetic Surgery & Laser Centre Singapore Neil Sadick, M.D. Clinical Professor of Dermatology Weill Cornell Medical College New York, NY, USA Insuck Suh, M.D., Ph.D. Professor Department of Plastic and Reconstructive Surgery College of Medicine, Hallym University Kangnam Sacred Heart Hospital Seoul, Korea Sabine Zenker, M.D. Dermatologist Dermatology Surgery Clinic Munich, Germany Claudine Santos-Roura, M.D., F.P.D.S. Dermatologist and Cosmetic Surgeon Contours Advanced Face and Body Sculpting Institute Manila, Philippines Nantapat Supapannachart, M.D. Dermatologist Clinical Professor Ramathibodi Hospital, Mahidol University Medical School Clinical Staff Bumrungrad Hospital Bangkok, Thailand Guoyu Zhou, M.D. Oral and Maxillofacial Surgeon Deputy Director Medical Laser Centre of Shanghai Jiaotong University Medical College, Ninth People s Hospital Shanghai, China Deborah S. Sarnoff, M.D., F.A.A.D., F.A.C.P. Clinical Professor of Dermatology NYU Langone Medical Center New York, NY, USA Atchima Suwanchinda, M.D., M.S. Consultant Laser and Dermatologic Surgery Unit Ramathibodi Hospital, Mahidol University Director Medisci Biointegrative and Anti-Aging Center Bangkok, Thailand Craig L. Ziering, D.O., F.A.O.C.D. CEO and Medical Director Ziering Medical Worldwide West Hollywood, CA, USA 16 THE European Aesthetic Guide Volume 15

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19 Aesthetic Insights THE Aesthetic Forum Showcases Top Players in $9.5 Billion Industry After 25 years of continuous unbridled growth, the global medical aesthetic industry shows no signs of slowing down. Medical Insight ( research shows that in 2017 the B2B side of this lucrative sector will exceed $9.5 billion in revenues with a projected 10.5% CAGR. On the procedure fee side, healthcare providers are generating over $25 billion per year with an estimated CAGR of 5.7%. This consistent expansion in a private pay arena is incredibly exciting to major global healthcare companies that want to hedge against government price controls on reimbursed drugs and devices. As a result, we are seeing an increase of high-level investor and corporate business development activity, combined with major investments in pipeline R&D projects focused on producing the next generation of aesthetic treatments and products. Private equity buy-outs of market leaders such as Syneron Candela are now competing with major manufacturers such as Allergan, Almirall, Hologic and Merz to grab the best assets in the industry. This bidding war environment explains the record-breaking valuations that ZELTIQ Aesthetics, Cynosure and Kythera recently obtained. Meanwhile, smaller competitors like Alma Lasers, The HyrdaFacial Company, Sienna Pharmaceuticals, Thermi, Valeant / Solta Medical, Revance Therapeutics and Viveve are taking advantage of this rising tide of investment frenzy to either execute on public offerings to raise large amounts of capital or to cash out via private equity players such as APAX. These tactical moves then lead to investors using the platform or the capital to make more acquisitions and build out their respective portfolios. In this extremely rich environment, innovative start-ups are claiming their niche position and building strategic value at an amazing rate. Some new ventures enter the market with a concept and then receive incredibly lucrative investment offers within a short period of time before they have even commercially launched or sold a single product. Michael Moretti Editor-In-Chief / Group Publisher In this extremely rich environment, innovative start-ups are claiming their niche position and building strategic value at an amazing rate. Based on the substantial business development demand to learn more about new opportunities and market potential faster, Medical Insight has created a very focused and exclusive event on February 18, 2018 in San Diego, California, U.S. during the American Academy of Dermatology (AAD) annual meeting. While this private invitation-only conference has no connection to the AAD, it will draw upon the top 25 medical aesthetic and pharmaceutical company executives in our industry to lead a progressive discussion and strategic analysis. Joining these seasoned business leaders will be several Wall Street analysts and major investors. If you wish to participate in this exclusive and highly immersive business development forum, please contact me directly for further details. THE European Aesthetic Guide Volume

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22 Fractional CO 2 GynoLaser Addresses Genitourinary Syndrome of Menopause By Anthony J. Varro, Contributing Editor Gayle Fischer, M.D., M.B.B.S. Associate Professor of Dermatology The University of Sydney Medical School Sydney, Australia With its patented GynoLaser applicator, the Fraxis fractional CO 2 laser by Ilooda (Suwon, South Korea) may help women with genitourinary syndrome of menopause (GSM). Low levels of circulating estrogen, the cause of GSM, can cause vaginal and/or vulvar dryness, burning, dyspareunia and urinary problems. While topical estrogen therapy is an effective treatment option even after breast cancer many women are understandably reluctant to undergo hormonal therapy, said Gayle Fischer, M.D., M.B.B.S., an associate professor of dermatology at the University of Sydney Medical School (Sydney, Australia). Estrogen is the physiological answer for post-menopausal vaginal problems, but there are a number of women who, for whatever reason, are unable to use it. Most of it centers around fear of breast cancer risk, Dr. Fischer explained. Allergy to or intolerance of the topical estrogen preparations, and side effects (such as increased risk of candidiasis), also make it difficult to use estrogen supplements, she noted. Despite a lack of robust evidence, ever since the microablative vaginal laser has become available, it has been enthusiastically used for many women, particularly in Australia, Dr. Fischer stated. Dr. Fischer likes that the GynoLaser was designed specifically for vaginal use. I do not have any concerns about safety. In the patients I have treated there have been no adverse effects, she shared. Nevertheless, the real questions are, how well does it work? Is it really a substitute for estrogen; and is it cost-effective? Currently, patients pay up to $3,000 (Australian dollars) per treatment cycle. This expense likely introduces a significant placebo effect, she indicated. In a small prospective study, Dr. Fischer and colleagues used the GynoLaser to treat six patients (median age 52 years) with GSM for free. Investigators applied topical anesthesia 20 minutes prior to treatment. Then, the treating physician inserted the cylindrical handpiece tip (covered with a disposable sleeve and operating at a fluence of 120 mj with 0.8 mm dot spacing) approximately 11 cm into the vagina and progressively withdrew it to treat the entire vaginal wall. Then we changed the handpiece to a conventional fractional tip for treating the vaginal vestibule (at 12 mj, 8 mm square spot). The whole procedure takes approximately five minutes, Dr. Fischer noted. Patients typically rate discomfort felt mostly during external treatment as three on a ten-point scale, and they usually experience slight soreness in treated tissues for a few days post treatment. Five patients completed the cycle of three sessions spaced one month apart; a sixth patient underwent two treatments. After treatment, four patients reported improvement in Dermal Life Quality Index (DLQI), Vulvar Disease Life Quality Index (VLQI) and Female Sexual Dysfunction Scale (FSDS) scores. Median VLQI dropped from 16/45 before treatment to 6/45 after (p= 0.043). Also, median FSDS decreased from 29 to 18 (p = 0.043). The GynoLaser s exact mechanism of action remains unknown, Dr. Fischer reported. As with facial treatments, we re creating microscars in the dermis that result in collagen regeneration, which contracts the dermis. What I find fascinating is that the treatment returns lubrication to the vagina. It must somehow be stimulating the glands in the vaginal wall to secrete again. So far, patients who responded well have maintained results up to six months post treatment, she said. Dr. Fischer and colleagues are already looking ahead to 2018 and have planned a double-blind, randomized, controlled trial in patients with GSM who have had breast cancer. What I find fascinating is that the treatment returns lubrication to the vagina. It must somehow be stimulating the glands in the vaginal wall to secrete again. So far, patients who responded well have maintained results up to six months post treatment. Illustration depicts vaginal tightening treatment with Ilooda s GynoLaser handpiece. Photo courtesy of Ilooda 22 THE European Aesthetic Guide Volume 15

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24 Ultrasound Visualization Creates Unrivaled Precision for Ultherapy By Kevin A. Wilson, Contributing Editor user learns using DeepSEE imaging plays a major role in how transducer depth is modulated. For example, since the introduction of Ultherapy Amplify software-optimization of treatment parameters, Ultherapy is more efficient and tolerable, but you want to avoid the bone. Treating on or below the bone surface is painful, and DeepSEE helps us avoid that as we choose which transducer to use, Dr. Bucay explained. There are other nearby tissue structures where the application of energy may cause unnecessary damage or at least provide no therapeutic benefit. The goal of any therapy is to target tissue or tissue structures that will lead to a therapeutic benefit, and avoid anything else. The better one can do that, the better any therapy will be. Vivian Bucay, M.D. Medical Director Bucay Center for Dermatology and Aesthetics San Antonio, TX, USA The use of ultrasound to visualize organs and tissue structures non-invasively has been a boon to medicine for decades. The Ulthera System from Merz Aesthetics (Frankfurt, Germany) utilizes that same energy as a therapeutic modality for noninvasive facial tightening, but still incorporates a real-time ultrasound visualization component known as DeepSEE imaging into the platform to provide unparalleled precision in treatment, a feature that sets Ultherapy apart. Ultherapy targets as deep as the superficial muscular aponeurotic system (SMAS layer), the same facial anatomy tightened during surgical face-lifting to combat tissue redundancy due to aging, in a single 30 to 90 minute treatment with no downtime. The capability to visualize subsurface tissue stratification is what makes truly effective non-invasive tightening of the SMAS possible. There is no substitute for having real-time visualization when performing a treatment of this type, said Vivian Bucay, M.D., medical director of the Bucay Center for Dermatology and Aesthetics (San Antonio, Texas, U.S.). We know exactly where we re supposed to be treating. We know where our target should be and can see where it is, exactly. You can know facial anatomy in and out and have years of experience, but until you see it you don t know where that individual patient needs to be treated. Everyone is different, so it s a great advantage that we re not treating blindly. We can see where we re supposed to treat, as well as structures we want to avoid. Ultherapy transducer depth can be set at 1.5 mm (superficial dermis), 3.0 mm (deep dermis) and 4.5 mm (SMAS/platysma), depending on the needs of the patient, and what the Before treatment 90 days after one Ultherapy treatment using DeepSEE technology Photos courtesy of Merz Aesthetics Using intensive, up-to-date training programs and regular forums promoting the free exchange of information, Merz keeps its physician partner base informed and performing so that the patient gets the best outcomes Ultherapy has to offer. I don t know of any company that spends as much time and money on their presence at conferences around the world, regularly bringing in expert physicians to share with users at all levels of experience, said Dr. Bucay, who herself has often been called upon in that capacity. Add to that the safety and efficacy, realtime imaging, and what I believe to be the best ROI of any treatment I offer, and you have a proven winner in Ultherapy. 24 THE European Aesthetic Guide Volume 15

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26 Non-Invasive Scizer Comfortably Melts Subcutaneous Fat By Kevin A. Wilson, Contributing Editor minimal discomfort for patients of any skin type. A typical course of Scizer treatment is three sessions at monthly intervals, Dr. Lim noted. Some patients may require additional sessions for a greater result, or will wish to treat other body areas, he said. Maintenance is not usually needed because this type of fat reduction is likely to be permanent, as long as patients adhere to a healthy lifestyle. Fat cells are destroyed by necrosis, which is irreversible cell death, and generally do not repopulate in number, although remaining adipocytes can still enlarge with excessive caloric intake. Adrian Lim, M.D. Dermatologist Royal North Shore Hospital Sydney, Australia Scizer from Classys, Inc. (Seoul, South Korea) combines the power of 2 MHz macrofocused scanning ultrasound (MSFU), with state-of-the-art intelligent cooling to melt subcutaneous adipocytes without damaging the epidermal barrier, for maximum safety and efficacy. Its linear scanning technology, harnessed for use with ultrasound, delivers the necessary energy in a remarkably consistent and reproducible manner for recontouring areas such as the abdomen, flanks or thighs with Before and after Scizer treatment Photos courtesy of Adrian Lim, M.D. According to Adrian Lim, M.D., a dermatologist at Royal North Shore Hospital in Sydney, Australia, it takes a lot of energy to permanently disrupt fat cells. Scizer s uniform linear scanning technology not only delivers ultrasound energy at precise depths, it allows for the accumulation of therapeutically adequate levels of energy, which carefully elevates subcutaneous tissue temperature to between 65 C and 70 C, to destroy fat cells, without sedation or analgesia. But the key to patient comfort is the built-in intelligent cooling system, he added. Contact Cooling Control is coordinated with energy delivery to protect skin and surface tissue structures, focus thermal effect at the target depth, and minimize the perception of pain. Detailed demonstration of Scizer outcomes and its mechanism of action have been reported in scientific literature. 1 Outcomes begin to manifest soon after the first session. There may be some initial mild swelling and bruising, which resolves predictably, Dr. Lim continued. Real improvement in contour will be noticeable by the third or fourth week, with subsequent applications leading to progressive improvement in contour and reduction in circumference. One of the best aspects of Scizer treatment is the natural look of the result, created by the diffusion of energy and the way the body responds as it removes fat and cellular debris. We see noticeable fat reduction without evidence of imprints, divots or uneven contours. The 9 mm and 13 mm spot size cartridges improve coverage and treatment speed, but there are other advantages as well. Scizer is not only effective and well tolerated, enabling flexible and personalized targeting of different body areas, it is fast, with procedure times of about two minutes per area, Dr. Lim reported. Scizer is safe and predictable enough for use by ancillary staff rather than the physician, and patients enjoy the hands-on attention of staff during therapy. In addition to being tolerable, the procedure itself is clean and efficient because no topical anesthesia or sticky contact facilitating gels are required. Furthermore, since Scizer does not employ a laser, no special laser certification/ licensing or goggles are required. Reference: 1. Kwon TR, Im S, Jang YJ, et al. Improved methods for evaluating pre-clinical and histological effects of subcutaneous fat reduction using high-intensity focused ultrasound in a porcine model. Skin Res Technol 2016;0: THE European Aesthetic Guide Volume 15

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32 Fotona 4D Provides Fast Non-Invasive Face-Lift By Anthony J. Varro, Contributing Editor Annamaria Pfau, M.D. Policlinic Novakov i Sar. Novi Sad, Serbia Marijana Krsticevic, M.D. Policlinic Novakov i Sar. Novi Sad, Serbia Fotona s (Ljubljana, Slovenia and Dallas, Texas, U.S.) 4D procedure, performed via the SP Dynamis, treats all the required levels of tissue to provide a quick, comfortable and effective non-invasive face-lift. According to Annamaria Pfau, M.D., of the Policlinic Novakov i Sar. in Novi Sad, Serbia, the complementary combination of Er:YAG and Nd:YAG wavelengths is at its best in 4D Fotona treatment. It provides deep thermal firming effects with superficial peeling and buccal firming, she explained. Together, the superficial ablative effect of the Er:YAG laser (2940 nm) and the deep tissue stimulation of the Nd:YAG laser (1064 nm), give the effect of glowing, firmer, more toned skin. The 4D procedure works especially well when combined with platelet-rich plasma (PRP), said Marijana Krsticevic, M.D., who also practices at Policlinic Novakov i Sar. Dr. Krsticevic shared a recent case, which involved a 43-year-old female with no previous history of aesthetic treatments who presented with relaxation of the lower face and cheeks, skin tone and discoloration concerns and fine lines. After thoroughly cleaning the patient s face, Dr. Pfau and Dr. Krsticevic performed the four steps of 4D treatment. Step one involves intraoral treatment with the Er:YAG laser in SMOOTH mode (2 J/cm 2, 1.6 Hz, 7 mm spot size, three to four passes on each side of the mouth). This helps firm and lift the nasolabial region, Dr. Krsticevic noted. Step two consists of a full-face treatment with the Nd:YAG laser in FRAC3 mode (35 J/cm 2, 1.6 ms, 1.5 Hz, 6 mm spot) to correct skin imperfections and light to moderate lines. Step three is a full-face treatment with the Nd:YAG laser in PIANO mode (110 J/cm 2, 5 second pulses, 1.5 Hz, 9 mm spot). Dr. Krsticevic pointed out that with a few passes on each region effective heating is reached and the emission of long pulses rapidly and safely warms the deep skin structures, leading to overall firming of tissue. Step four includes fractional superficial peeling with the Er:YAG laser (50% coverage at 4 J/cm 2, 6 Hz, 1 ms pulse, 7 mm spot). Partially ablating the superficial epidermis leads to healthier, firmer skin and a more even complexion, Dr. Pfau reported. Typically Dr. Krsticevic and Dr. Pfau also target the neck during treatment, avoiding the area above the thyroid gland with the deeply penetrating Nd:YAG modalities. Before treatment After treatment a cream containing glycerin, cyclopentasiloxane, cyclohexasiloxane, panthenol, zinc gluconate and dimethicone was applied, Dr. Krsticevic shared. The patient was instructed to apply it several times daily for the next week. We also recommended a high SPF sunscreen. Post-treatment, the patient experienced slight erythema that resolved within one day, followed by mild flaking a couple of days later. The 4D laser treatment took around 45 minutes, Dr. Pfau stated. We use chilled-air cooling, which in the vast majority of cases is more than enough anesthesia to perform this efficient yet safe, comfortable therapy. Two weeks after 4D treatment, the patient also received PRP therapy. 45 days after SP Dynamis 4D treatment followed by PRP treatment Courtesy of Annamaria Pfau, M.D. and Marijana Krsticevic, M.D. To maximize results, both Dr. Pfau and Dr. Krsticevic recommend repeating the 4D procedure two to three months after the initial application. 32 THE European Aesthetic Guide Volume 15

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34 Cutera s enlighten Platform Delivers Powerful Photodamage Treatment By Kevin A. Wilson, Contributing Editor Sach Mohan, M.D. Revere Clinics London, UK Powering away the pigmentary signs of photo-aging and photodamage, the PICO Genesis and PICO Genesis FX protocols for the versatile enlighten laser system from Cutera, Inc. (Brisbane, California, U.S.), utilize picosecond pulse capabilities for maximum clinical impact and outstanding results for overall skin tone and appearance. By creating zones of laser-induced optical breakdown (LIOB) in the dermis, skin quality is improved, pigment is resolved and a lighter, more even skin tone is achieved. Primarily a pigment and tattoo laser system, the high-performance enlighten platform features a full range of spot sizes and variable pulse durations in the nano and picosecond domains, using non-ablative 532 nm, 670 nm and 1064 nm wavelengths through a single handpiece, without consumables or contact with the skin. Its new micro lens array (MLA) attaches to the Sabika Karim, M.D. Revere Clinics London, UK handpiece to create a fractional effect. Users transcend the limits of basic pigment lasers by harnessing the platform s unrivaled power and adjustable pulse delivery to target pigment with photomechanical, rather than photothermal treatment vectors, with little or no downtime. What I appreciate the most in the dayto-day use of enlighten is that it has a userfriendly interface, making it easy to move between wavelengths and pulse durations at the touch of a button on the screen, said Sach Mohan, M.D., who practices at the Revere Clinics in London, U.K. Variation in spot size is just as easy with no need to change lenses or handpieces. But best of all, there are no consumables. PICO Genesis and its sister, PICO Genesis FX (using the MLA attachment), combine high power and picosecond pulse duration (with the 1064 nm or 523 nm wavelengths) to initiate a cavitation effect (via LIOB) that shatters pigment and improves overall tone without the usual heat injury and related side effects. Treatment is safe enough even for typically challenging skin types, such as Asian skin. In addition to pigment, collagen remodeling and revitalization of overall skin quality, the PICO Genesis FX treatment utilizing the MLA provides a three-in-one treatment for textural irregularities and more challenging pigmentation, as well as minor scarring and blemishes. Since water is not the target chromophore, the laser doesn t behave like your traditional CO 2 or erbium in that there are no ablation or coagulation zones, and the parameters allow for a no downtime, minimal, or moderate downtime protocol, where pinpoint petechia is visualized followed by a mild plasma ooze similar to that seen after microneedling, explained Sabika Karim, M.D., who practices with Dr. Mohan at the Revere Clinics. Downtime is dependent on how aggressive the treatment is, with postprocedure erythema and edema that can last between one day to a few days based on treatment density, number of passes and fluence. Two sessions are recommended at minimum, spaced four weeks apart, using either protocol seperately or both in combination. Furthermore, additional applications using enlighten s nanosecond pulse duration can further enhance outcomes. The capabilities of these protocols go beyond skin rejuvenation and these are being explored, Dr. Mohan noted. With our initial evaluation, the response for atrophic acne scarring has so far been on par with any traditional resurfacing laser, in a one-to-three session, six-week protocol, and we have been treating every Fitzpatrick skin type. Before and eight weeks after second PICO Genesis treatment and one PICO Genesis FX treatment Photos courtesy of Cutera Before and four weeks after PICO Genesis and PICO Genesis FX treatments Photos courtesy of Cutera 34 THE European Aesthetic Guide Volume 15

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36 Hybrid Laser and Light-Based Platform Addresses Multiple Skin and Vascular Conditions By Jeffrey Frentzen, Executive Editor Michael Drosner, M.D. Dermatologist Aesthetic Laser Specialist Schwerin, Germany The multi-modality, hybrid laser-based Nordlys Platform from Ellipse A/S (Hoersholm, Denmark) addresses a broad range of frequently encountered vascular and skin pigmentation disorders, including solar lentigines, melasma and rosacea; unwanted body hair, acne, scars and onychomycosis. Offering both intense pulsed light (IPL)-based skin rejuvenation and laser-based hair removal, this system also combines fractional and infrared lasers into a single device for the treatment of multiple conditions and larger areas more quickly, with fewer sessions. As reported by Professor Michael Drosner, M.D., a dermatologist and aesthetic laser specialist in Schwerin, Germany, I use Nordlys on many different kinds of blood vessels, from spider veins and venous lakes of the lip, to tiny or large hemangioma and enlarged vessels like venectasia. The precision of the device enables two distinct methods of treating telangiectases and angiokeratoma, as well as symptoms of rosacea and acne. In addition, the system offers a solution to other conditions, such as xanthelasma or sebaceous gland hypertrophia, which are perfectly treated by the Nordlys s noninvasive Nd:YAG component, he stated. Using the Nordlys, Prof. Drosner gained the ability to treat deeper vessels, as well. I can also use the Nd:YAG to treat smaller, awkwardly placed vessels, he said. Thicker hemangioma could be squeezed out by compressing them with the window tip the Nd:YAG comes with three different treatment tips which would reduce the amount of chromophore and thus the risk of overheating. This system also features Selective Waveband Technology (SWT ), which utilizes a proprietary dual-mode filter that delivers only wavelengths beneficial to treating the intended chromophores, excluding those wavelengths that mostly heat water. This allows for a more targeted outcome with less pain or discomfort. The user interface includes an expert mode that allows the practitioner to further fine tune settings to fit individual patient needs. Both the Nd:YAG laser and the SWT narrowband IPL have met my needs and the needs of my patients, said Prof. Drosner. In addition, the Nd:YAG has a unique cooling mechanism. Instead of freezing the area, which causes the vessels to constrict, the system uses a stream of cool air, which makes treatment more comfortable for the patient and allows me to more easily see the target. SWT gives practitioners a choice of longer or smaller pulse durations, and even greater flexibility of treatments, Prof. Drosner added, Especially in the case of homogeneous redness occurring in portwine stains, ulerythema or erythematous rosacea, which can be cleared with fewer treatments since these short pulse durations fit better with the smaller vessel diameter present in those disorders. Having this combination offers a significant advantage over pulsed dye lasers, noted Prof. Drosner. The narrowband wavelengths (530 nm to 750 nm or 555 nm to 950 nm) allow a more variable penetration depth. We can better target an increased number of different vessel diameters, meeting specific relaxation times. As Prof. Drosner concluded, In my professional career, I have used many different Nd:YAG lasers from several manufacturers but I chose the Nordlys by Ellipse due to its wide-range of effective treatments. In my professional career, I have used many different Nd:YAG lasers from several manufacturers but I chose the Nordlys by Ellipse due to its wide-range of effective treatments. Diffuse redness before and after one Nordlys treatment Photos courtesy of Michael Drosner, M.D. 36 THE European Aesthetic Guide Volume 15

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38 Middle Eastern Patients Seek Painless and Effective Feminine Rejuvenation By Jeffrey Frentzen, Executive Editor The Viveve system employs cryogen-cooled monopolar radiofrequency (CMRF) energy to deliver controlled heating 3 mm to 5 mm into mucosal tissue. This ability to cool and protect the surface tissue allows practitioners to reach, as well as volumetrically heat and remodel, the deeper vaginal tissue without damaging the epithelial layer. According to Uzay Yildirim, M.D., a plastic surgeon in Ankara, Turkey, Feminine rejuvenation is gaining increased recognition throughout the Middle East and definitely deserves even more. This treatment represents a painless, effective, single-session approach to address vaginal laxity and other women s health concerns, stated Maria Azarova, M.D., a regional brand and training manager in the medical machine department at Medica, and aesthetic physician in Dubai, United Arab Emirates. In the past, I ve used RF-based technology for body shaping and skin tightening, so it was very exciting to see that we could apply this proven technology to vaginal laxity, which can contribute to incontinence and reduced sexual sensation, she said. Uzay Yildirim, M.D. Plastic Surgeon Ankara, Turkey Maria Azarova, M.D. Aesthetic Physician Regional Brand and Training Manager, Medical Machine Department Medica Dubai, UAE The Geneveve treatment is an effective, single session, nonanesthetic procedure with no downtime, Dr. Yildirim explained, adding that the target patient is easily identified. Potential patients include almost all women, especially those who suffer from vaginal introital laxity. They are the best candidates regardless of a history of giving birth. With the introduction of energy-based aesthetic platforms offering safe, effective and painless treatments without the need for surgery, non-surgical feminine rejuvenation procedures are on the rise in the Middle East region, similar to most everywhere else in the world. One such platform is standing out from the rest. The Geneveve treatment by Viveve (Englewood, Colorado, U.S.) utilizes the Viveve System, a non-ablative medical device, for the treatment of introital laxity to improve sexual function. For women of the Middle East region, there is a heightened awareness around the available procedures for these issues and the demand is growing, Dr. Azarova expressed. Vaginal laxity treatments are extremely popular, she added, In all age groups, in some cases as early as the 20s. Another distinction of the Geneveve treatment is that since it focuses on the introitus, or lower third of the vaginal canal, it is a minimally invasive and dignified procedure. In this region, cultural tradition has many women having many children, which results in laxity, Dr. Azarova indicated. Also, men are allowed to have more than one wife, so you can imagine the pressure these women feel in this sense. Regardless of region or culture, managing patient expectations is key to successful treatment outcomes, stated Dr. Yildirim. I strongly believe that this procedure is the best one on the market, so it is very important to explain what the treatment might accomplish, and discuss the patient s expectations. The Geneveve treatment delivers cryogen-cooled monopolar radiofrequency to the introitus to improve vaginal laxity in a single, 30 minute session. Photo courtesy of Viveve, Inc. Marketing feminine rejuvenation treatments in the Middle East tends to be by word-of-mouth and internal marketing approaches, Dr. Azarova pointed out. It is difficult to market this type of treatment using local mass media, such as TV and magazines. However, in the physician s clinic, it is fine to put up a banner or hand out flyers to promote it. Plus, patients coming in are very well informed and educated about the procedure, mostly via the Internet. Also, in this area there are many ladies clubs where people exchange information. 38 THE European Aesthetic Guide Volume 15

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42 New Applicator Extends Cryolipolysis Reach to Include Effective Upper Arm Treatments By Jeffrey Frentzen, Executive Editor Jean-Michel Mazer, M.D. Dermatologist and Medical Director Centre Laser International de la Peau Paris, France As the latest entry in the growing list of CoolSculpting applicators, the new CoolAdvantage Petite from ZELTIQ Aesthetics (Pleasanton, California, U.S.) answers what was once a lingering need for non-invasive fat reduction treatment of the upper arms via Cryolipolysis. Using Cryolipolysis to freeze and permanently destroy fat cells while leaving the skin unharmed, CoolSculpting treatments with the new CoolAdvantage Petite applicator last around 35 minutes, giving operators a choice of interchangeable contours for addressing the upper arms and small pockets of fat. Tracy Mountford, M.B.B.S., M.B.C.A.M. Founder and Medical Director The Cosmetic Skin Clinic London, UK Jason K. Rivers, M.D., F.R.C.P.C., F.A.A.D. Medical Director Pacific Derm Clinical Professor Department of Dermatology and Skin Science University of British Columbia Vancouver, BC, Canada founder and medical director of The Cosmetic Skin Clinic (London, U.K.). It can be used on the upper arms to obtain a very smooth contour by overlapping the central part of the bulge. It is a very good applicator that can really hold in that fat bulge. The clinical trials were very impressive. It is going to be very popular. The ideal candidate has limited areas of pinchable subcutaneous fat that cannot be treated using the other CoolSculpting applicators, noted Jason K. Rivers M.D., F.R.C.P.C., F.A.A.D., clinical professor in the department of dermatology and skin science at the University of British Columbia, and medical director of Pacific Derm (Vancouver, British Columbia, Canada). For the arms, the overlying skin should have good tone and elasticity, but without laxity in order to avoid accentuating the latter after fat has been reduced, Dr. Rivers continued. We use all the applicators alone or in combination. The CoolAdvantage series is great because it reduces treatment times, in some cases by almost 50%. Patient satisfaction is very high, expressed Dr. Mountford. CoolSculpting results are generally very good and we can pretty much expect the same from a bespoke treatment and applicator for the upper arms. CoolSculpting for arms has been a very positive addition to Dr. Rivers practice. As with CoolSculpting in general, not only has the number of treatments grown quickly by virtue of the procedure s efficacy, but also patients are encouraged to try other services available at our center, he said. As reported by Dr. Mazer, Soon after we started using the CoolAdvantage Petite applicator we found it to be very popular, effective and safe for patients. The CoolAdvantage Petite is a worthwhile investment for CoolSculpting practices, Dr. Mountford added. CoolSculpting is always focused on end points that achieve better results for patients, she stated, and this applicator is a natural progression of that innovation. For Jean-Michel Mazer, M.D., a dermatologist and medical director of Centre Laser International de la Peau (Paris, France), CoolAdvantage Petite has been a welcome addition. It was needed because even though we have several sizes of applicators, including the CoolMini for submental treatments, we needed something to address the upper arms, in particular, he said. Many women asked for this treatment, and I ve found that the CoolAdvantage Petite applicator effectively addresses fat. This is the best kind of result that had been very difficult to achieve in the past. CoolAdvantage Petite is easy to use and does an excellent job, stated Tracy Mountford, M.B.B.S., M.B.C.A.M., Before and eight weeks after CoolSculpting treatment Photos courtesy of A. Jay Burns, M.D. Before and 12 weeks after CoolSculpting treatment Photos courtesy of Jason Rivers, M.D., F.R.C.P.C., F.A.A.D. 42 THE European Aesthetic Guide Volume 15

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44 New Vaginal Rejuvenation Procedure Features Novel Use of RF Energy By Jeffrey Frentzen, Executive Editor Gianluca Benincà, M.D. Plastic and Cosmetic Surgeon Professor L.U.de.S. University of Lugano Lugano, Switzerland As non-surgical, energy-based vaginal rejuvenation procedures explode in popularity worldwide, European practitioners now have a versatile choice in the EVA system from Novavision Group S.p.A. (Misinto, Milano, Italy). This unique device employs innovative Dynamic Quadripolar Radiofrequency (DQRF) energy designed to trigger anatomical remodeling in vulvar tissues. Compared with other non-invasive modalities, the EVA treatment offers a new approach to feminine rejuvenation. Lowenergy DQRF technology provides a novel interaction between the subepithelial layers of the vulva and the energy emitted by the system s RF generator, stated Gianluca Benincà, M.D., a plastic and cosmetic surgeon and professor at L.U.de.S. University of Lugano, Switzerland. This procedure is technologically superior, Dr. Benincà continued, noting the system s quadripolar 1.0 MHz to 1.3 MHz DQRF generator. The four electrodes are continuously electronically cycled between receiver and transmitter states. This hightech feature conveys energy with solid tridimensional precision in the subepithelial As demonstrated retrospectively in my study, this therapy seems to meet or exceed patients expectations both in terms of subjective aesthetic gratification, as well as self-esteem and impact on daily life. 35 year old patient with vulvar atrophy before and after one EVA treatment session layers of the vulva. This is why low-energy vulvar rejuvenation is often pleasant with no downtime. In addition, the risk of burns is virtually eliminated. Furthermore, the EVA s electronically controlled movement and temperature sensors allow the operator to fine tune the vulvar thermal effect in terms of both tissue volumes and depth. To test outcomes, Dr. Benincà conducted a recent clinical study following 25 healthy women that completed four treatment sessions of EVA, with a three month follow-up assessment. Working above all on collagen and elastin fibers as we know from the scientific literature, this simple procedure guarantees visible and perceived tightening and rejuvenation effects, Dr. Benincà stated. It demonstrates the efficacy of new DQRF technology when applied to vulvar rejuvenation. Clinical images show the tightening effect is clearly apparent after the first or second treatment session. In considering the overall biological effects of DQRF technology on patients, Dr. Benincà noted, The subjectively perceived vulvar aesthetics and the discomfort in everyday life such as loss of self-esteem, problems with intimate relationships and sex life are deeply related, and both have been improved by the EVA treatments. Patients expressed gratification for superior vulvar aesthetics, perceived psychological benefits, and the discomfort that improved greatly. The results were both aesthetically and functionally pleasing. This system is also easy to learn and use, Dr. Benincà expressed. Additionally, the procedure is free of any serious or disturbing complications, he said. None of my EVA patients have reported any clinically significant side effects, such as inflammatory states or discomfort during the procedures. As demonstrated retrospectively in my study, this therapy seems to meet or exceed patients expectations both in terms of subjective aesthetic gratification, as well as self-esteem and impact on daily life. The EVA vaginal rejuvenation therapy is safe, comfortable and effective, Dr. Benincà reiterated. DQRF technology overcomes the unwieldiness and safety problems of conventional light and energy-based vulvar rejuvenation devices. That s why I chose EVA. 44 THE European Aesthetic Guide Volume 15

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46 SculpSure Destroys Submental Fat in Two Easy Sessions By Kevin A. Wilson, Contributing Editor According to Dr. Bass, submental treatment with SculpSure, involves a more superficial focus point for attaining peak temperature, as well as higher energies than used when treating the body. The cycling of laser and cooling is different as well. The result is a uniquely thorough treatment of submental fat. In September 2017, SculpSure from Cynosure, Inc. (Westford, Massachusetts, U.S.) the first and only FDA cleared laser device for non-invasive lipolysis received clearance to diminish submental fat. This new treatment indication was proven effective on patients with a body mass index (BMI) of up to 43, while the closest competitor is only cleared to treat patients with a BMI of up to 30. In addition, this 1060 nm diode laser device is also indicated for non-invasive fat reduction of the abdomen, flanks and back, as well as inner and outer thighs. (n=57) received two treatments six weeks apart using the device, with excellent results and a 100% satisfaction rate. This technology has been precisely engineered to heat the fat while being extremely safe for the skin, he said. Treatment is predictable and reproducible regardless of skin type, which is important because unwanted submental fat can occur within persons of any ethnicity. The heating profile for the submentum is quite different than what is used for body applications because the fatty layer is thinner and closer to the surface. Additionally, the skin in this region is thinner and more sensitive than that of other body areas, but the protocol has been carefully refined through research and testing to provide excellent, visibly noticeable results comfortably. One of the beautiful things about this new indication is that there are no new applicators to purchase, Dr. Bass continued. The protocol for laser and cooling application requires just an upgrade to the device and a specially designed mask for attaching the applicators to the target area in the most therapeutically appropriate manner. This makes offering this new procedure very cost-effective. As previously mentioned, another SculpSure advantage is the treatability of higher BMI patients. Cryolipolysis is recommended for patients with a BMI no higher than 30, which does put a limit on its utility. Being able to effectively treat patients with a BMI as high as 43 allows us to offer effective fat reduction to larger patients, thus further expanding our patient base. Lawrence Bass, M.D. Plastic Surgeon New York, NY, USA Users attach SculpSure s laser applicator to the Submental headgear to effectively target fat underneath the chin. Laser energy cycles on and off to penetrate fat without damaging the skin, raising the temperature of underlying adipocytes to therapeutically relevant levels for long enough to disrupt them. Adipose tissue and cellular debris are cleared away naturally. Advanced Contact Cooling protects skin for a no downtime, 25 minute treatment that is easily tolerated without anesthesia, and the natural diffusion of heat energy prevents shelving or other visible demarcations of the treated area, for a supremely natural-looking outcome. Reduction of submental fat is a common aesthetic concern. Lawrence Bass, M.D., a plastic surgeon in New York, New York, U.S. was part of a multi-center SculpSure Submental trial in which most subjects Submental region before and 12 weeks after two SculpSure Submental treatments Photos courtesy of Lawrence Bass, M.D. Submental region before and 12 weeks after two SculpSure Submental treatments Photos courtesy of Bruce Katz, M.D. 46 THE European Aesthetic Guide Volume 15

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48 Delivers Promising Results for Lineae Albicantes By Kevin A. Wilson, Contributing Editor Daniel Cassuto, M.D. Plastic Surgeon Professor of Plastic Surgery University of Catania Milan and Catania, Italy Stretch marks, or striae, are an aesthetic nuisance for those who have experienced rapid weight changes or any other condition in which skin is stretched, causing reddish or purple lesions which, over time, turn white as the tissue atrophies and loses pigmentation. The appearance of stretch marks diminishes over time, but they do not disappear completely, and as with any mature scar, they can be difficult to resolve. Utilizing the unique synergy between needleless microtrauma and implantation of a therapeutic compound, JVR (jet volumetric remodeling) Powered EnerJet2.0 from PerfAction Technologies (Rehovot, Israel) provides an effective and valuable treatment option for striae, specifically for lineae albicantes or white stretch marks. The proprietary needle-free technology of EnerJet2.0 simultaneously delivers kinetic energy and a hyaluronic acid (HA) based healing compound via a tiny entry point in the epidermis (up to 200 microns). The molecular mass of the compound is accelerated by the pneumatic jet stream breaking through the fibrotic tissue of the scar. Acting as nano-bullets, the particles create a microtrauma during implantation, which stimulates the wound healing cascade with virtually no visible sign of damage, covering an area more than 2,500 times the size of the entry point, and gentle enough for even the most delicate areas of skin tissue. This combination of controlled microtrauma and implantation of healing compounds for each indication induces neocollagenesis and dermal remodeling, creating thicker dermal tissue and correcting skin imperfections for long lasting, healthy aesthetic improvement via a gentler, more natural pathway. For stretch marks, EnerJet rebuilds healthy dermal tissue while simultaneously supplying it with HA, a building block of the dermal extracellular matrix, for a more natural color and texture that diminishes the appearance of stretch marks. This low-downtime treatment is applicable to many scar subtypes and is safe for all skin types. With JVR technology, the specific scar area is treated, in contrast to other modalities such as laser skin resurfacing where a significantly larger area outside the scar is subject to treatment. EnerJet2.0 challenges the limits of non-surgical therapies for deep remodeling and long lasting skin treatments, incorporating a new dosing system, stronger jet, new lighter and more ergonomic applicator, and intuitive and modern user interface. The outcomes for stretch marks are the best I have seen in years, stated Prof. Cassuto. Controlled, uniform delivery of compounds plus kinetic energy, with high versatility in terms of areas that can be treated and different implanted formulas that can be used, make this a great non-surgical solution. This device is without a doubt, the best option for stretch marks on the market today, said Daniel Cassuto, M.D., a plastic surgeon in Milan, Italy and professor of plastic surgery at the University of Catania (Catania, Italy). Depending on the patient, it will take between one and three treatments to see results. More are needed in rare cases. Outcomes are outstanding, even three years after treatment. Prof. Cassuto mainly uses JVR Powered EnerJet for treatment of scarring and stretch marks, but sees its versatility as a key advantage. The fact that it can be used for a wide variety of indications is an important benefit we hope for in any device, he said. The ability to control depth of delivery of healing compounds is also a great advantage that no other solution offers. Stretch marks before and eight months after one EnerJet treatment Photos courtesy of Daniel Cassuto, M.D. This device is without a doubt, the best option for stretch marks on the market today. Outcomes are outstanding, even three years after treatment. 48 THE European Aesthetic Guide Volume 15

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50 INNOJECTOR Micro Vortex Technology Achieves Needleless Skin Remodeling that penetration depth is different depending on pressure and injected solution. 2 Prof. Kim also researched the histological analysis of INNOJECTOR in a mouse model. 3 Skin thickness and collagen fibers of the dermis were significantly increased after treatment. In addition, these effects lasted longer than conventional injections. After injection we observed activation of vimentin protein, thus we can suggest that INNOJECTOR effectively induced collagen synthesis via activation of vimentin in fibroblasts and myofibroblasts. All of these processes can reduce wrinkles. In comparison with other treatments, INNOJECTOR has the added advantage of being less invasive and less time-consuming than other therapies. Additionally, its speedy recovery time allows patients to return to their daily lives in a short period of time. Beom Joon Kim, M.D. Head Professor Department of Dermatology Chung-Ang Unversity Seoul, Korea INNOJECTOR from WONIK Corporation (Gyeonggi-do, Korea) features unique vortex technology, which delivers millions of micro jet bubbles to the active target. These micro bubbles stimulate fibroblasts, as well as promote collagen and elastin regeneration and remodeling. Upon initiation of this powerful, yet gentle modality, the propulsive micro jet stream travels through the epidermal layer to penetrate the dermis where the active target lies or even deeper. No injectable anesthesia is required. INNOJECTOR is unique in employing the smallest 100 µm spot size, resulting in less pain and shorter downtime as well. According to Beom Joon Kim, M.D., head professor in the department of dermatology at Chung-Ang University Hospital in Seoul, Korea, the effectiveness of INNOJECTOR treatment for scars has been proven by publications and clinical studies. Using pressurized air, the INNOJECTOR delivers medicinal fluid beneath the skin layer at a high speed of up to 180 m per second. This fluid is dispersed laterally into the skin in a near-spherical shape due to the inertia of the jet stream, he explained. Using this vortex technology, INNOJECTOR provides mechanical stimulation and drug delivery simultaneously. Treatment also targets the papillary layer, which is the most effective area for mechanotransduction therapy. During the wound healing process, growth factors are stimulated and formation of new collagen fibers are promoted. We have observed great improvement in patients with depressed, hypertrophic and/ or keloid scars. According to a cadaveric study of INNOJECTOR published in Lasers in Surgery and Medicine 1, various solutions such as saline, hyaluronic acid (HA) and placental extract that were introduced into the dermis evenly during treatment, resulted in an increased rejuvenation effect of skin. This study has histologically identified the mechanism and effect of INNOJECTOR, and proved Penetration depth and shape of INNOJECTOR micro jet stream depends on delivery pressure of the vortex technology and the solution used. Photos courtesy of Professor Beom Joon Kim, M.D. Scar before treatment Two months after INNOJECTOR treatment Photos courtesy of Professor Beom Joon Kim, M.D. References: 1. Investigating Skin Penetration Depth and Shape Following Needle- Free Injection at Different Pressures: A Cadaveric Study. Lasers Surg Med Aug;48(6): The NEEDLELESS MICROJET: a novel device for hypertrophic scar remodeling on the forehead. J Eur Acad Dermatol Venereol Nov;30(11):e145-e Needle-free jet injection of hyaluronic acid improves skin remodeling in a mouse model. Eur J Pharm Biopharm Aug;105: THE European Aesthetic Guide Volume 15

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52 Patients Value Positive Laser Treatment Experiences with Hybrid Fractional Halo By Kevin A. Wilson, Contributing Editor Christopher Robb, M.D., Ph.D. Dermatologist Medical Director Skin & Allergy Center Murfreesboro, TN, USA With an unparalleled capability to modulate treatment settings, as well as combine the effects of ablative and non-ablative laser energies, Halo from Sciton (Palo Alto, California, U.S.) provides patients with a safe and effective therapeutic solution that s as comfortable as needed. This device is ideal for addressing a variety of aesthetic and medical skin conditions including enlarged pores, dyschromia, erythema, fine lines and wrinkles, and other manifestations of sun damage, along with more delicate indications such as melasma, achieving noticeable results with minimal downtime. Dermatologist Christopher Robb, M.D., Ph.D., medical director of the Skin & Allergy Center (Murfreesboro, Tennessee, U.S.), discussed the patient experience with Halo. The ability to combine non-ablative 1470 nm and ablative 2940 nm wavelengths to varying degrees depending on the condition, while tuning the parameters to the unique situation, places the Halo s technology in a class by itself, he said. Having two different lasers firing at the same time, affecting the same section of skin, works synergistically. We need fewer treatments, maybe two versus the eight we d need with other lasers, and we can manage downtime; patients can wear makeup the next day in almost all cases. Next to safety and efficacy, managing comfort and downtime is a key factor to a positive patient experience. They will vividly remember how it felt, how long it took and similar aspects of the experience, even more so if it is negative, Dr. Robb continued. A positive experience helps to ensure compliance with physician directives and keep them excited about what s happening. Even at more aggressive settings, with Halo we generally see patients scoring discomfort no greater than 3 out of 10 on an analog scale with simple topical anesthesia and, if needed, mild oral analgesia. He added that this is also true for darker skin types, because even with less deposited energy Halo s dual-wavelength synergy causes a better overall effect. Another hallmark of Halo is rapid, consistent healing. Patients look completely healed in less than a week as well, Dr. Robb pointed out. I call this the referral machine because of the great treatment experience, low downtime and superior outcomes. Patients come back for more and enthusiastically recommend us to friends. For a real home run, Dr. Robb combines Halo with Sciton BBL broadband light therapy. Even for your average patient the before and after photographs of Halo and BBL combination treatments look like they were hand-picked for marketing. I think of Halo as the laser that does what the industry has seemingly been promising for years a wow effect in just a few treatments with minimal discomfort and downtime. The ability to provide patients with this level of outcome consistently is tremendously affirming. Halo is also cost-effective for patients, according to Dr. Robb. The overall result is much less expensive for patients to achieve, he explained. Not only does fewer treatments mean less financial outlay, but patients can be back at work in no time so they don t have to sacrifice income, which is appealing to everyone. 36 year old patient before and after one Halo Tx Photos courtesy of Christopher Robb, M.D., Ph.D. 52 THE European Aesthetic Guide Volume 15

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55 IMCAS Celebrates 20 Years of Educational Excellence and Innovation in Aesthetic Medicine By Jeffrey Frentzen, Executive Editor E very year the International Master Course on Aging Science (IMCAS) organizes educational conference events in some of the best destinations around the world, before returning home to Paris, France for its Annual World Congress. In 2018, it will be an exceptionally special homecoming, as IMCAS will be celebrating its 20th anniversary, marking two decades of excellence in the field of aesthetic medicine. From February 1 3, 2018 over 8,000 delegates and 600 expert speakers from all over the world will attend the critically acclaimed IMCAS Annual World Congress. THE European Aesthetic Guide Volume

56 IMCAS Celebrates 20 Years of Educational Excellence and Innovation in Aesthetic Medicine Aliaxin dermal fillers by IBSA Farmaceutici Stylage dermal fillers by Laboratoires VIVACY Hyabell dermal fillers by Adoderm Before and after mesoestetic Dermamelan treatment Photos courtesy of mesoestetic Pharma Group Control Site: dermis = 1.6 mm Treated Site: dermis = 3.0 mm Before and after PerfAction EnerJet2.0 treatment Photos courtesy of Abigail Arad, M.D. Over the past 20 years, IMCAS has built a reputation as being a world leader in medical aesthetic conferences, consistently receiving fantastic feedback from delegates. This year, the meeting will feature 270 educational hours and over 160 sessions, compressed into three days to ensure no one has to miss out on a lecture or workshop. Delegates can customize their learning experience by choosing from a vast array of courses that explore every aspect of aesthetic medicine. The important themes of this year s conference include body shaping, injectables, lasers and energybased devices, genital treatments, anti-aging, body, breast and face surgery, clinical dermatology, professional business, regenerative medicine and lipofilling, hair restoration and cosmeceuticals. As always, the famous Anatomy on Cadaver workshop is the can t-miss event of the congress. This extraordinary one-day workshop features a cadaver dissection by live satellite transmission and live treatment demonstrations. Physicians and other delegates should attend this workshop to discover how important it is to understand anatomy in all aesthetic procedures. The IMCAS Annual World Congress also boasts a range of other innovative educational formats including video classes that dive deep into a specific subject, target courses which offer practical training, and chaired lecture sessions featuring findings from international experts. These different approaches ensure that there is something for every learning style. IMCAS is always striving to build and improve on their past successes. The 20th anniversary congress, to be held over three levels at the Palais de Congres in the heart of Paris, promises to be the most impressive event yet. By attending symposia, product analysis workshops and visiting the exhibition hall, delegates at the 2018 IMCAS World Congress will also discover the newest products and devices on the market from 250 of the leading companies in our industry, including a variety of popular applications, from injectables to energy-based systems demonstrating the latest technological advancements. Among the dermal fillers on display, Aliaxin SR from IBSA Farmaceutici (Lodi, Lombardy, Italy) is a novel hyaluronic acid (HA)-based product that offers three molecular weights in a combination of cross-linked and natural HA. The clinical results supported by the rheological characteristics of Aliaxin SR show high tissue integration and deep hydration, which are lacking in many fillers. This novel formulation provides wrinkle filling and prevention, contour definition and skin texture improvement. Laboratoires VIVACY (Paris, France) offers STYLAGE XL and XXL, high density volumizing HA-based gels that can be used to restore volume to facial tissues that have diminished over time in the temples, cheeks, the oval of the face and the chin. Using STYLAGE volumizers and advanced facial contouring techniques, physicians are able to produce more face-lift like results to meet patient demands for long lasting, non-surgical treatment options. HYABELL fillers from Adoderm GmbH (Langenfeld, Germany) provide long lasting improvement, a convincing safety profile and incorporate lidocaine (0.3%) to facilitate the injection procedure, reduce pain and enhance patient satisfaction. HYABELL fillers have enhanced visco-elastic properties and softer extrusion forces than other HA-based dermal fillers, due to the innovative monophasic particle technology (MPT) used in the 56 THE European Aesthetic Guide Volume 15

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58 IMCAS Celebrates 20 Years of Educational Excellence and Innovation in Aesthetic Medicine production process. The optimized physical properties of HYABELL fillers allow better clinical results. Indications include lip contouring and lip augmentation; middle to deep dermis injection and correction of moderate facial wrinkles and folds; deep dermis and correction of deep folds; and subcutaneous tissue correction of deep folds and facial volumizing. Acne scars before and after three WONIK INNOJECTOR treatments Photos courtesy of WONIK Co., Ltd. HydraFacial system by The HydraFacial Company Ydun system by Ellipse Before and after eight Syneron Candela PicoWay treatments Photos courtesy of Tina Alster, M.D. Thunder MT by Quanta System In the area of novel skin-related solutions, Dermamelan from Mesoestetic Pharma Group (Barcelona, Spain) provides a medical lightening method for treating melanin skin spots, and is suitable for all skin types. It effectively combines professional treatment with at-home maintenance for rapid whitening of all types of skin blemishes at any time of year. Dermamelan s double action is corrective and regulative, to correct hyperpigmentation and regulate the overproduction of melanin in the melanocytes, thus preventing the appearance of new spots. As a result, it attenuates and eradicates melanin skin spots, restores radiance to the skin and improves skin tone. The EnerJet2.0 from PerfAction Technologies, Ltd. (Rehovot, Israel) simultaneously delivers kinetic energy and a healing compound, enabling a controlled deep micro-trauma profile effect for dermal remodeling. The result is smoother, well-hydrated and younger looking skin with long-term structural benefits. It also offers clinically proven solutions to treat acne scars, keloid scars, upper lips, stretch marks and submental wrinkles. Employing micro-jet VORTEX Technology (VT), the INNOJECTOR from WONIK Corporation (Seoul, South Korea) delivers both mechanical stimulation and enhancing compounds to the skin via intentional microdamage to dermal tissues. Kinetic Energy, the unit s pneumatic injection technology, induces collagen regeneration resulting in a thicker dermis and initiating a wound healing process to treat scars and also act as a face-lifting technology. HydraFacial, from The HydraFacial Co. (Long Beach, California, U.S.), uses proprietary vacuum technology that delivers serums via unique, spiral designed HydroPeel Tips. This process creates a vortex effect to easily dislodge and remove impurities from the skin while simultaneously introducing hydrating skin solutions containing potent antioxidants. This allows for unparalleled non-invasive skin resurfacing and temporary opening of pores to effectively cleanse, exfoliate and extract impurities evenly while simultaneously delivering proprietary serums to the skin. Top-of-the-line laser systems will be presented as well. This includes the Ydun from Ellipse (Hoersholm, Denmark), a very effective fractional laser system with a small and light design, featuring independent control of pulse length and energy via the Frax 1550 laser handpiece. Incorporating a user-friendly design and clinical intelligence, Ydun is an easy-to-use and effective tool. PicoWay from Syneron Candela (Irvine, California, U.S.), a remarkably innovative three wavelength (532 nm, 785 nm and 1064 nm) picosecond laser targets a wide-range of tattoo colors and pigmented lesions. It includes both full-beam and fractional capabilities. PicoWay s unique mode of action is based on delivering ultra-short picosecond pulses of energy to the tissue. These bursts of energy create a photoacoustic impact which breaks up the target pigment into smaller, more easily eliminated 58 THE European Aesthetic Guide Volume 15

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60 IMCAS Celebrates 20 Years of Educational Excellence and Innovation in Aesthetic Medicine particles. The new Resolve dual wavelength picosecond fractional module treats pigmentation, skin irregularities and signs of aging. VeLux by Ilooda Co., Ltd. Before and 45 days after one DEKA MOTUS AX treatment with Moveo technology (area near tattoo left untreated) Photos courtesy of P. Bonan, M.D. and M. Troiano, M.D. The Thunder MT from Quanta System, S.p.A. (Milan, Italy) is a cutting edge laser system offering up to two wavelengths 755 nm and 1064 nm in single or combined modes using Proprietary Mixed Technology. The system addresses hair reduction, vascular lesions and provides skin rejuvenation treatments, and the Optimized Spot Shape feature is designed to overcome the overlapping limits of traditional spot shapes. This platform can be also equipped with the OptiScan TH scanner, which utilizes AutoMotion technology to perform a variety of tailored and automatic low pain treatments. Laser-based systems for hair reduction include the VeLux 755 from Illooda Co., Ltd. (Seoul, South Korea), which offers a permanent solution by combining 755 nm and 810 nm laser wavelengths, based on diode motion scanning technology. By radiating simultaneously, these two wavelengths apply concentrated energy to remove unwanted hair. By taking full advantage of its sapphire cooling system, the epidermis is not only protected, but patient pain is also minimized during treatment without the use of anesthesia or numbing gels. Furthermore, the adjustable large 50 mm by 15 mm spot size enables practitioners to perform quick treatments. The MOTUS AX from DEKA (Calenzano, Firenze, Italy) is a 755 nm High Frequency Alexandrite laser system that offers painless and smokeless hair removal procedures. Utilizing DEKA s proprietary Mŏveō Technology, MOTUS AX offers a high degree of patient comfort. MOTUS AX procedures provide operators with easy-to-use full parameter control in three levels (soft, medium and high), as well as selectable energy levels that give physicians the ability to tailor treatments for all the skin types. primelase HR excellence by cocoon medical Cellfina System by Merz Aesthetics AWT treatment for facial wrinkles by STORZ MEDICAL The primelase HR excellence laser platform from cocoon medical (Barcelona, Spain) treats hair-related issues by offering a procedure that works at a high (4,800 Watts) peak power. Featuring three handpieces operating at 755 nm, 810 nm and a special mixed mode, practitioners are given a very effective and safe hair removal solution even for dark skin types. Exclusive Ultra Short Pulse (USP) technology delivers ultra-short pulses with a high fluence of energy, thus removing even residual hair. Still one of the fastest growing segments in our industry, it goes without saying that there will be numerous non-surgical body shaping devices discussed and presented that treat the full array of indications, including circumferential reduction, skin tightening and wrinkle reduction, as well as cellulite. The latest approach to cellulite reduction includes the Cellfina System from Merz Aesthetics (Frankfurt, Germany). Combining highly advanced, proprietary technology with Subcision, the unit treats the underlying structural cause of cellulite with precise and reproducible results. The Cellfina treatment is U.S. FDA cleared and E.U. CE marked, and effectively improves the appearance of cellulite for at least three years. After a single, minimally invasive treatment, participants of a clinical study reported 93% patient satisfaction at three years. 60 THE European Aesthetic Guide Volume 15

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62 IMCAS Celebrates 20 Years of Educational Excellence and Innovation in Aesthetic Medicine Before and after Zimmer Z Lipo and Z Wave treatment Photos courtesy of Zimmer MedizinSysteme STORZ MEDICAL s (Tägerwilen, Switzerland), CELLACTOR SC1»ultra«and D-ACTOR»ultra«are powered by advanced Acoustic Wave Therapy (AWT ) to treat cellulite, body contouring, skin elasticity and facial wrinkles. High-energy acoustic waves penetrate the adipose deposits and mobilize the metabolism activity in the subcutaneous fatty tissue. As a result, the upper layer of the skin becomes smoother in appearance and the circumference of the treated body regions is reduced. Powerful radial acoustic waves are applied to deep skin layers, such as epidermis, dermis and connective tissue. Complementing AWT is the firm s VACU-ACTOR vacuum therapy. The Z Lipo Cryolipolysis system from Zimmer MedizinSysteme (Neu-Ulm, Germany) enables non-invasive targeting of fat deposits for permanent reduction. This method cools fat deposits over a longer period of time to a controlled and safe temperature range. The combination of the firm s Z Lipo and Z Wave Pro shockwave therapy provides an effective treatment for significantly improved fat reduction while stimulating lymphatic drainage and also tightening the skin. Before and 12 weeks after one Cutera trusculpt treatment Photos courtesy of Cutera trusculpt from Cutera, Inc. (Brisbane, California, U.S.), offers a multidimensional RF-based approach to body contouring by directing clinically therapeutic temperatures to the subcutaneous adipose tissue to achieve high clinical efficacy in the shortest possible treatment time. The longer durations of deep uniform heating elevate the temperature within the targeted subcutaneous tissue, which increases basal metabolic activity in adipose tissue. This targeted, repeatable and uniform approach ensures that the best results are achieved. Dynamis Pro from Fotona (Ljubljana, Slovenia) combines complementary Nd:YAG and Erbium YAG laser wavelengths in a single, highly versatile system that performs an exceptionally wide-range of aesthetic treatments, including the TightSculpting procedure. This dual-wavelength, non-invasive laser treatment for fat reduction, body sculpting and skin tightening is a fast, safe and effective non-invasive alternative to laser lipolysis, with no consumables or patient downtime and exceptional results. Before and after Fotona TightSculpting treatment Photos courtesy of Adrian Gaspar, M.D. Before and after Hironic Double Gold treatment Photos courtesy of Hironic Co., Ltd. Advancements in ultrasound-based energy have led to products like Doublo Gold from Hironic Co., Ltd. (Seoul, South Korea). Doublo Gold is a new model in the company s Doublo series, which non-invasively delivers High Intensity Focused Ultrasound (HIFU)-based energy to skin layers from 1.5 mm to 4.5 mm below the epidermis for effective lifting of skin and remodeling of the collagen layer. This new system reduces treatment time and comes with other upgrades, such as continuous shot mode and a shot interval control system. Similarly, the Microson Dual system from Eunsung Global Corp. (Gangwon-do, South Korea) is a HIFU-based system that produces focal thermal coagulation points at the superficial musculoaponeurotic system (SMAS), deep dermis and subcutaneous adipose tissue. The Microson Dual offers non-surgical facial and body lifting effects without causing superficial damage to the skin. It also incorporates five cartridge types and a dual handpiece for convenient operator use. 62 THE European Aesthetic Guide Volume 15

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64 IMCAS Celebrates 20 Years of Educational Excellence and Innovation in Aesthetic Medicine Before and after Eunsung Microson Dual treatment Photos courtesy of Eunsung Global Corp. Wrinkles before and after four BTL Exilis Ultra 360 treatments Photos courtesy of BTL Aesthetics Viveve System by Viveve, Inc. EVA by Novaclinical / Novavision VECTRA 3D Automated Markerless Tracking system by Canfield Scientific, Inc. Combining RF and ultrasound, the Exilis Ultra 360 from BTL Aesthetics (Staffordshire, U.K.) represents an advanced technology for body contouring, skin tightening, facial rejuvenation and female intimate wellness. Its two applicators and various exchangeable tips enable the treatment of various body areas. This unique combination of monopolar RF, ultrasound and adjustable cooling enables the system to selectively focus energy to various tissue layers as needed. It effectively stimulates the growth of collagen and elastin, enhancing the power of skin to lift and tighten. Physicians can enhance women s intimate health and provide patients with a newfound self-confidence by employing the same technology on vaginal and vulvar areas. With exchangeable single use tips and distinctive 360 Volumetric Heating technology, the system provides the shortest non-invasive intravaginal treatment. In addition, the Exilis Ultra 360 platform incorporates impedance intelligence that constantly monitors skin impedance changes during treatment. This allows maximum efficacy with maintained comfort leading to higher patient satisfaction. Along these lines, it is safe to say that of all the recent body related technology innovations, none have captured the interest of practitioners as much as energy-based vaginal rejuvenation. Viveve, Inc. (Englewood, Colorado, U.S.) offers the Viveve System, which safely delivers cryogencooled monopolar RF (CMRF) energy deep into the vaginal mucosa while protecting delicate epithelial tissue. Geneveve by Viveve is the only singlesession, 30 minute treatment with CE clearance for treating vaginal laxity. Vaginal laxity is associated with urinary incontinence and reduced sexual sensation. In addition, FDA cleared InControl Products by Viveve treat incontinence conditions and improve pelvic floor strength. Novaclinical / Novavision (Misinto, Italy) offers EVA (Enhancer of Vaginal Anatomy), an innovative, effective and advanced medical solution for feminine intimate care with a special focus on vaginal atrophy, vaginal laxity, mild stress urinary incontinence, vulvodynia and vulvovaginal rejuvenation. This system employs patented Vaginal Dynamic Quadripolar Radiofrequency (VDR ), a Radiofrequency Safety System (RSS ), and Internet of Medical Things (IoMT) technologies, which help facilitate effective, safe and comfortable vaginal and vulvar treatments. Prior to performing procedures, physicians need a comprehensive understanding of what they are treating. That is where sophisticated imaging tools come into play. The VECTRA 3D Automated Markerless Tracking system from Canfield Scientific, Inc. (Parsippany, New Jersey, U.S.) utilizes a quantitative approach to assessing variations in soft tissue, for a dynamic multi time point evaluation of the changing face. A real-time three-dimensional map of soft tissue fluctuations illustrates stretch and compression, while also objectively evaluating lift, tightening and volumization. Markerless Tracking advances the ability to evaluate age-related tissue changes and validate subjective assessments with objective evidence. Practitioners can thoroughly review and provide patients with individual improvement results, confirmed via detailed evidence of outcomes. 64 THE European Aesthetic Guide Volume 15

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66 Case Study Proves INTRAcel PRO N16TIP Effectively Improves Pigmentation and Skin Tone By Lukas Choi, M.D. Acne, flushing and uneven skin tone before and eight weeks after five sessions of INTRAcel PRO Photos courtesy of Lukas Choi, M.D. Since the introduction of INTRAcel into the medical aesthetic market in 2008, cosmetic practitioners have had a powerful tool to treat acne, acne scars, various other scars including stretch marks, anti-aging and more. Now in its tenth year on the market, most practitioners who have used the INTRAcel from Jeisys (Seoul, South Korea) agree that it has become an unrivaled device offering stable and consistent results. Microneedling radiofrequency (RF) is, no doubt, one of the leading edge technologies in recent years. And while many generic versions of INTRAcel have been introduced, there have been issues related to stability and effectiveness with these copycat devices. New INTRAcel PRO N16TIP RF using low level energy. Based on these findings, the INTRAcel has received a valuable upgrade. A new 16 pin noninsulated needle tip has been designed to decrease pain levels during treatment by penetrating skin with a lesser amount of needles compared to the existing 49 pin needle tip. With this upgrade INTRAcel PRO now offers the existing INTRAcel applications, with the addition of bipolar RF delivery. This will enable treatment of many other skin conditions not previously possible with the original system; mainly in regards to pigmentation. In my case study I have completed treatment of four patients and I am in the process of treating 12 other patients that have melasma, hyperpigmentation, facial erythema and large pores. All subjects have noticed at least some improvement even after just one or two sessions, but overall enhancement of skin tone and pigmentation changes were the most noticeable. There were no major complications, and the pain level scores registered mostly in the tolerable range under 4 on a scale of 1 to 10) with some patients noting a higher pain intensity during the procedure. In comparison to conventional INTRAcel treatments using the 49 pin needle tip, treatment with the N16TIP could be done with a significantly lower amount of pain when adequate topical anesthesia (9% lidocaine for 30 to 40 minutes) was applied. I have observed high satisfaction rates with low complication rates when performing this procedure, and I strongly believe it will become an exceptional addition to my treatment options. I am very excited that I can now offer this modality for many of my patients presenting with different skin problems. While INTRAcel PRO offers the benefit of being used as a stand-alone therapy, or in combination with conventional treatments, I find the biggest advantages of this new upgrade to be that it can now be used for pigmentation purposes, which was not considered in the prior iteration, and that it can be used for any age group, skin type, and/or skin condition. Another exciting prospect about this treatment is that the likelihood of rebound hyperpigmentation is going to be much lower compared to laser toning procedures (using Q-switched Nd:YAG) because it utilizes low level RF. Recent reports have shown favorable results for melasma, post-inflammatory hyperpigmentation (PIH), large pores, vascularity related to facial erythema and general skin tone, when delivering bipolar Lukas Choi, M.D. Dr. Choi is the clinic director at DC Cosmetic Enterprise Incorporated in Surrey, British Columbia, Canada. 66 THE European Aesthetic Guide Volume 15

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68 Aliaxin and Profhilo Simplify Challenging Treatments By Kevin A. Wilson, Contributing Editor Beatriz Molina, M.D. Medical Director Medikas Ltd. Bristol and Somerset, UK The family of biocompatible injectables from IBSA Farmaceutici Italia Srl (Italian subsidiary of the IBSA Group, Switzerland), is designed to provide physicians with stable, high-quality hyaluronic acid (HA) products that work extremely well alone or in combination to suit the needs of virtually every patient. Each product is easily integrated into tissue and provides natural, long lasting correction. The concept of Hydrolift Action, a property of all IBSA dermoaesthetic injectables, describes the effect of filling and remodeling tissue by maximizing elasticity and skin tone as well as hydration. The Aliaxin filler line features carefully managed properties differentiating each formulation within the range between superficial correction and volumization. Profhilo on the other hand is more of a biomodulator than a traditional filler, said Beatriz Molina, M.D., medical director of Medikas Ltd. clinics with locations in Bristol and Somerset, U.K. Profhilo hybrid complex is a unique combination of different molecular weight HA designed to induce a regenerating trophic effect on the epidermis and remodeling of the dermis, Dr. Molina continued. It has a high concentration of HA, but is stabilized to reduce degradation. The lower dynamic viscosity of Profhilo means it may be injected with a 29G needle and spreads homogeneously within the dermis. Enhanced biocompatibility leads to more gradual initiation of the inflammatory cascade, reducing the number of injection points and treatment time. We ve seen amazing results using this product on the face, neck and chest, as well as other areas. Aliaxin long lasting monophasic HA fillers encompass four distinct products which share stability, performance and natural tissue integration. Aliaxin GP (Global Performance) and EV (Essential Volume) harness the power of Hydrolift Action but feature additional cross-linking, with viscoelastic characteristics more suitable for volumization. EV has the highest G and is injected more deeply, but may also be effective when implanted up in the mid-dermis, with reduced occurrence of swelling or bruising, Dr. Molina reported. GP, she added, is a step down in terms of G and lifting. Aliaxin FL (Fine Lines & Lips) and Aliaxin SR (Shape & Restore) are designed to be more malleable for easier superficial implantation and shaping, without sacrificing the biomodulation effect. SR is a remarkable product, there is nothing like it on the market, said Dr. Molina. It features a unique combination of natural and cross-linked HA, combining three molecular weights of HA for a well-rounded blend of Hydrolift Action and filling. We see mild lifting as well as hydration and an anti-aging effect, with the full result often observed within just a few weeks after treatment. It is well-suited for use even in the periorbital region. A particularly potent combination therapy is Profhilo and Aliaxin SR for the neck. The neck is difficult to treat with fillers because lines are horizontal, and most injectables will not provide the natural looking correction required for this dynamic anatomical region, Dr. Molina explained. The unique properties of Profhilo and Aliaxin SR make them ideal for this application. First, you treat the neck with Profhilo to improve skin and address overall laxity, then use Aliaxin SR to fill in fine lines. Enhanced by using Aliaxin EV, and/or GP for volumization where called for, the same can be done with the face using Aliaxin SR and Profhilo. There are no other fillers that can treat skin laxity this way. It is quite revolutionary. There are no other fillers that can treat skin laxity this way. It is quite revolutionary. Before and after one Aliaxin EV treatment to the cheekbones (1 ml) and two Aliaxin SR treatments to the periorbital area (1 ml each treatment given six weeks apart) Photos courtesy of Beatriz Molina, M.D. 68 THE European Aesthetic Guide Volume 15

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70 New Energy-Based Device Offers Minimal to No Downtime Vaginal Rejuvenation By Jeffrey Frentzen, Executive Editor without the use of hormones; contract vaginal tissues to help improve muscular coordination and strength; and improve stress urinary incontinence. In addition to tightening vulvar tissues and increasing blood flow, ThermiVa treatments improve the sensitivity of the vulvar structures, clitoral region and internal vagina. The result is collagen regeneration that is necessary for thickening of the vaginal lining. It also works to solve the problem of painful intercourse 2. Women can have many and varied problems with their pelvic floor. Dryness, looseness, laxity, poor urinary control in every way, unsatisfactory and perhaps painful sex due to increasing age, childbirth and genetics; they all take their toll, stated Jim Dornan, M.D., F.R.C.O.G., F.R.C.P.I., a gynecologist and chair in Fetal Medicine at Queens University Belfast in Belfast, Northern Ireland. Jim Dornan, M.D., F.R.C.O.G., F.R.C.P.I. Gynecologist Belfast, Northern Ireland Chair in Fetal Medicine Queen s University Belfast Belfast, UK Sonja Sattler, M.D. Dermatologist Darmstadt, Germany More females today are willing to be frank and admit when things aren t right. Earlier approaches to some of these conditions, such as using dermal fillers around the neck of the bladder, are just not as effective when ThermiVa can do the job for you to stimulate new collagen and elastin, Prof. Dornan expressed. Extensive surgical procedures had always been the last resort, so medical professionals have been very keen to develop other affordable and effective remedies. Answering an unmet need in European aesthetic clinics, the new ThermiVa device from Thermi (Irving, Texas, U.S.) features advanced radiofrequency (RF) technology that effectively addresses a range of women s health concerns, offering patients a non-invasive feminine rejuvenation therapy that is pain free with minimal to no downtime. Vulvovaginal changes occur over time and can affect a woman s self-esteem 1. The ThermiVa device performs non-surgical transcutaneous temperature-controlled therapy in the vulvovaginal region using proprietary, controlled RF to heat vulvovaginal tissue comfortably and quickly, and is well tolerated due to customized dosage. The system s handpiece works with the company s multifunctional ThermiRF aesthetic platform, which features RF-based technology combining strict temperature control with innovative real-time temperature monitoring when treating both the internal and external structural features of the vagina. When in use, the handpiece contracts external and internal vulvovaginal tissue via a thermocouple tip, and employs a minimally invasive probe to monitor tissue temperature. In this way, ThermiVa works to strengthen labial tissues to reduce sag and laxity; improve atrophic vulvovaginitis; increase sexual response Before and after one ThermiVa treatment Photos courtesy of Barry DiBernardo, M.D. More females today are willing to be frank and admit when things aren t right. Earlier approaches to some of these conditions, such as using dermal fillers around the neck of the bladder, are just not as effective when ThermiVa can do the job for you to stimulate new collagen and elastin. 70 THE European Aesthetic Guide Volume 15

71 Dermatologists and surgeons are taking advantage of this opening and I think it is just the beginning. As dermatologists, we can deal better with patient management because we know the devices and have worked with RF for many years. Also, we know how to market this type of treatment effectively. Before and after three ThermiVa treatments Photos courtesy of Patricia Wallace, M.D. This is where ThermiVa comes in. As a physician, you always like to cure or relieve symptoms in any patient, Prof. Dornan continued. It is very exciting to find a tool that can deal with so many different parallel issues. This device addresses these problems most effectively and affordably. According to Sonja Sattler, M.D., a dermatologist in Darmstadt, Germany, At our clinic we use many energy-based devices so at first, we looked at the ThermiRF platform and its ThermiTight skin tightening treatment. We also perform vaginal rejuvenation via surgery. However, we were quick to add ThermiVa to help our patients that didn t want or need a surgical solution for their concerns. As such, patient selection is vital to successful outcomes, Prof. Dornan added. However, during the consultation and careful assessment keep in mind not all women s tissues respond the same, just like every headache doesn t always respond equally to painkillers. ThermiVa can be customized to meet individual patient needs. The course of treatment is three monthly sessions and an annual treatment for upkeep purposes. ThermiVa can be used on a range of ages from 21 to 55 and all skin types, Dr. Sattler noted. It is also generally a very well tolerated therapy because of the unit s temperature control, which is a feature not all RF devices have, she said. Throughout Europe few gynecologists have been implementing energy-based vaginal rejuvenation, which creates an opportunity for aesthetic practitioners to provide this service. Dermatologists and surgeons are taking advantage of this opening and I think it is just the beginning, stated Dr. Sattler. Gynecologists generally see a new patient every 10 minutes and they do not want to take the time for a 40 minute aesthetic consultation. Additionally, they are not familiar with devices like this. It is not something many of them have considered. As dermatologists, however, we can deal better with patient management because we know the devices and have worked with RF for many years. Also, we know how to market this type of treatment effectively. As feminine rejuvenation becomes more well-known throughout Europe, ThermiVa attracts different tiers of patients, Dr. Sattler reported. Post-partum women are the largest group I see. This patient wants the same kind of tightness she had prior to having children. She wants her body to look more like it did in her 20s. A second group is the younger woman that thinks she can have better sex if only she was tighter. For her, the ThermiVa experience is more about trying out new things and learning what is a benefit and what is not. The last group is post-menopausal women. I see only a few of them. When the estrogen runs out and they get atrophy of the mucosa, many of them will go to the gynecologist and not yet be aware that they can be treated with ThermiVa. As the word gets out about this procedure, I suspect we will see more of this age group, said Dr. Sattler. Even though ThermiVa has been in release in Europe for only a short time, The popularity of this treatment has been meteoric, expressed Prof. Dornan. People around the world are talking about it. One patient I know was dealing with menopause after years of raising kids, and she had started losing confidence in herself. It was not the same world as it was in her 20s, but after ThermiVa she said she had gotten her vagina back. The results were that profound. In Prof. Dornan s opinion, Ultimately, I think the initial course of three monthly treatments will become an annual maintenance procedure for life. Nature has produced an exquisite part of the human body and ThermiVa is helping to keep it that way. References: 1. Karcher et al., Vaginal Rejuvenation using energy based devices, Internal Journal of Women s Dermatology 2(2016) Alinsod, R. Temperature Controlled Radiofrequency for Vulvovaginal Laxity, PRIME, International Journal of Aesthetic and Anti-Aging Medicine (July 2015): Print. *Multicenter study. Data on file THE European Aesthetic Guide Volume

72 Clinical Study Demonstrates Improved Efficacy in Hand Rejuvenation via Combination of mesoestetic Products By E. Lorente, M.D., F. Galcerán, M.D., R. Vidal, M.D., L. Luis, M.D., et al. Hands are one part of the body exposed the most to external aggressions. Aging in hands is mainly characterized by atrophy of soft tissues (thin hands with prominent veins and metacarpal bones), loss of skin elasticity (diminished capacity to return to its original state after pinching), and a reduction in tissue density, as well as the appearance of wrinkles and senile or solar lentigines. Such manifestations are mainly due to the loss of hyaluronic acid (HA) present in skin, as well as reduced functionality of collagen and elastin fibers, determining the state of the connective tissue. Therefore, skin that is well hydrated and has a higher number of fibroblasts, collagen and elastin fibers remains visibly younger and firmer. with mesofiller global (cross-linked HA at a concentration of 20 mg/ml), applied in a single session with a touch-up 15 days later when deemed necessary. Each patient received 1 to 2 ml per hand. In subgroup B, a base mixture of 1 ml of mesofiller global, 3 ml of mesohyal X-DNA (polynucleotides) and 2 ml of mesohyal NCTC 109 (vitamins, amino acids and coenzymes) was applied in two sessions, 15 days apart. Each session involved the application of 3 ml of the mixture in each hand. The effectiveness and safety of treatment was evaluated at two follow-up visits (at 15 days and at three months after the initial treatment) based on a photographic record, and also assessed using the cutometer probe. A clear improvement in the skin s appearance and texture was evident in both subgroups. Subgroup A showed greater volume replenishment (lessprominent bone silhouettes) than Subgroup B. Conversely, in Subgroup B a greater average improvement was observed compared to Subgroup A in terms of elasticity (24.9% vs. 9.1%) and firmness (19.8% vs. 12.8%). In conclusion, combination treatment consisting of mesohyal X-DNA and mesohyal NCTC 109 with mesofiller global cross-linked HA provides a greater increase in tissue elasticity and firmness due to the properties of the active substances, which foster the synthesis of collagen, elastin and fibronectin. This combination protocol has proven to be a comprehensive and effective approach in improving the signs of aging in hands. In aesthetic medicine, cross-linked HA is commonly applied to the dermis to restore volume, rehydrate tissues and stimulate collagen synthesis. mesoestetic (Barcelona, Spain), a leading pharmaceutical group specialized in aesthetic medicine and dermatology, carried out a study to prove the additional benefits obtained from combining administration of crosslinked HA, like their product mesofiller, with a solution rich in polynucleotides such as sodium deoxyribonucleate, vitamins, amino acids, mineral salts and free HA, as in some of their solutions from the mesohyal range. The study included 14 Caucasian women who were divided into two subgroups of seven patients. Subgroup A was treated Before and three months after combination treatment of mesofiller global, mesohyal X-DNA and mesohyal NCTC 109 Photos courtesy of mesoestetic Combination treatment consisting of mesohyal X-DNA and mesohyal NCTC 109 with mesofiller global cross-linked HA provides a greater increase in tissue elasticity and firmness due to the properties of the active substances. 72 THE European Aesthetic Guide Volume 15

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76 Increasingly Sophisticated Energy-Based Devices Accelerate Combination Therapies By Michael Moretti, Editor-in-Chief The use of lasers, radiofrequency (RF), ultrasound, cryotherapy and lightbased energy sources in aesthetic medicine has expanded in recent years as developers push the frontiers of technology. Increasingly, progressive manufacturers have been responding to practitioner calls for devices that provide multifunction capabilities, which typically take the form of single platforms offering a variety of treatment modalities to address multiple indications. 76 THE European Aesthetic Guide Volume 15

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78 Increasingly Sophisticated Energy-Based Devices Accelerate Combination Therapies Marina Landau, M.D. Dermatologist Wolfson Medical Center Holon, Israel Sabine Zenker, M.D. Dermatologist Munich, Germany The most popular energy-based procedures, such as hair removal, body shaping, skin tightening, facial rejuvenation, cellulite reduction and feminine rejuvenation, have advanced in high-tech sophistication and functionality. Many experienced practitioners are fully embracing these newer technologies that offer more impact in a fewer number of treatment sessions, satisfying the needs of a growing patient base. To further validate these trends, in 2017 the global market for all energybased aesthetic device platforms and disposables is expected to reach over $1.6 billion (excluding skin tightening and body shaping systems), according to Medical Insight s (Irvine, California, U.S.) recently released Energy-Based Aesthetic Devices market study referenced at miinews.com. As reported by Medical Insight, a major expansion of these types of systems is underway with solid growth in this segment. Over the next few years the total market for energy-based aesthetic devices, including disposables, are expected to expand by 5.8% per year to over $2 billion. Before and after two combination treatments with Ellipse SWT and Frax 1550 Photos courtesy of Vicent Alonso, M.D. At the clinic level, practitioners echo the conclusions contained in these reports. According to Marina Landau, M.D., a dermatologist at Wolfson Medical Center in Holon, Israel, The general trend in the last few years indicates that procedures with less downtime are still gaining popularity among a patient base that now includes an increasing number of men. Both men and women are growing more accustomed to accepting less dramatic results from non-surgical, energy-based treatments. Skin quality is appreciated as an important and valuable asset for patients and physicians, she said. According to Sabine Zenker, M.D., a dermatologist in Munich, Germany, Around the world, we see that patients are seeking natural results with the least effort possible, and they are always looking for non-invasive procedures. Today, patients are well informed and understand that there are different options when it comes to energy-based treatments. They might approach a number of physicians, shop around, ask their friends and use the Internet. European patients are not as keen on aesthetics as Asians and Americans. They are looking for maintenance and small improvements rather than big changes. Before and after Fotona4D treatment Photos courtesy of Adrian Gaspar, M.D. Benefitting from next-generation design innovations, energy-based facial rejuvenation has entered a new era that embraces regenerative medicinestyle procedures. These approaches can, for instance, combine RF or ultrasound lifting with autologous fat transplants, and/or the application of dermal fillers and suspension threads. The most significant progress in facial rejuvenation occurred when physicians understood that facial aging is a combination of gravitational forces, volume loss and skin quality deterioration, noted Dr. Landau. For better outcomes, all of these concerns have to be addressed. Physicians started to address skin quality via skin boosters and autologous technologies in combination with energy-based systems. Before and three weeks after two PerfAction EnerJet2.0 treatments Photos courtesy of Abigail Arad, M.D. For instance, Nordlys from Ellipse (Hoersholm, Denmark) employs various wavelengths to treat all aspects of facial rejuvenation and skin concerns, from diffuse redness and small telangiectases to dyspigmentation. Collagen 78 THE European Aesthetic Guide Volume 15

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80 Increasingly Sophisticated Energy-Based Devices Accelerate Combination Therapies remodeling, skin texture and small rhytides are treated by the Frax 1550 fractional laser, and treatment can be optimized by combining this with Selective Waveband Technology (narrowband IPL). Genesis from mesoestetic Pharma Group The Dynamis Pro from Fotona (Ljubljana, Slovenia) is a multi-application laser system that provides a single, full-featured solution based on Er:YAG and Nd:YAG laser technologies. Facial rejuvenation procedures use the Fotona4D procedure, which enables full-thickness contraction of collagen for persistent, no downtime tightening, volumization and wrinkle reduction without injectables. Fotona4D works on deeper, medial and superficial connective structures while simultaneously targeting various skin imperfections to effectively combat facial aging. For advanced, long lasting non-surgical deep remodeling procedures, the EnerJet2.0 from PerfAction Technologies, Ltd. (Rehovot, Israel) simultaneously delivers kinetic energy and a healing compound enabling a controlled deep micro-trauma profile effect for dermal remodeling. The result is smoother, well-hydrated and younger looking skin with long-term structural benefits. It also offers clinically proven solutions to treat acne and keloid scars, upper lips, stretch marks and neck wrinkles. YouLaser MT from Quanta System Before and after cocoon medical primelase HR treatment Photos courtesy of cocoon medical mesoestetic Pharma Group (Barcelona, Spain) offers the Genesis device featuring next-generation SmartDrivity technology, which is a form of low power regenerative diathermy designed to act at the cellular level without raising the temperature of the treated area. High-intensity red LEDs boost fibroblastic activity and tissue stimulation for regeneration of collagen and elastin. This multifactorial, multilevel and multi-zone device includes 44 preset programs and a free program to perform both facial and body treatments, adapting itself to the needs of each patient, even those with sensitive or reactive skin. The LaseMD Cosmeceutical Delivery System from Lutronic (Boston, Massachusetts, U.S.) represents a new technology that administers specially designed compounds into the skin for better delivery of cosmeceutical products with minimal downtime. Micro-channels are created in the skin tissue using this fiber-based laser, which produces a high-quality beam that reduces or eliminates thermal distortion of the optical path, resulting in very little or no damage to the surrounding tissue. These micro-channels are sealed during the recovery process while the serums are absorbed into the dermis. Unlike other laser therapies that treat specific indications, LaseMD works on all skin types improving skin tone and texture, and lightening of pigmentation. YouLaser MT from Quanta System, S.p.A. (Milan, Italy) utilizes proprietary Mixed Technology to establish a positive synergy between the 10,600 nm and 1540 nm wavelengths in a sequential or simultaneous fractional emission. The system targets wrinkles, scars and pigmentation problems with improved results in just one session and almost no downtime. It also offers feminine rejuvenation procedures via the firm s DivaTight procedure, which addresses vaginal atrophy concerns. Bra fat before and after four BTL Exilis Ultra 360 treatments Photos courtesy of BTL Aesthetics Hair removal procedures have likewise seen impressive technology advancements. For instance, the primelase HR excellence laser platform from cocoon medical (Barcelona, Spain) treats hair-related issues by offering the highest peak power on the market (4,800 W) and three 80 THE European Aesthetic Guide Volume 15

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82 Increasingly Sophisticated Energy-Based Devices Accelerate Combination Therapies specialized handpieces operating at 755 nm, 810 nm and a mixed mode. This enables effective and safe hair removal in dark photo types. Furthermore, exclusive Ultra Short Pulse (USP) technology delivers ultrashort pulses with a high fluence of energy, thus removing even residual hair. According to the exclusive research report, Energy-Based Body Shaping & Skin Tightening from Medical Insight, all non-surgical body shaping and skin tightening systems are experiencing notable growth across the globe, driven by rising consumer interest in these treatments compared to other, more established energy-based device markets. Before and after InMode BodyTite treatment Photos courtesy of J. Altman, M.D. For instance, in 2017 the worldwide market for all body shaping and skin tightening device platforms and disposables will reach over $1 billion, the report stated. Through 2021, the overall market is expected to grow by an impressive 14.5% per year. An example of this trend is the versatile Exilis Ultra 360 from BTL Aesthetics (Staffordshire, U.K.), which offers advanced technology for body contouring, skin tightening, facial rejuvenation and female health wellness. Its two applicators and various exchangeable tips can treat more than 20 body areas utilizing combined monopolar radiofrequency (RF) and ultrasound energy, adjustable cooling and technology that constantly monitors skin impedance changes during treatment. By selectively focusing energy to various tissue layers, the system effectively stimulates the growth of collagen and elastin in order to lift and tighten the skin. In addition, unique 360 volumetric heating provides a short non-invasive intravaginal treatment with no pain or downtime. Before and 12 weeks after one Cutera trusculpt treatment Photos courtesy of Cutera BodyTite from InMode (Richmond Hill, Ontario, Canada) is a minimally invasive body contouring procedure that provides internal and external lipolysis, delivering the kind of results usually achieved via more extensive excisional surgical procedures. The system s real time temperature monitoring, Radiofrequency Assisted Lipolysis (RFAL), adds three-dimensional remodeling and features special technology to optimize treatment outcomes and patient safety. Body sculpting and circumferential reduction gets a multi-dimensional approach with trusculpt from Cutera, Inc. (Brisbane, California, U.S.), an RF-based body contouring device that introduces clinically therapeutic temperatures to the subcutaneous adipose tissue, achieving the highest clinical efficacy in the shortest possible time. The longer durations of deep uniform heating elevate the targeted subcutaneous tissue, which increases basal metabolic activity in adipose tissue. Before and after Zimmer Z Lipo and Z Wave treatments Photos courtesy of Zimmer MedizinSysteme The new Z Lipo Cryolipolysis system from Zimmer MedizinSysteme (New Ulm, Germany) enables practitioners to target fat deposits and reduce them permanently and non-invasively. This method cools fat cells over a longer period of time to a controlled and safe temperature range. Studies have shown that adding intensive, pain-free shockwave treatment after Z Lipo, via Z Wave Pro, not only ensures better fat loss, but also stimulates lymphatic drainage and tightens the skin. Cellulite reduction therapies have been enriched recently, as well, as evidenced by the Cellfina System from Merz Aesthetics (Frankfurt, 82 THE European Aesthetic Guide Volume 15

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84 Increasingly Sophisticated Energy-Based Devices Accelerate Combination Therapies Germany). Combining highly advanced, proprietary technology with a well-established procedure called Subcision, this device treats the underlying structural cause of cellulite with precise and reproducible results. The Cellfina treatment is the only U.S. FDA cleared and E.U. CE marked minimally-invasive procedure that effectively improves the appearance of cellulite for at least three years. With a single, minimally invasive treatment, results from a clinical study reported 93% patient satisfaction at three years. Cellulite patient before and one month after Merz Cellfina treatment Photos courtesy of Melanie Palm, M.D. Cellfina System by Merz Aesthetics CELLACTOR SC1»ultra«and D-ACTOR»ultra«acoustic wave therapy (AWT ) systems from STORZ MEDICAL (Tägerwilen, Switzerland) noninvasively addresses cellulite, fat pads and facial wrinkles via high-energy acoustic waves that reach deep skin layers such as the epidermis, dermis and connective tissue, targeting subcutaneous fatty tissue. As a result, the skin becomes smoother in appearance while the treated body areas achieve circumferential reduction of fat. Scars, striae and lymph congestion can also be effectively treated using AWT. 4PLUS from Novaclinical / Novavision (Misinto, Italy) offers a widerange of functions including face-lifting, contouring and tightening, as well as body sculpting. Exclusive Dynamic Quadripolar energy focuses on specific tissue layers the epidermis, dermis or hypodermis utilizing VRF technology that directs energy deep in the skin, leaving the outer layer safe from damage. Manufacturers have also implemented refined RF, and other energies such as lasers and ultrasound, in response to the increasing popularity of non- or minimally invasive feminine rejuvenation. According to Medical Insight s April 2017 Non-Surgical Feminine Rejuvenation market study, in 2016 there were an estimated 5,900 installed devices globally, with an anticipated compound annual growth rate of 37%, resulting in about $2 billion in physician fees by Over the last few years several established multi-functional platforms have been modified to specifically address female health and wellness concerns, such as vaginal laxity, stress urinary incontinence problems and sexual dysfunction. AWT cellulite treatment by STORZ MEDICAL Before and after Novaclinical 4PLUS treatment Photos courtesy of Novaclinical / Novavision For instance, the CO 2 RE system from Syneron Candela (Irvine, California, U.S.), used primarily for skin resurfacing, wrinkles and scar reduction, now offers the CO 2 RE Intima application, which targets women s intimate wellness treatments, including vulvovaginal atrophy and vaginal rejuvenation. The system remodels vaginal connective tissue, treats the introitus, and improves the appearance of the external genitalia with the single-use internal and external handpieces. In addition, the system s surgical handpiece can be used to excise or incise external tissue. The SmartXide Touch system from DEKA (Calenzano, Firenze, Italy) combines two wavelengths 755 nm and 1064 nm to address a wide-range of tailored and automatic low-pain procedures, including hair removal and skin rejuvenation, as well as treatment of vascular lesions. The company s feminine rejuvenation component, MonaLisa Touch utilizes fractional CO 2 laser technology to rejuvenate vaginal tissue naturally and effectively, restoring the vaginal mucosa and working to restore functionality that was lost due to age, such as hydration, tropism, tone and sensitivity. 84 THE European Aesthetic Guide Volume 15

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86 Increasingly Sophisticated Energy-Based Devices Accelerate Combination Therapies Synergistic therapies are also a hallmark of the latest advancements in energy-based procedures. Increasingly, platelet-rich plasma (PRP) treatments have been combined with energy-based microneedling products for low impact clinical outcomes, particularly in hair transplantation therapies. CO 2 RE system from Syneron Candela According to Dr. Landau, For a while PRP was of questionable value in aesthetic medicine. In the last few years though, we have seen a positive effect on hair growth that has been supported by multiple scientific publications. The effect was shown in cosmetic indications, such as androgenetic alopecia and post hair transplant situations, but also in hair diseases such as Alopecia Areata (autoimmune condition). PRP s medicinal effect originates from a multitude of growth factors and signaling molecules found in platelets and blood plasma, which harnesses the body s healing and regeneration processes. Treatment with PRP improves skin texture and volume to a degree, and is also ideal for combination with microneedling. Croma-Pharma GmbH (Leobendorf, Austria) has introduced Arthrex Personalized Cell Therapy, which is performed using the firm s Arthrex ACP Double syringe. The combination of PRP and microneedling leads to better clinical results and higher patient satisfaction. Colposcopic images of vaginal mucosa show atrophic, thin epithelium with petechiae, lack of vaginal rugae and muco before treatment and 30 days after one DEKA MonaLisa Touch treatment Photos courtesy of M.G. Fallani, M.D., A. Pieralli, M.D., Prof. S. Guaschino, M.D. and Prof. C. Penna, M.D. Arthrex ACP Double Syringe PRP by Croma-Pharma Male patient with Alopecia before and after three combination treatments of Dermapen microneedling with PRP given six weeks apart Photos courtesy of Natali Kelly, M.D. Another example of this technique is the combination of PRP and the Dermapen device from DermapenWorld (Terrey Hills, New South Wales, Australia), which deploys 1,296 rejuvenating puncture channels per second. This effectively infuses and distributes platelets for fast, effective and comfortable procedures. Treatment may be performed in as little as five minutes with no injections required. Ultimately, the availability of so many different, but nearly equally efficacious energy-based platforms may only confuse the practitioner. When confronted with the need to make the correct buying decision, several factors must be taken into account, stated Dr. Zenker. There are so many devices in competition, and some of them are basically the same but with different labels, she said. For instance, every dermatologist has an IPL device, so who will buy the next one that comes out? That s when we see the prices rapidly decrease and the market becomes more competitive. Increasingly, we see a need to offer patients very customized treatments so practices should take a service oriented approach. However, from a business point of view, there are additional considerations. From an organizational aspect it could make sense to buy a single machine for use by several physicians. Another approach is to lease a machine per use. According to Dr. Landau, While not every new technology or treatment will be proven as effective, every effective therapy was new at one point. New technology has to be followed, investigated and evaluated. I love seeing old technologies return with new applications or adopted from other professions. For instance, a simple tattoo removal machine that can also serve as a very efficient drug delivery system, was recently shown by a group of Brazilian dermatologists who treated Idiopathic guttate hypomelanosis, which are typically very resistant to any treatment. I believe the market is ripe for innovation of all kinds. 86 THE European Aesthetic Guide Volume 15

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88 ABy Jeffrey Frentzen, Executive Editor esthetic Clinics Adapt to Millennial Patient Needs As young consumers seek cosmetic procedures earlier in life, one of the pressing issues for medical aesthetic practices is determining the best strategy for targeting, acquiring and retaining patients within this demographic. While Baby Boomers and Gen-X groups continue to drive most of the aesthetic procedure volume, the largely untapped Millennial generation of 20 to 35 years olds represent the most important long-range future growth opportunities for our entire industry. 88 THE European Aesthetic Guide Volume 15

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90 Aesthetic Practices Adapt to Millennial Patient Needs Benjamin Ascher, M.D. Plastic Surgeon Chairman Clinique of Aesthetic Surgery IENA Founder and Scientific Director International Master Course on Aging Science Paris, France Petra Berger, M.D. Plastic Surgeon Frankfurt, Germany Ruth Moro Garcia, M.D. Aesthetic Physician Valencia, Spain tend to communicate via certain social media services. They are totally connected, he expressed. You will find them on Twitter and Instagram, where they can share selfies and exchange ideas in quick succession. When they approach aesthetic physicians, they will try to connect with the physician and arrange a consultation immediately. If the physician does not answer quickly then they will switch very easily to the next clinic. In Europe as in other regions, physicians find challenges when trying to target and attract the Millennial patient, noted Dr. Ascher. Unlike their parents, Millennials seek anti-aging treatments at a younger age as a preventive measure, he said. This aspect and the fact that they communicate almost exclusively online has forced clinics to reevaluate and change the way they market their services. As a result, the use of digital services has made it easier for some physicians to connect with younger patients. Sheila Nazarian, M.D. Plastic Surgeon Beverly Hills, CA, USA Mara Shorr Partner Vice President of Marketing and Business Development Shorr Solutions Coral Springs, FL, USA Tim Sawyer President Crystal Clear Digital Marketing Orlando, FL, USA In addition, Millennials are not comfortable with lengthy consultations and generally arrive at our clinic already very well informed about aesthetic procedures, Dr. Ascher added. With them, the 20 to 40 minute consultation is a thing of the past. They want to just read a summary of treatments and then move very quickly to a decision because they are not used to waiting, he said. Deepak Dugar, M.D. Facial Plastic Surgeon Beverly Hills, CA, USA Jason Emer, M.D., F.A.A.D. Board Certified Dermatologic Surgeon Beverly Hills, CA, USA Millennials, also known as Generation Y, make up the demographic cohort following Generation X. While the exact date range of the Millennial generation fluctuates slightly, the largely recognized characterization are those born in the early 1980s to late 1990s. Glabella lines before and after one BOTOX treatment Photos courtesy of Deepak Dugar, M.D. Ethnically diverse, tolerant of cultural and personal differences, and confident in most things, Millennial patients are now the largest consumer generational group in the U.S. and have started to flood clinics in Europe as well. Unlike previous generations, Millennial patients often view aesthetic treatments as a way to enhance their lifestyle and appearance, rather than waiting until later in life to address them. According to Benjamin Ascher, M.D., a plastic surgeon and chairman of the Clinique of Aesthetic Surgery IENA (Paris, France), as well as founder and scientific director of the International Master Course on Aging Science (IMCAS), Millennial patients Before and after non-surgical rhinoplasty procedure Photos courtesy of Deepak Dugar, M.D. 90 THE European Aesthetic Guide Volume 15

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92 Aesthetic Practices Adapt to Millennial Patient Needs Furthermore, Previously a youth would go to a clinic with his or her parents, but increasingly we see that they come in by themselves to receive a consultation, Dr. Ascher pointed out. Millennials simply have different concerns compared to older generations, stated Petra Berger, M.D., a plastic surgeon in Frankfurt, Germany. I see it as less of a generational issue and more of an issue of anatomy. Since they are younger they have fewer wrinkles. They are more interested in preventive treatments so they tend to focus on BOTOX and dermal fillers, she explained. As Ruth Moro Garcia, M.D., an aesthetic physician in Valencia, Spain, conveyed The philosophy of Millennial patients is that the anti-aging care they seek should be a reflection of their well-being. They desire a healthy and natural beauty, they usually go to the gym regularly and want aesthetic practitioners to help improve their results, both with nutrition and techniques that treat localized fat, as well as cellulite, in the case of women. According to Sheila Nazarian, M.D., a plastic surgeon in Beverly Hills, California, U.S., Millennials are willing to invest in their appearance and do quite a lot of research on the Internet to find their physician. However, they are actually very excited to have preventative and optimization work done, as opposed to Gen-Xers that are more concerned with not looking fake and often express that opinion. Unlike previous generations that were more likely to keep their aesthetic work private, Millennials are very open about it, noted Mara Shorr, partner and vice president of marketing and business development at Shorr Solutions (Coral Springs, Florida, U.S.). Key influencers on social media and celebrities talk about which treatments they re having done. Sometimes they even broadcast their procedures on Instagram or Facebook. This sets off a trickle-down effect to the rest of the population where now we see cosmetic surgery is no longer taboo. As such, the Millennial s approach is proactive versus reactive, stated Tim Sawyer, president of Crystal Clear Digital Marketing (Orlando, Florida, U.S.). They want to get ahead of the curve on anti-aging. They re careful with how they spend their money, but once they become familiar with a product or service and feel it is organic in nature, and that it is proven and by that I mean celebrity-endorsed they will spend their money. They are also very comfortable talking about their procedures. Although Millennials do have distinctly different needs from earlier age groups, some similarities exist, expressed Dr. Berger. Baby Boomers are now at the stage where deeper procedures are needed, like face-lifts and mommy makeovers. Lips before and after dermal filler treatment Photos courtesy of Deepak Dugar, M.D. Before and after CO 2 laser skin resurfacing, microneedling using platelet-rich plasma, Sculptra filler to the temples and Juvéderm Vollure to the lips Photos courtesy of Jason Emer, M.D., F.A.A.D. Before and after laser-based treatment to increase cheek volume Photos courtesy of Deepak Dugar, M.D. Both generations have only recently had access to stems cells from fat and / or blood, and that is where the future is. Both generations are using it equally. This is the age of stem cells, fat and regenerative medicine. Aesthetic practices are making adjustments to accommodate this wave of Millennials, said Deepak Dugar, M.D., a facial plastic surgeon in Beverly Hills, California, U.S. The over-40 crowd was my major demographic until the Millennials came along, he shared. More recently, I ve been seeing an uptick in the number of patients in their 20s. They re willing to do neurotoxins, plateletrich plasma (PRP) and energy-based, non-surgical devices like radiofrequency and lasers, in a preventive approach to aging. 92 THE European Aesthetic Guide Volume 15

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94 Aesthetic Practices Adapt to Millennial Patient Needs Research shows that the average age of a new BOTOX user is now about 25 years old, Mr. Sawyer noted. These are 20-somethings who have done their research and view neurotoxins, chemical peels, fillers and a strong skincare regimen all as a normal part of an overall health and wellness regimen, he said. Before and after one BTL Vanquish treatment Photos courtesy of Deepak Dugar, M.D. Before and after hair regrowth treatment using platelet-rich plasma Photos courtesy of Deepak Dugar, M.D. Within the Millennial demographic, the largest group of patients is female, but males are certainly open to treatments, Dr. Dugar added. The average Millennial female is starting earlier in their 20s; while most of the males are in their late 20s and early 30s when they seek anti-aging approaches. Dr. Ascher advises practitioners to approach Millennials with a more conservative attitude. In my opinion, we should avoid treating patients under the age of 30 because except for unusual cases there is little reason to perform procedures on people where no signs of aging exist yet, he expressed. Some young patients, usually in their 30s, may begin to show some signs of aging, such as a decrease in facial volume. For them, a program of injecting fillers to correct any volumetric concerns may be appropriate. This is a preventive approach that seems to have a positive result for patients in that age range, but there is little reason to perform procedures on a patient any younger than that. Nevertheless, like their forbearers Millennials ask for the same types of aesthetic procedures, stated Jason Emer, M.D., F.A.A.D., a board certified dermatologic surgeon in Beverly Hills, California, U.S. They want fillers, neurotoxins, methods for wrinkle prevention, facials, and to address their skincare, he stated. They don t want to look tired or like they have sun damage. They want a chiseled and youthful appearance. Before and after non-surgical rhinoplasty procedure Photos courtesy of Deepak Dugar, M.D. In addition, non-invasive, energy-based approaches seem perfectly timed for this group of patients that don t really need any major work, but just want spot treatments here and there. They are also looking for a whole body approach, and that includes a big increase in body shaping, as well as female rejuvenation. Women want to treat their vagina like they re treating the skin of their face, and men are doing PRP and stem cells to address penile problems, added Dr. Emer. Targeting, attracting and maintaining Millennial patients comes down to knowing how to communicate correctly. If practices can successfully navigate the social media universe, then they have an opportunity to attract prospective Millennial patients. Before and after high-definition liposuction of the abdomen, chest and back Photos courtesy of Jason Emer, M.D., F.A.A.D. From a marketing standpoint, practitioners that want to capture this diverse demographic have to be willing to put themselves out there a little bit, Mr. Sawyer expressed. What really moves the needle in social media for the Millennials especially is showing patients and staff having fun in the office, so that they can identify with the clinic as full of friendly, professional human beings and not just a dry, sterile provider-patient type atmosphere. 94 THE European Aesthetic Guide Volume 15

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96 Aesthetic Practices Adapt to Millennial Patient Needs Ultimately, the practitioner s goal is to develop long lasting relationships with their Millennial patients, explained Dr. Dugar. While most practitioners work with older patients, I m dealing with Millennial patients day in and day out, he reported. It is a huge market on which to capitalize, but the trick is learning how to keep them coming back in. You have to determine this according to your specialty. Some Millennials have gone as far as calculating a lifestyle that assumes regular aesthetic treatments, noted Dr. Emer. I have patients that have planned it out. They know that every three to four months they will get a procedure of some kind, plus a filler and a facial twice a year, and they set money aside for these treatments. Crow s feet before and after BOTOX treatment Photos courtesy of Deepak Dugar, M.D. Another major driver of this upsurge of Millennial patients is the development of new technologies in the past decade that have made procedures much safer. As more treatments become nonsurgical, they also become more affordable, Ms. Shorr noted. While price is a strong motivator for younger patients, their primary motivation is to observe quality results and develop a relationship with the physician. They want to believe in your abilities, Mr. Sawyer indicated. Apply the appropriate outreach and social media tools to draw them into your special beauty event, for instance. Attract them into the clinic and start building that relationship, rather than see them go somewhere else. To me, this demographic is a cash grower. We re all going to get our fair share of 40, 50 and 60 year olds, but if you can tap into the Millennial market, you ll discover an unlimited shelf life. While much attention has been given to the rise of the Millennial patient, what about the Millennial physician? As reported by Dr. Ascher, younger aesthetic practitioners bring some of the same attitudes and behaviors to the table so everything is changing. The new aesthetic physician is also very connected to the digital world and they know how to deal with the Millennial patient. This has changed the approach of many practitioners in terms of patient appointments, consultations and the types of aesthetic solutions that they provide. They are having success with less invasive, even non-invasive procedures or minimally invasive surgery. Some physicians see the growing population of younger patients as a downside of this trend. It is a very serious problem when physicians think it is all right to put breast implants into a 14 year old, which is entirely reckless, or to inject BOTOX into the face of an 18 year old woman, noted Dr. Ascher. They are being utterly irresponsible. Conversely, the upside of all these changes is that younger physicians are becoming familiar with performing less invasive, preventive treatments, Dr. Ascher continued. This is a valuable aspect of Before and after non-surgical rhinoplasty procedure Photos courtesy of Deepak Dugar, M.D. Before and after hair regrowth treatment using platelet-rich plasma Photos courtesy of Deepak Dugar, M.D. retaining Millennial patients. And, of course, board certification is a very important concern with newer physicians, as well. Despite the ups and downs associated with the Millennial phenomenon, this trend shows no sign of dissipating, Dr. Nazarian concluded. Considering the extent of our mobile lives and the importance of social media, I don t see it stopping. Everyone wants to look their best. Trends come and go, but looking your best is not a passing trend, she said. 96 THE European Aesthetic Guide Volume 15

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100 Adoderm GmbH Elisabeth-Selbert-Str. 5 Langenfeld, Germany D (0) telephone +49 (0) facsimile Adoderm develops various dermal filler products (VARIODERM ) for the field of aesthetic plastic surgery and dermatology. Featuring a high crosslinking grade up to 80% without dilution, these hyaluronic acid fillers treat various indications in the dermis, increasing volume and contours of the body and facial volumizing. The product range includes newly developed HYABELL dermal filler + Lidocaine, offering long lasting improvement and a convincing safety profile, while significantly reducing pain. With more than 20 years of ongoing research and development, Adoderm has introduced numerous patented products and has achieved global distribution in more than 50 countries. Allergan 1st Floor, Marlow International Parkway Marlow, Bucks SL7 1YL, UK telephone facsimile Allergan is a multi-specialty healthcare company focused on discovering, developing and commercializing innovative pharmaceuticals, biologics and medical devices that enable people to live life to its greatest potential to see more clearly, move more freely and express themselves more fully. With patient satisfaction at the heart of research and development, Allergan has the treatments, devices and professional support to help you offer patients the natural look they want. BTL Industries, Ltd. Unit 5 High Carr Network Center High Carr Business Park Millenium Way Newcastle under Lyme Staffordshire ST5 7XE, UK telephone There may not be one device to meet all of your clinical needs, but there is one company. This has been the mantra of BTL Industries, Ltd. ever since the company established itself as a leader in the aesthetic industry, providing scientifically proven devices for body shaping, skin tightening and facial treatments. With direct offices in all major European markets, BTL guarantees an unrivalled level of service support and customer care. Canfield Scientific, Inc. 4 Wood Hollow Road Parsippany, NJ USA / telephone facsimile Canfield Scientific, Inc. is a global leader in developing medical imaging and photographic systems. Canfield s advanced solutions, including VECTRA 3D, VISIA Complexion Analysis System, Reveal, VEOS, IntelliStudio, Mirror medical imaging software and practice specific imaging and photographic systems and products, are an integral part of aesthetic and medical consultations. Today, thousands of surgical and non-surgical consultations begin with images captured by Canfield s powerful imaging tools that improve communications, align doctor-patient expectations, facilitate treatment planning and highlight results. Classys 3F, Baekyung Bldg. 546 Samsung-ro, Gangnam-gu Seoul, Rep. of Korea telephone facsimile / / Classys is a leading global solution provider in the medical and aesthetic device fields. The company has developed high intensity focused ultrasound (HIFU) and cryocooling systems to improve patients quality of life. Classys strives to deliver happiness to both patients and practitioners via cutting edge technologies. cocoon medical Passatge de Masoliver, Barcelona 08005, Spain telephone cocoon medical is a manufacturing company based on scientific research and development, carried out by its own RDI and Scientific Department. From here springs medical and aesthetic devices with the highest technology such as the cooltech cryoadipolysis device and the primelase HR diode laser platform for hair removal. Contura International A/S Sydmarken 23 Soeborg 2860, Denmark telephone facsimile / Contura develops and markets the Aquamid product line of injectable volumizers for long lasting augmentation and restoration of facial and body features. Manufactured in Denmark using Contura s patented polyacrylamide hydrogel technology, Aquamid is sold in more than 30 countries. Aquamid has ten years of efficacy and safety data published, with numerous clinical trials involving more than 5,000 patients. Croma-Pharma GmbH Industriezeile 6 Leobendorf, Austria telephone facsimile Croma is an Austrian family-owned company and one of the world s leading experts in the field of hyaluronic acid products. Croma is committed to improving customers well-being by the development, manufacturing and distribution of innovative products and services in minimally invasive aesthetic dermatology, focusing on hyaluronic acid dermal fillers, lifting threads, PRP and skincare. Cutera 3240 Bayshore Blvd. Brisbane, CA USA telephone facsimile Cutera is a trusted authority in energy-based medical aesthetic technologies for face and body, that practitioners turn to for innovation, sophistication and performance. Cutera s premium portfolio of products include xeo, trusculpt 3D, excel V, excel HR and enlighten. 100 THE European Aesthetic Guide Volume 15

101 Cynosure, Inc. 5 Carlisle Road Westford, MA USA telephone facsimile Cynosure develops and markets aesthetic treatment systems that enable plastic surgeons, dermatologists and other medical practitioners to perform non-invasive and minimally invasive procedures to remove hair, treat vascular and benign pigmented lesions, remove multi-colored tattoos, revitalize the skin, liquefy and remove unwanted fat through laser lipolysis, reduce cellulite and ablate sweat glands. Cynosure also markets radiofrequency energy sourced medical devices for precision surgical applications such as facial plastic and general surgery. Cynosure sells its products globally under the Cynosure, Palomar, ConBio and Ellman brand names. DEKA M.E.L.A. s.r.l. Via Baldanzese, 17 Calenzano, Firenze Italy telephone facsimile DEKA designs, manufactures and markets medical lasers and pulsed light equipment for specialized medical requirements in over 83 countries worldwide. DEKA produces laser and light systems like the revolutionary MonaLisa Touch for gynecology; ear, nose and throat; surgery; aesthetic medicine; and dentistry. DEKA develops systems with innovative technologies such as, CO 2, Nd:YAG, Nd:YAP, Er:YAG, Er:Glass, Ho:YAG, Dye, KTP and Alexandrite lasers, Flash Lamp and CW IR lamp systems. Ellipse A/S Agern Allé 11 Hoersholm, DK 2970 Denmark telephone Ellipse has long-term experience producing clinically-proven, safe and effective Nd:YAG and Selective Waveband Technology (narrowband light) systems for hair removal, photorejuvenation, vascular and pigmented lesions, acne, rosacea, onychomycosis and PDT. Ellipse, sold worldwide, offers a powerful sub-millisecond pulse that rivals pulse dye lasers. A non-ablative, fractional 1550 nm laser is also available. Eunsung Global Corp. 120 Gieopdosi-ro, Jijeong-myeon Wonju-si, Gangwon-do, Republic of Korea telephone facsimile Founded in 1995, Eunsung Global provides a full range of medical laser devices for skin treatments and body contouring. Eunsung Global products include Cool Shaping, 3-Max, Magicpot, PowerShape, Megason, Spring and Jet Clear, which are marketed in more than 50 countries. Eunsung Global also provides innovative products and services to over 100 partners worldwide. Through our expansive international network we are able to offer our clients more convenient access to our products, solutions and services. Fotona d.o.o. Stegne 7 Ljubljana 1000 Slovenia telephone facsimile Fotona develops and manufacturers high performance, quality made laser systems. Our wide-range of laser systems purvey quality, reliability, safety and cutting edge innovation in treatment speed and efficiency. Our global network of representatives and reference medical centers guarantees exceptional customer support, as well as technical and clinical training. GALDERMA International Tour Europlaza - La Défense 4 20 avenue André Prothin La Défense Cedex, France +33 (0) telephone +33 (0) facsimile Galderma is a leading global pharmaceutical company specializing in the research, development and marketing of therapeutic, corrective and aesthetic solutions in dermatology. With products sold in more than 65 countries, Galderma provides a wide-range of innovative medical solutions which meet the highest standards of safety and efficacy. Gateway Aesthetic Institute & Laser Center 440 West 200 South, Suite 250 Salt Lake City, UT USA telephone facsimile info@gatewaylasercenter.com / The Gateway Aesthetic Institute & Laser Center is renowned as one of the world s top cosmetic dermatologic surgery and laser centers. Mark B. Taylor, M.D., has been a leader in the field of cosmetic laser surgery, pioneering and teaching many new laser and surgery techniques to over 4,000 doctors worldwide. General Project S.r.l. Via della Gora 15/19 Montespertoli, Florence Italy telephone facsimile General Project is an Italian company that designs and produces electromedical devices for medical and aesthetic use: effective and innovative machines that serve the most current needs and requirements of the market. The range of products includes laser platforms, ultrasound and radiofrequency-based body contouring devices, intense pulsed light and microdermabrasion systems. General Project is UNI EN ISO 9001 and UNI EN ISO certified; all devices are manufactured in compliance with European, American and Asian standards. Hironic Co., Ltd. 19F U-Tower, 767, Sinsu-ro, Suji-gu, Yongin-si Gyeonggi-do, 16827, South Korea telephone facsimile Established in 2006, Hironic is a KOSDAQ-listed company that manufactures innovative medical aesthetic laser and energy-based devices for dermatology and plastic surgery clinics. Committed to creating value for beauty and health, Hironic provides a diverse range of products including Doublo, a skin lifting device utilizing high intensity focused ultrasound (HIFU) technology for skin rejuvenation, Micool, which permanently destroys fat cells using cryo fat reduction technology for body shaping, MIRACLEAR and A-Fit for acne treatment, VeraShape for obesity care, ByeLIPO for fat reduction and cellulite removal, Q-Fit for pigmented lesion treatment and Easymo Graft, a non-invasive hair transplant device. The Hironic brand continues to be recognized, valued and trusted globally because of its beautifully designed, innovative and reliable technology. The HydraFacial Company 2165 East Spring St., 4th Floor Long Beach, CA USA telephone Established in 1997, The HydraFacial Company designs award-winning, patented skincare technologies and solutions. This Southern California-based company pioneered hydradermabrasion and now HydraFacial and Perk products are popular in over 75 countries around the world. THE European Aesthetic Guide Volume

102 IBSA Farmaceutici Italia S.r.l. via Martiri di Cefalonia, 2 Lodi, Lombardy, Italy telephone facsimile IBSA safety made in Italy is unique in this vast market owing to its complete control of the hyaluronic acid (HA) lifecycle; from raw material production to the finished product. IBSA s core products; PROFHILO, Viscoderm and Aliaxin are based on Hydrolift Action, an approach aimed at counteracting the physiological reduction of HA, restoring hydration, elasticity and skin tone. Ilooda Co., Ltd. 120 Jangan-ro 458 beon-gil Jangan-gu Suwon-si, Gyeonggi-do, Korea telephone facsimile Ilooda Co., Ltd. is a professional manufacturer of laser and other energybased systems for the dermatological and aesthetic markets. Its major product lines include a diode hair removal laser, CO 2 fractional laser and vascular laser systems, etc. The VIKINI diode hair removal laser system is one of the most well-known brands in the market, with more than 400 units sold worldwide since early Made at Ilooda technology guarantees the highest quality and world class service. InMode 100 Leek Crescent, #15 Richmond Hill, ON L4B 3E6 Canada telephone facsimile InMode is an international medical device company that manufactures and markets aesthetic applications. InMode has revolutionary non-invasive and minimally invasive options from its radiofrequency-assisted liposuction (RFAL), to fractional skin resurfacing and contraction (Fractora and Forma), ultra-fast diode hair removal (Diolaze), skin pigmentation and vascular lesions (Lumecca Photofacial), and cellulite / body contouring (BodyFX). InMode will continue to provide superior quality and innovative technology for the most in-demand procedures patients want. Jeisys Medical, Inc. 307, Daeryung Techno Town 8-cha Gasan-dong, Geumcheon-gu Seoul, South Korea telephone facsimile Jeisys Medical, Inc. produces medical devices featuring IPL / RF microneedling, HIFU, fractional CO 2 / Q-switched Nd:YAG laser, diode laser, etc., that are reliable and better quality for dermatologists, plastic surgeons and other aesthetic physicians, based on large investment in research & development and valuable experience. Lumenis (Germany) GmbH Dreieich, Germany telephone facsimile / Lumenis, one of the world s largest medical laser companies, is a global developer, manufacturer and distributor of laser and light-based devices for aesthetic, surgical and ophthalmic applications. The Lumenis Aesthetic division is a worldwide leader in energy-based aesthetic devices with a presence in over 100 countries, a pioneer in the field of aesthetic medicine and has introduced many technologies to the field, such as intense pulsed light (IPL) and CO 2 laser skin resurfacing. Leading products include: UltraPulse and AcuPulse MultiMode SuperPulse CO 2 laser, M22 multi-application platform, LightSheer Desire, LightSheer INFINITY and LightSheer DUET. Lutronic 219 Sowon-ro, Deogyang-gu Goyang-si, Gyeonggi-do, Republic of Korea telephone facsimile At Lutronic our passion is to improve the lives of physicians and their patients by developing innovative solutions that are intuitive, versatile, efficacious and beneficial to society. We are committed to investing in R&D to ensure our systems remain innovative, while maintaining reasonable pricing. Merz Aesthetics Eckenheimer Landstraße Frankfurt, Germany telephone facsimile As part of the Merz Pharma Group, Merz Aesthetics offers not only a multifaceted portfolio of products, but also a unique range of customer services and professional training that set us apart in the field. Today, our products are used by healthcare professionals in more than 90 countries. Building on more than a century of healthcare expertise, we have a clear mission: We strive to improve patients health, helping them live, feel and look better. mesoestetic Pharma Group C/ Tecnologia, 25 Viladecans, Barcelona telephone facsimile Specializing in dermatology and cosmetic medicine, mesoestetic Pharma Group offers leading anti-aging and depigmenting treatments. With a production plant, logistics platform, as well as Biotechnology, Medical Monitoring and Follow-up Units, the company can carry out the entire production cycle, including in vitro and in vivo studies to develop, manufacture and market products under its brand name mesoestetic, including cosmeceutics, nutraceutics, class III intradermal administration medical devices with CE marking, topical medication and electro-medical equipment available in over 80 markets. All products are supported by clinical research guaranteeing their safety, quality and excellent therapeutic results. N-Finders Co., Ltd. #1211, 55, Digital-ro 33-gil Guro-gu, Seoul Korea telephone facsimile N-Finders Co., Ltd. is a relatively new corporation established in 2012 that has earned considerable recognition in the regenerative medicine market based on a regenerative medical theory by a group of experts. With regeneration as the motto, the company s RE: brand was launched. Its collection includes RE: PRP, RE: PDO Thread and Ozein Peel(O 3 ), which received the world s first patent. The power of regenerative medicine extends to skincare, hair loss, obesity and pain treatments, based on scientific evidence through clinical trials. Furthermore, an in-house R&D center has been founded in order to respond to environmental changes with decisive and sustainable research, development and investment. N-Finders Co., Ltd. is constantly proving itself as a leader in regenerative medicine both nationally and globally. Novavision Group S.p.A. Via Dei Guasti 29 Misinto, Milano, Italy telephone facsimile / / Novavision Group is an all-italian company, which has been a leader for over 30 years in the research, development and production of new biotechnologies. Every phase takes place in-house. Expert staff and an Ethics Committee made up of physicians, engineers and specialists, dedicate themselves daily to the study and creation of new high-performance technologies and the constant improvement of existing ones. 102 THE European Aesthetic Guide Volume 15

103 PerfAction Technologies, Ltd. 10 Plaut St. Rehovot, Israel telephone facsimile PerfAction Technologies is a medical technology company pioneering new treatment modalities for aesthetic and dermatological applications. The EnerJet platforms bring together the company s proprietary Jet Volumetric Remodeling (JVR) technology, which simultaneously delivers kinetic energy and a healing compound to create a unique micro-trauma profile, enabling a controlled deep injury effect for scar repair and dermal remodeling. Quanta System S.p.A. Via Acquedotto, 109 Samarate, VA Italy telephone facsimile Quanta System is an Italian company founded in 1985, based in Milan, Italy. Since 2004 it has been part of the El. En. international group. Quanta is among the first companies in the world producing lasers for three scientific fields: aesthetic medicine, surgery and art. Three areas united by one principle: to improve patients quality of life and take care of people. Sciton, Inc. 925 Commercial Street Palo Alto, CA USA telephone facsimile Sciton is committed to providing best-in-class laser and light solutions for medical professionals who want superior durability, performance and value. Sciton offers superior medical devices for laser-assisted lipolysis, fractional and full-coverage skin resurfacing, hair removal, phototherapy, wrinkle reduction, treatment of vascular and pigmented lesions, scar reduction and acne, all on an expandable platform. The new Halo laser is the first hybrid fractional laser, combining ablative and non-ablative wavelengths for epidermal renewal and deep dermal rejuvenation with non-ablative downtime. Sinclair Pharma rue de la Bienfaisance Paris, France telephone Sinclair provides aesthetic dermatology solutions through collagen stimulation for facial volume loss, thread lifting for facial contouring and dermal fillers for wrinkles and lines. Skin Tech Pharma Group S.L Castelló d Empúries Spain telephone As a pioneer in the field of aesthetic medicine since 1996, Skin Tech Pharma Group S.L. offers a complete line of innovative solutions for aesthetic dermatology, through its brands Skin Tech and Aesthetic Dermal. The Skin Tech brand is focused on chemical peels and post-peel care cosmeceuticals, while Aesthetic Dermal is specialized in injectable solutions that improve skin quality, prevention of facial or body skin aging, and other specific dermatologic situations. Both brands offer a complete range of professional and home care products. As an ISO 9001, ISO and ISO certified laboratory, the company manufactures cosmeceuticals and medical devices such as injectable hyaluronic acid, organic silicium based skin boosters (Class III), CE marked TCA peels and Phenol (Class II), with worldwide exportation. SmartGraft by Vision Medical, Inc. 46 Regency Plaza Glen Mills, PA USA telephone facsimile / sales@smartgraft.com SmartGraft is an exciting new breakthrough for hair loss patients allowing more men and women to take advantage of the benefits of no-scalpel / nosuture FUE hair transplants. SmartGraft uniquely offers a closed harvesting system that is revolutionizing the way physicians perform minimally invasive hair restoration. The SmartGraft device allows physicians to gently and precisely harvest, collect and store donor grafts more efficiently and safer than other devices. Soft Medical Aesthetics 55 boulevard Péreire Paris France telephone facsimile French ISO & CE manufacturer SoftFil, offers the largest range of flexible microcannulas for a perfect method of injection 18 sizes including the SoftFil Precision with its famous graduation, surface treatment, extra thin wall and red dot. Discover the revolutionary patented medical device, SoftFil EasyGuide, the two-in-one pilot needle that combines puncture and injection with a cannula. SRS International SPRL Rue Abbé Cuypers 3 Brussels 1040 Belgium +32 (0) telephone SRS International is a European company specializing in Transdermal Therapy for more than ten years with refined expertise in beauty, aesthetics and cosmeceutical solutions. Implemented in more than 30 countries, our brand covers a highly-dosed professional range, precisely targeting each skin disorder with safe, effective and non-invasive formulas to create products with proven efficacy for aging, flaccidity, melasma, hair loss, cellulite and fat. Sterimedix Limited 1 Madeley Road, North Moons Moat Redditch, Worcestershire, B98 9NB UK telephone facsimile Sterimedix manufactures a complete range of aesthetic cannulas for injection of dermal fillers and fat. Manufactured in our U.K. facility and approved for sale worldwide, the products under the Silkann brand represent the highest quality of cannulas at sensible prices. With over 25 years experience in the manufacture of medical devices, Sterimedix is uniquely qualified to provide the products required by the modern aesthetic practitioner. STORZ MEDICAL AG Lohstampfestrasse 8 Tägerwilen, Switzerland telephone facsimile STORZ MEDICAL was one of the first companies worldwide to successfully enable the use of shock waves in aesthetic and anti-aging medicine as pulsating acoustic waves. With this development, known as Acoustic Wave Therapy (AWT ), STORZ MEDICAL now offers non-invasive treatment options for body shaping, cellulite treatment, striae, scars, wrinkles, postliposuction treatment, lymphatic congestion, muscle and connective tissue relaxation with the CELLACTOR SC1»ultra«and D-ACTOR»ultra«lines. THE European Aesthetic Guide Volume

104 Syneron Candela Spain Campezo, 1. Edif. 5. PB Norte Madrid, Spain telephone Syneron manufactures and sells non-ablative to ablative medical aesthetic devices that use a wide variety of energies including Syneron s signature elōs technology a combined energy platform that effectively treats dermatological conditions including wrinkles, pigmentation, skin laxity, acne, rosacea, hair removal, vascular lesions, cellulite and circumferential reduction. TEOXANE Laboratories 105 rue de Lyon Les Charmilles CH 1203 Geneva, Switzerland +41 (0) telephone +41 (0) facsimile Established in Geneva in 2003, TEOXANE Laboratories are specialized in the design and manufacturing of hyaluronic acid-based dermal fillers. As a result of its uncompromising commitment to innovation, quality and patient satisfaction, TEOXANE is now among the top three hyaluronic acidbased dermal filler manufacturers in the world with products in more than 80 countries. Thermi, LLC 8304 Esters Blvd., Suite 890 Irving, TX USA telephone facsimile Thermi, an Almirall company, is a leading global manufacturer and distributor of Temperature Controlled Radiofrequency technology. Thermi offers the Thermi250 device, the newest innovation in Temperature Controlled Radiofrequency technology for body applications. Ulthera, Inc., a Division of Merz, Inc S. Stapley Drive, Suite 200 Mesa, AZ USA telephone facsimile Ulthera, Inc. is a global, high-growth medical device innovation center pioneering aesthetic and medical applications using therapeutic ultrasound platform technology. The Ulthera System is CE Marked for non-invasive dermatological sculpting and lifting of the dermis of the upper face, lower face, neck and décollete. Laboratoires VIVACY 44 rue Paul Valéry Paris, France telephone / French manufacturer, Laboratoires VIVACY is specialized in the design, production and distribution of high quality injectable medical devices for use in the field of anti-aging, especially in medical aesthetics. The company has acquired recognized expertise in dermal fillers based on hyaluronic acid and natural antioxidants, mannitol and sorbitol with the range STYLAGE. Viveve, Inc. 345 Inverness Drive South, Suite 250 Englewood, CO USA telephone Viveve, Inc. is committed to advancing solutions to improve women s overall well-being. Backed by randomized, placebo-controlled data, their flagship product, the Viveve System, is the only device in its class that uses patented, Cryogen-Cooled Monopolar Radiofrequency (CMRF) to remodel vaginal tissue in a single, 30-minute session satisfying patient demand for a painless solution for vaginal laxity. Vaginal laxity is associated with decreased sexual sensation and urinary incontinence. WONIK Corporation 7th Floor Wonik Building, 20 Pangyo-ro, 255 beon-gil Bundang-gu, Seongnam-si, Gyeonggi-do, South Korea telephone facsimile WONIK Corporation specializes in providing innovative treatment solutions in medical and aesthetic applications. We combine our expertise in marketing world-class products and satisfying customers for over 30 years to enhance the patient experience and clinical results. We re offering our flagship product, INNOJECTOR, which provides a clinically-proven, new treatment option for aesthetic and dermatological applications. ZELTIQ Aesthetics, Inc Rosewood Drive Pleasanton, CA USA telephone facsimile ZELTIQ is a medical technology company focused on developing and commercializing products utilizing its proprietary controlled-cooling technology platform. ZELTIQ s first commercial product, the CoolSculpting system, is designed to selectively reduce stubborn fat that may not respond to diet or exercise. Zimmer MedizinSysteme GmbH Junkersstraße 9 Neu-Ulm, Germany telephone facsimile Zimmer MedizinSysteme is a leading supplier of skin cooling devices used during laser and intense pulsed light treatments and prior to aesthetic dermatology injections. A new dermal filler for the dermatology sector has been launched into the Zimmer product pallet. Based on hyaluronic acid, the brand new ZFill product line (refresh 2, contour 2 and deep 2 ) is suitable for all established indications of wrinkle injections. In 2010 ZWave, a new system for cellulite treatment using radial shockwave, was launched. The brand new Cryolipolysis system ZLipo enables targeting fat deposits and reducing them permanently and non-invasively. 104 THE European Aesthetic Guide Volume 15

105 Skin Rejuvenation Comparison Chart Supplier Product Name Device Type Wavelength (nm) Energy Output (Joules) Pulse Length Accessories BTL Industries, Inc. BTL Protegé Elite Focused Monopolar RF Impedance intelligence and square spectrum energy profiling handpiece prevents sparking or tissue burn. No consumables. Candela Alex TriVantage with Laser- Pumped Laser Handpieces Vbeam Perfecta GentleMAX Pro GentleLase Pro-U GentleYAG Pro-U Microsecond Pulse and Q-switched Alexandrite / Nd:YAG / KTP Nd:YAG Pulsed Dye Laser Long Pulse Alexandrite / Nd:YAG Long Pulse Alexandrite (upgradable to GentleMAX Pro) Long Pulse Nd:YAG (upgradable to GentleMAX Pro) 755 nm / 1064 nm / 532 nm 595 nm 755 nm / 1964 nm 755 nm 1064 nm Up to 18 J/cm 2 Q-switched; up to 70 J/cm 2 long pulse Up to 40 J/cm 2 Up to 520 J/cm 2 Up to 520 J/cm 2 Up to 520 J/cm 2 50 ns (all wavelengths); 100 μs at 755 nm ms ms ms ms 2, 3 and 4 mm spots at 755 nm. 2, 3 and 5 mm spots at 1064 and 532 nm. Eight spot sizes up to 12 mm, including 3 x 10 elliptical and pigmented lesion handpieces. Unique, patented Dynamic Cooling Device maximizes patient comfort and Tx efficacy mm spot sizes. Unique, patented Dynamic Cooling Device maximizes patient comfort and Tx efficacy. Air Cooling Compatible delivery systems available. Same as above. Same as above. Classys ULTRAFORMER III Cutera xeo excel V enlighten High Intensity Focused Ultrasound (HIFU) Laser Laser Laser J/cm 2 Four face cartridges: 1.5 mm, 2 mm, 3 mm, 4.5 mm; three body cartridges: 6 mm, 9 mm, 13 mm nm 532 nm, 1064 nm 532 nm, 670 nm, 1064 nm Up to 300 J/cm 2 Up to 300 J/cm 2 Up to 300 ms Up to 60 ms 750 ps, 660 ps plus 2 ns Optional IPL handpieces. Micro Lens Array. Cynosure Icon MaxG handpiece 1540 handpiece 2940 handpiece Emerge PicoSure RevLite SI MedLite C6 Affirm with Multiplex Elite MPX Elite+ Elite Acclaim Pellevé Wrinkle Reduction System Cortex Resurfacing Work Station Medley Multifunction Laser and IPL System DEKA SmartXide DOT SmartXide 2 DOT/RF SmartXide Touch Synchro HP Excellium MiniSilk FT Optimized Light Fractional Non- Ablative Laser Fractional Ablative Laser Fractional Non-Ablative Laser Alexandrite Nd:YAG Nd:YAG Non-Ablative Fractional Multi-Wavelength Aesthetic Platform Alexandrite / Nd:YAG Alexandrite / Nd:YAG Nd:YAG High Frequency Monopolar RF (4.0 MHz) CO2 / Er:YAG Laser Er:YAG / QS Nd:YAG / IPL / 810 nm Diode Fractional CO2 Fractional CO2 plus RF Fractional CO2 plus RF Multi-Functional Platform Pulsed Light System nm, nm 1540 nm 2940 nm 1410 nm 755 nm 1064 nm, 532 nm, 585 nm, 650 nm 1064 nm, 532 nm, 585 nm, 650 nm 1440 nm, 1320 nm, Multiplex 755 nm, 1064 nm MultiPlex, IPL 755 nm / 1064 nm 755 nm / 1064 nm 1064 nm Up to 80 J/cm 2 Up to 70 mj per microbeam 3 24 mj mj per microbeam mj Up to 30 J/cm 2 Up to 14 J/cm 2 Up to 14 J/cm 2 Up to 600 J/cm 2 Up to 600 J/cm 2 Up to 600 J/cm 2 Up to 600 J/cm 2 10,600 nm / 2940 nm Up to 40 W / up to 1 J 2940 nm / 532 nm, 1064 nm / nm, 810 nm 10.6 µm 10.6 µm 10.6 µm 1064 nm Nd:YAG / 500 nm, 520 nm, 550 nm, 600 nm, 650 nm IPL 500 nm, 520 nm, 550 nm, 600 nm, 650 nm IR filter 50 W max. 80 W max. 60 W max. LP 120 J 180 W (max.), SP 120 J (max.) / 160 J (max.) energy per pulse J/cm ms ms ms 6 20 ms picoseconds 5 20 ns 5 20 ns 3 ms ms ms ms ms Adjustable to 6 ms / 300 µs µs µs µs From 2 50 ms SP, from ms LP / from 3 8 ms 2 85 ms (1-3 pulses) Advanced contact cooling and dual filters minimize unnecessary epidermal exposure for enhanced patient comfort. XF microlens provides high, non-ablative coverage for fast resurfacing treatments; XD microlens offers greater treatment depth for challenging conditions. Three light delivery modes: Manual activation for focused Tx areas, AutoStamp for faster treatments and AutoGlide for ease of use and enhanced comfort. Five pre-set parameters for treatment of pigment, wrinkles or general skin resurfacing. Compact system design to easily store within a practice. Picosecond skin rejuvenation and toning for treatment of acne scars, wrinkles and removal of pigmented lesions. PressureWave technology enables impressive results with less fluence leading to increased patient comfort and minimal downtime. MultiLite handpieces converting to 585 and 650 nm wavelengths. Additional MultiSpot handpiece offering 2-8 mm spot sizes. Same as above. Proprietary MultiPlex technology, optional XPL ( nm) and Erbium handpiece. Compatible with SmartCool air cooling system. High powered Nd:YAG and Alexandrite with spot sizes ranging from mm. Patented MultiPlex technology blends wavelengths for superior results. Integrated IPL (530, 560, 590 nm) and Zimmer cooling system. High powered Nd:YAG and Alexandrite with spot sizes ranging from mm. Compatible with SmartCool air cooling system. High powered Nd:YAG and Alexandrite with spot sizes ranging from mm. Compatible with SmartCool air cooling system. Same as above. Upgradable to Elite dual wavelength system. Pellevé GlideSafe handpieces four sizes (7.5, 10, 15 and 20 mm) enable customized treatment for each patient. Fixed-life reusable design minimizes consumable costs per patient. Pellevé S5 Generator powers GlideSafe handpieces, as well as hundreds of traditional electrosurgery tips for a variety of surgical procedures. Fractional CO2 combined with Er:YAG with 1.5, 3 and 6 mm spot sizes. One year manufacturer warranty. DOT scanner and freehand handpiece; touch screen monitor; Stack feature; Smart Track delivery mode; Smart Pulse; patient database; CW, PW, traditional and fractional scanning modes available. PSD technology with selectable pulse shape (SP, DP, UP, HP, PW, CW, traditional and fractional scanning modes available); DOT/RF scanner with RF feature; freehand, TFT touch screen monitor; Stack and Smart Track delivery modes; multimedia built-in training videos; patient database with videos and photos. Store user protocols. Optional diode laser module. PSD technology with selectable pulse shape (SP, DP, HP, PW, CW, traditional and fractional scanning modes available); DOT/RF scanner with RF feature; freehand; TFT touch screen; Stack and Smart Track delivery modes, built-in training videos; database with videos and photos. Store user protocols. Optional diode laser module. Multidisciplinary. 180 W Nd:YAG laser module with up to 27,000 W pulse peak power; three delivery pulse designs; 11 application handpieces (22 mm and 24 mm available) and optional five filter IPL with enhanced vascular capabilities 500G. Auto Spot Size Recognition system. Top Hat technology; contact or optional external cooling connections; patient database and protocols; no disposables. Interchangeable snap-on filters, integrated contact cooling; lamp water cooling; transportable. 3.1 cm 2 or 6.2 cm 2 spot area available. IR filter available for greater skin tightening. Note: Data subject to change; please refer to Company Directory for supplier contact information. THE European Aesthetic Guide Volume

106 Skin Rejuvenation Comparison Chart Supplier Product Name Device Type Wavelength (nm) Energy Output (Joules) Pulse Length Accessories DEKA continued Synchro FT Synchro REPLA:Y Ellipse A/S Nordlys Nordlys LIMITED Sirius Eunsung Global Corp. Duet RF Fraction CO2 Comfort Dual Microson Focus Dual Fotona d.o.o. SP Dynamis XS Dynamis StarWalker General Project 3face Med Flash II CS Med Visage Med Visage RF MC1 Multipower Laser Touch Hironic Co., Ltd. New MIDAS MIXEL DOUBLO-S MIRACLEAR Doublo Gold Q-Fit Ilooda Co., Ltd. Secret RF Fraxis Fraxis DUO Multiple IRIS CuRAS InMode Lumecca Forma Fractora Multi-Functional Platform Multi-Functional Platform Multi-Technology Platform Selective Waveband Technology (SWT) SWT Bipolar / Monopolar RF CO2 Bipolar RF High Intensity Focused Ultrasound HIFU + RF Needle Nd:YAG / Er:YAG Er:YAG Nd:YAG Q-Switched / Long Pulse Multiple System for face Pulsed Light Ultrasound Ultrasound / RF Ultrasound / RF Multiple Laser Platform RF / IR CO2 Fractional High Intensity Focused Ultrasound Blue Light, Vacuum, IPL High Intensity Focused Ultrasound Q-switched Nd:YAG RF microneedle CO2 Fractional CO2 Fractional / RF microneedle OPS Diode Laser Q-Switched Nd:YAG Spectrum Shifted IPL Bipolar RF Bipolar RF 1064 nm Nd:YAG / 500 nm, 520 nm, 550 nm, 600 nm, 650 nm IPL 755 nm Alexandrite / 1064 nm Nd:YAG / 500 nm, 520 nm, 550 nm, 600 nm, 650 nm IPL 700 J/cm 2 (max.) SP and LP / 160 J (max.) energy per pulse 63.5 J (max.) 125 W (max.) / 120 J 180 W (max.) LP; 120 J (max.) SP / 160 J (max.) energy per pulse nm, nm Up to 19 J/cm nm, nm Up to 17 J/cm nm Up to 12 J/cm 2 10,600 nm 1064 nm / 2940 nm 2940 nm 1064 nm nm, nm, nm nm, nm 5 MHz Nd:YAG 1064 nm, 1320 nm / Er:YAG 2940 nm Bipolar (RF: 1 MHz / IR: 700 2,000 nm), monopolar (RF: MHz) 10,600 nm nm 1064 nm / 532 nm 10,600 nm 10,600 nm 532 nm (Fractional); 532 nm (Normal) 1064 nm; 532 nm nm, nm 7 50 W mj 25 W J/cm J/cm 2 Up to 600 J/cm 2 Up to 500 J/cm 2 Up to 160 J/cm 2 Up to 30 J Up to 600 J at lamp level 3 W/cm² 3 W/cm² / 40 W 3 W/cm² / 65 W 18 J, 12 J / 2 J 360 W / 75 W 60 mj J/cm J/cm J/cm J / 0.5 J 25 W 30 W 30 W / 20 W 70.7 J/cm 2 ; 832 J/cm J/cm J/cm 2 Up to 65 W Up to 62 mj / Pin ms SP; 2 30 ms LP (1 3 pulses) / 3 8 ms 2 50 ms (single pulse); 2 40 ms (double pulse) / 2 50 ms SP; ms LP / 3 8 ms ms (programmable) Up to 100 ms) (programmable) Up to 15 ms 70 1,600 ms ms ms ms 5 20 ns / 250 μs / VERSA3: ms Pre-set from 0 4 sec Single pulse: ms, pulsed mode: ms (duration), ms (interval) Width: 3-10 ms / ms Continuous Up to 5,000 µs 3 27 ms 5 10 ns ms ms ms / ms 100 ms; 400 ms 5 20 ns; 100 ns; 300 µs 5 30 ms Up to 2 pps Nd:YAG and IPL platform with five application specific handpieces. Top Hat technology and Auto Spot Size Recognition; contact or optional external cooling connections; delivery pulse settings available; patient database and protocols. IPL: five optional filters, 30,000 shots guaranteed. No disposables. 5 Hz and high power (125 W) on Alexandrite emission; 180 W Nd:YAG laser module with up to 27,000 W pulse peak power. Three delivery pulse designs and adjustment feature for Alexandrite and Nd:YAG. Twelve application handpieces to 24 mm. Auto Spot Size Recognition. Top Hat technology; contact or optional external cooling connection; patient database and protocols. IPL: five optional filters with enhanced vascular capabilities 500G. No disposables. Rejuvenation is performed using Selective Waveband Applicators: VL555 handpiece available on all systems. PR530 handpiece available on Nordlys and Nordlys LIMITED. All systems include dual mode filter and programmable pulse technology. Sirius includes patient database. Nordlys and Nordlys LIMITED feature database, expert pulse adjustment and unique submillisecond SWT pulse. Nordlys also offers dual-mode Nd:YAG with SoftCool cooling and a fractional laser (Frax 1550) for treatment of skin resurfacing, acne and surgical scars, and stretch marks. Partical handpiece with easy tip replacement; NS, NC, NCE; 64 pin, 100 pin, 196 pin. Specialized handpiece for optimum functionality; micro spot beam size; more than 70 μm. Shot mode: treatment selection per body area. Motion mode: two pre-set programs per body area and respective energy density. Five cartridges: SM 4-4.5, DD 7-3.0; SD 7-1.5, SD 7-1.5N, SC 4-13; three dot density levels; 25 mm max. length. Five cartridges: SM 4-4.5, DD 7-3.0; SD 7-1.5, SD 7-1.5N, SC 4-13; 25 pin needle. F-Runner, fractional Er:YAG scanner: 250 µm spot size, 168 mm 2 Tx area S-Runner, Er:YAG scanner: 4 mm spot size, 16 cm 2 Tx area. L-Runner Nd:YAG scanner: 42 cm 2 Tx area. Er:YAG handpieces: mm spot sizes; Nd:YAG handpieces: 2-20 mm spot sizes. F-Runner, fractional Er:YAG scanner: 250 µm spot size, 168 mm 2 Tx area S-Runner, Er:YAG scanner: 4 mm spot size, 16 cm 2 Tx area. Er:YAG handpieces: mm spot sizes. Handpieces: 2-8 mm spot sizes. Multiple system for face care (microdermabrasion, vacuum-assisted massage, phototherapy) with HBLM technology. Handpiece with integrated skin cooling system. Spot sizes: 50 x 25 mm, 35 x 15 mm and 15 x 15 mm. Non-invasive ultrasound for facial Tx. Non-invasive ultrasound / RF for facial Tx. All in one handpiece. Multi-technology, multi-application platform. Nd:YAG 1064 spot sizes: 1.5, 3, 5, 8, 5-12 mm, fractional tip; 1320 spot sizes: 3, 6, 9, 5-12 mm, fractional tip; Er:YAG spot sizes: 3,6,9, 5-12 mm, fractional tip. No consumables; real-time cooling system (up to -5 C). Metal tube; scanner type, scan size 2 x 2 mm to 20 x 20 mm. Beam size: µm. Maximum spot quantity: 40,000. Three types of cartridges: M7, D4, D7, available to 10,000 shots; mm space between dots, length 5-25 mm. Small tip: 14.5 x 12.5 mm; normal tip: 26.5 x 14.5 mm. Three types of cartridges: M7, D4, D7 available to 10,000 shots mm space between dots; length 5 25 mm. 532 Fractional, 1064 Fractional, Fixed Collimated handpieces. 25 pin sterilized RF bipolar tips (optional 64 insulated pin available); monopolar handpiece for small Tx areas such as around the eyes; optional smart pen handpiece for acne and thread vein. CO2 fractional handpiece; optional surgical handpiece. RF fractional needle handpiece; CO2 fractional handpiece; optional surgical handpiece. 532 nm Fractional, 532 nm Normal; available to treat vascular lesions in the epidermis. Energy meter including Zoom handpiece; collimated handpiece; optional fractional handpiece. Delivers 40% of total energy between nm. Provides a photofacial in one to three treatments. Powerful peak power: 3,000 W/cm 2. Non-invasive subdermal heating for collagen remodeling and contraction. RF current flows uniformly between the electrodes for a comfortable and safe Tx. Special technology features built-in temperature controls to attain clinically proven optimal epidermal temperature, and exclusive capability for prolonged exposure at therapeutic temperatures. Variable pin tip configurations (24 coated, 24, 60) and Tx depths allow for a Designer Dermis approach. Note: Data subject to change; please refer to Company Directory for supplier contact information. 106 THE European Aesthetic Guide Volume 15

107 Skin Rejuvenation Comparison Chart Supplier Product Name Device Type Wavelength (nm) Energy Output (Joules) Pulse Length Accessories Jeisys cellec v TRI-BEAM SmoothCool Edge Fractional INTRAcel INTRAcel PRO IntraGen ULTRAcel IPL QS Nd:YAG Intense Pulsed Light Fractional CO2 Laser Fractional RF Microneedling Fractional RF Microneedling Grid Fractional RF Multi-Functional Platform (HIFU / Fractional RF Microneedling / Grid Fractional RF) nm 1064 nm / 532 nm / 585 nm / 650 nm nm / nm 10,600 nm Up to 60 J/cm J (1064 nm PTP) / 500 mj (532 nm) Up to 65 J/cm mj Up to 50 W Up to 50 W Up to 200 W Up to 3 J / up to W / up to 200 W 1 60 ms 5 10 ns (QS) / 300 µs (Quasi-Long) 1 60 ms ms 5 1,000 ms 10 ms 5 sec 0 2 sec ms / 60 2,000 ms / 0 2 sec Nine interchangeable filters: 420S ( nm), 500S ( nm), 530S ( nm), 550S ( nm), 530D ( nm and nm), 560 nm, 640 nm, 700 nm. Spot size: 40 x 10 mm; contact cooling. Zoom, collimated and fractional handpieces; Dye handpieces: 585 and 650 nm. 560 ( nm) handpiece: 34 x 8 mm spot size; 700 ( nm) large handpiece: 50 x 10 mm spot size; 700 ( nm) small handpiece: 34 x 8 mm spot size. Contact cooling (below 0 C). Spot size: 120, 350, 800 µm, surgical tip; surgical handpieces (50 and 100 mm). Invasive tip (FRM) and non-invasive tip (SRR); bipolar and monopolar available. Insulated except for 0.3 mm at end of the tips where it emits the RF energy. 49 tip (insulated). Insulated (except 0.3 mm) at end of tips where RF is emitted. SRR Tip / 16 Tip (non-insulated). Bipolar and monopolar available. Full tip (15 x 15 mm) and small tip (7 x 7 mm). Platform device features HIFU, RF microneedling and non-invasive RF technology. HIFU: B cartridge (depth: 3.0 mm); C cartridge (depth: 4.5 mm). FRM: FRM tip; SRR tip. GFR: large (15 x 15); small (7 x 7) tip. Lumenis M22 LightSheer INFINITY with HS with ET ChillTip Applicator with LR ChillTip Applicator IPL / MultiSpot Nd:YAG / ResurFX / Q-Switched Diode Laser Diode Laser Diode Laser nm / 1064 nm / 1565 nm / 1064 nm 805 nm, 1060 nm 805 nm, 1060 nm 805 nm, 1060 nm J/cm 2 / J/cm 2 / mj/mb / J/cm J/cm J/cm J/cm 2 IPL: 4 20 ms / Nd:YAG: 2 20 ms / QS: 6-8 ns ms ms ms Multi-technology, multi-application platform. Upgradable, expandable, 7 IPL filters, novel OPT, optimized presets, spot sizes: 15 x 35 nm and 8 x 15 nm (IPL); 6 mm, 2 x 4 mm 2 (Nd:YAG); 1565 nm fiber laser, 2, 2.5, 3.5, 5 and 6 mm (Q-switched Nd:YAG). Spot size: 22 x 35 mm; comfort management: vacuum-assisted (up to 18 in Hg); repetition rate: up to 3 Hz; pulse repetition: 1-3 pulses. Spot size: 9 x 9 mm; comfort management: Chilltip contact cooling (2 C); repetition rate: up to 3 Hz; pulse repetition: 1 pulse. Spot size: 9 x 27 mm; comfort management: Chilltip contact cooling (12 C); repetition rate: up to 3 Hz; pulse repetition: 1 pulse. Lutronic SPECTRA SOLARI HEALITE eco2 INFINI MOSAIC HP CLARITY ACTION II Lasemd SPECTRA XT PICOPLUS Q-switched Nd:YAG IPL LED CO2 Fractional Bipolar Fractional RF Er:Glass Fractional Long Pulsed Alexandrite / Nd:YAG Fractional Er:YAG Laser Thulium Fractional Laser Nd:YAG based Multi-Platform Q-Switched Nd:YAG 532 nm, 585 nm, 650 nm, 1064 nm nm 830 nm (with 590 nm); 633 nm; 415 nm available (single wavelength per head) 10,600 mm 1550 nm 755 nm / 1064 nm 2950 nm 1927 nm 1064 nm, 532 nm, 585 nm, 595 nm, 650 nm, 660 nm 1064 nm, 532 nm, 595 nm, 660 nm Up to 1.5 J 35 J/cm 2 (with 510 nm filter) Focused: up to 150 mw/cm 2 ; up to 80 mw/cm 2 ; up to 50 mw/cm mj 50 W mj Up to 600 J/cm 2 50 J, Long pulse: 180 J Up to 20 mj 1064: 1.2 J at ns max., 4.5 J at quasi-long max.; 532: 0.4 J max., 585 and 595: 0.25 J max., 650 and 660: 0.15 J max. Up to 800 mj 5 7 ns / 300 µs, (Spectra Mode) ms Ultra Pulse: 40 1,000 µs; Super Pulse: 1 5 ms 10 1,000 ms ms 250 µs, Long Pulse: 1,000 ms 5 10 ns, 300 ms 450 ps / 2 ns Variety of handpieces: 3-8 mm Zoom Collimated; 1-7 mm Zoom; 7 mm Fixed Collimated; 585 nm and 650 nm Dye. Cut-off filters. Variety of heads and configurations available: single and dual wavelength heads. Planar and Focused (max. intensity) delivery options. Fractional or Insicional handpieces. Variety of Fractional handpiece tips available: 120, 300, 500 micron tip. Variety of handpieces and tips available. MFR handpiece: 49 tip (7 x 7 needles, scan size: 10 x 10 mm); Comfort / 16 tip (4 x 4 needles, scan size: 5 x 5 mm); SFR handpiece: 144L tip (12 x 12 electrodes, Dual Channels, scan size: 20 x 20 mm); 64S tip (8 x 8 electrodes, Single Channel, scan size: 10 x 10 mm). Skin and hair tips. Nine adjustable spot sizes, ICD cryogen or air cooling. Fractional, Zoom, Shining Peel and Petit Lady handpieces. Variety of ampoules for cosmeceutical delivery: Vitamin C, Vitamin A, Tranexamic Acid, CK (human blood cell conditioned media + KGF) and RS (Resveratrol). Roller set. comb tip set, square tip set. Zoom HP, Collimated, Dye, Gold Toning, RuVY Touch, Fractional. Five different handpieces: 1-6 mm Zoom, 6-10 mm Pico Toning, 2 and 5mm Gold Toning+, 2 and 3 mm RuVY Touch+, 7.4 x 7.4 mm Focused Dots. Novaclinical, a division of Novavision Group 4PLUS/RADIO4M PLW IFL Patented Dynamic Quadripolar RF, RF Safety System (RSS), Variable RF (VRF), Quadripolar Dynamic Fractional RF (4RFH), Needled Fractional RF (4NFR) Incoherent Fast Light nm Up to 55 W Up to 100 J ms Movement sensors, pyrometric temperature detectors, five handpieces: small, medium, large and 4RFH with 32 golden pins and 384 µneedles, 4NRF for a targeted and focused action. Biofeedback. Interchangeable filters: 400 nm, 520 nm, 550 nm, 600 nm, 650 nm and 720 nm; biocompatible disposable filters, Suberburst: single, repetition, IFL modes. Note: Data subject to change; please refer to Company Directory for supplier contact information. THE European Aesthetic Guide Volume

108 Skin Rejuvenation Comparison Chart Supplier Product Name Device Type Wavelength (nm) Energy Output (Joules) Pulse Length Accessories Quanta System Discovery Pico Light B EVO Light C EVO Light A Star EVO Light 4V EVO Q-Plus Star 1 EVO Duetto MT EVO Q-Plus C EVO Q-Plus A EVO Q-Plus R EVO TWAIN IPL option TWAIN 2940 option Eterna Giovinezza Plus New Silk Light (table top) Thunder HR Thunder VT Thunder Thunder MT Picosecond Nd:YAG Nd:YAG Nd:YAG / KTP Nd:YAG Light A + Light B Light A + Light C Nd:YAG / Nd:YAG Q-Switched / KTP Nd:YAG Q-Switched Alexandrite / Nd:YAG Q-Switched Nd:YAG + Q-Switched Ruby all in one Q-Switched Nd:YAG Ruby Q-Switched Pulsed Light Er:YAG Pulsed Light Pulsed Light Alexandrite Nd:YAG Alexandrite / Nd:YAG Alexandrite / Nd:YAG 532 nm / 1064 nm 1064 nm, 1320 nm Up to 500 J/cm 2, up to 35 J/cm nm, 1320 nm / Up to 500 J/cm 2, 532 nm up to 35 J/cm 2 / up to 90 J/cm nm, 1064 nm, 1320 nm Light A, Light B 532 nm, 755 nm, 1064 nm, Light A, Light C 1320 nm 1064 nm, 1320 nm / 1064 nm / 532 nm 755 nm / 1064 nm 532 nm / 1064 nm / 694 nm 532 nm, 1064 nm 694 nm nm 2940 nm nm, nm nm 755 nm 1064 nm 755 nm / 1064 nm 755 nm / 1064 nm 0.3 J (ps), 0.4 J (ns) / 0.8 J (ps / ns), 2 J (μs) Up to 500 J/cm 2, up to 35 J/cm 2 / up to 37 J/cm 2 (ns), 50 J/ cm 2 (μs) / up to 15 J/cm 2 Up to 120 J/cm 2 / up to 500 J/cm 2 Up to 15 J/cm 2, up to 37 J/cm 2 (ns), 50 J/cm 2 (μs) up to 30 J/cm 2 (ns), 50 J/cm 2 (ms) Up to 15 J/cm 2, up to 37 J/cm 2 (ns), 50 J/cm 2 (μs) Up to 30 J/cm 2 (ns), 50 J/cm 2 (ms) Up to 25 J/cm 2 Up to 95 J/cm 2 Up to 30 J/cm 2 Up to 30 J/cm 2 Up to 500 J/cm 2 Up to 500 J/cm 2 Up to 500 J/cm 2 Up to 500 J/cm ps, 6 ns, 6+6 ns / 450 ps, 6 ns, 6+6 ns, 300 μs ms, 5 10 ms ms, 5 10 ms / 2 50 ms Light A, Light B Light A, Light C See above ms, 5 10 ms / 6 ns; 6+6 ns; 300 μs / 6 ns; 6+6 ns ms 6 ns, 6+6 ns / 6 ns, 6+6 ns, 300 μs / 30 ns, 2 ms 6 ns, 0.3 ms (1064 nm only) 30 ns, 2 ms ms ms ms ms ms ms ms ms Peak power up to 0.8 GW at 532 nm and 1.8 GW at 1064 nm. Exclusive Pico-Boost technology (patent pending) allows emission in pico, nano or micro seconds. OptiBeam II technology for fractional, squared and round flat top spots up to 8 mm. Twain options available. Contact skin cooling or cryo air system integrated with handpiece (not for Q-switched modules). Alexandrite 755 nm spot sizes: up to 16 mm; rep. rate up to 10 Hz. Pulsed Nd:YAG 1064 nm spot sizes: up to 14 mm; rep. rate up to 10 Hz. Nd:YAG 1320 nm (optional) spot sizes: up to 8 mm; rep. rate up to 5 Hz. Q-switched Nd:YAG 532 nm and 1064 nm with OptiBeam II handpieces for squared, rounded and fractional spot sizes up to 8 mm; rep. rate up to 10 Hz. TWAIN options available. Exclusive Mixed Technology allows delivery of both wavelengths simultaneously or sequentially. Mixed mode spot size up to 18 mm. Twain IPL and Twain 2940 nm options available. Rep. rate up to 10 Hz. Contact skin cooling or cryo air system integrated with handpiece. Rep. rate up to 10 Hz, 3 Hz for Ruby nm and 694 nm work in Q-switch and thermal modes for maximum flexibility of use. Unique OptiBeam II technology for effective flat-top squared, rounded and fractional spots up to 8 mm. TWAIN options available. See above. See above. IPL handpieces available at nm, nm, nm, nm, nm and nm. Skin cooling. Spot sizes: 48 x 13 or 25 x 13 mm. Speed 0.5 Hz at max. power. IPL handpieces available at nm, nm, nm, nm, nm and nm. Skin cooling. Spot sizes: 48 x 13 or 25 x 13 mm. Speed 0.5 Hz at max. power. Optimized spot shape handpiece. Spot size up to 24 mm. Scanner area up to 30 cm 2. Rep. rates up to 15 Hz with scanner. Optional Qool-air embedded skin cooling system. Exclusive Mixed Technology allows the delivery of two laser wavelengths sequentially or simultaneously. Optimized spot shape handpiece. Spot size up to 24 mm. Scanner area up to 30 cm 2. Rep. rates with scanner up to 15 Hz for single emission and 10 Hz for the Mixed Technology. Optional Qool-air embedded skin cooling system. Sciton JOULE Halo ClearScan YAG Contour TRL ProFractional-XC ProFractional ThermaScan BBLs BBL Nd:YAG / Er:YAG / BroadBand Light / Alexandrite Hybrid Fractional Laser (ablative and non-ablative) Nd:YAG Tunable Resurfacing Laser (TRL) Er:YAG Er:YAG Nd:YAG BroadBand Light BroadBand Light Various 1470 nm / 2940 nm 1064 nm 2940 nm 2940 nm 2940 nm 1319 nm nm nm Up to 400 J/cm mj/mtz, 50 mj/mtz Up to 400 J/cm 2 Up to 40 W Up to 400 J/cm 2 Up to 400 J/cm 2 Up to 30 J/cm 2 Up to 30 J/cm 2 Up to 30 J/cm ms, 1 10 sec Up to 5 ms Up to 200 ms Up to 50 ms Variable for desired ablation and coagulation Variable Up to 200 ms Up to 200 ms Up to 200 ms Configurable up to ten modules. Delivery of ablative and non-ablative wavelengths in single pass. Dynamic Thermal Optimization (DTO) for precise energy delivery. Roller tip adaptors; optical navigation; integrated Zimmer cooling advanced mode for precise and independent control of depth and density. Pre-programmed modes and integrated smoke evacuation system. Computerized scanner; 30 x 30 mm Tx; integrated cooling. Computerized scanner, smart user interface, MicroLaserPeel, Tunable Resurfacing Laser. Expandable module. Expandable module / density 1.5% 26%. Computerized scanner; 30 x 30 mm Tx; integrated cooling. Table top system, SkinTyte II, 420, 515, , 640, 695 nm filters, 15 x 45 mm and 15 x 15 mm spot sizes, integrated cooling. SkinTyte II, 420, 515, 560, 590, 640, 695 nm filters. 15 x 45 mm and 15 x 15 mm spot sizes, integrated cooling. Syneron Profound emax/elight SR emax/elight SRA emax/elaser ST etwo elōs Plus with SR/SRA and SR Plus/SRA Plus, SRA Mini Bipolar RF 460, 5 khz Optical Energy / RF Electrical Energy Optical Energy / RF Electrical Energy Diode / RF Electrical Energy Fractionated Bi-Polar RF Optical Energy / Bi-Polar RF nm nm 700 nm 2000 nm nm Max. output voltage 84 VRMS; 5 W per channel Up to 45 J/cm 2 / up to 25 J/cm 3 Up to 45 J/cm 2 / up to 25 J/cm 3 6 W/cm 2, up to 100 J/cm 3 Up to 62 mj per pin Up to 45 J/cm 2 ; up to 25 J/cm 2 Seven independent bipolar channels. Dermal: five independent pairs of bipolar microneedles; Sub-Q: seven independent pairs of bipolar microneedles. 12 x 25 mm spot size. Same as above. 12 x 8 mm spot size. Standard 64 pin tip with 12 x 12 mm spot and focal 44 pin tip with 11 x 3 mm spot. SR/SRA: 25 x 12 mm; SR/SRA Plus: 35 x 14 mm; SRA Mini 15 x 14 mm. Note: Data subject to change; please refer to Company Directory for supplier contact information. 108 THE European Aesthetic Guide Volume 15

109 Hair Removal Comparison Chart Supplier Product Name Device Type Wavelength (nm) Energy Output (Joules) Pulse Length Accessories BTL Industries BTL Exilite IPL 480 nm, 530 nm, 560 nm, 640 nm, 690 nm filters, up to 1200 nm Candela GentleMAX Pro GentleLase Pro-U GentleYAG Pro-U Long Pulse Alexandrite / Nd:YAG Long Pulse Alexandrite (upgradable to GentleMAX Pro) Long Pulse Nd:YAG (upgradable to GentleMAX Pro) 755 nm / 1064 nm 755 nm 1064 nm cocoon medical primelase HR Diode Alex 755 nm / Diode 810 nm / Mixed (810 nm, 940 nm, 1060 nm) Up to 40 J/cm 2 for 4.4 cm² spot size, 176 J/pulse (max.) Up to 520 J/cm 2 Up to 520 J/cm 2 Up to 520 J/cm 2 Up to 59 J/cm 2, up to 70 J/cm 2, up to 80 J/cm 2 Up to 250 ms; intelligent multipulse mode ms ms ms Five high precision filters determine light spectrum required to treat wide-range of aesthetic indications. Advanced thermoelectric cooling of sapphire spot makes therapy gentle. Post-light LED non-thermal Tx reduces erythema, improves skin regeneration and stimulates production of collagen after IPL Tx mm spot sizes. Unique, patented Dynamic Cooling Device maximizes patient comfort and Tx efficacy. Air Cooling Compatible delivery systems available. Same as above. Same as above ms Ultra-high power diode (up to 4800 W) with four wavelengths (755 nm, 810 nm, 940 nm and 1060 nm) and three spot sizes (20 x 9 mm, 30 x 9 mm, 30 x 17 mm 2 ). Works on all hair types and body areas year round. High safety, profitability and effectiveness in every treatment. Ultra Short Pulse (USP) technology allows inclusion of each diode laser applicator and advantages of solid-state laser for each applicator. Ultra short pulse energy delivery (up to 3 ms). Crystal freeze contact cooling (+5 C) and two work modes: Static (1-3 Hz) and Dynamic (5-10 Hz). Cutera xeo plus prowave excel HR Laser / IPL Laser 1064 nm / nm 755 nm, 1064 nm 300 J/cm 2 / up to 35 J/cm 2 Up to 300 J/cm 2 Up to 300 ms / up to 90 ms Up to 300 ms Cynosure, Inc. Icon MaxR handpiece MaxRs handpiece MaxYs handpiece handpiece Vectus Elite MPX Elite+ Elite Acclaim Apogee Apogee+ Cheveux II Medley Multifunction Laser and IPL System Optimized Light Optimized Light Optimized Light Nd:YAG Diode Multi-Wavelength Aesthetic Workstation Alexandrite Alexandrite Diode Diode / Pulsed Light nm nm nm 1064 nm 800 nm 755 nm, 1064 nm, Multiplex, IPL Alexandrite / Nd:YAG 755 nm / 1064 nm Alexandrite / Nd:YAG 755 nm / 1064 nm Nd:YAG 1064 nm 755 nm 755 nm Up to 48 J/cm 2 Up to 72 J/cm 2 Up to 90 J/cm 2 Up to 700 J/cm 2 Up to 100 J/cm 2 Up to 600 J/cm 2 Up to 600 J/cm 2 Up to 600 J/cm 2 Up to 600 J/cm 2 Up to 50 J/cm 2 Up to 50 J/cm nm Up to 100 J/cm nm / nm Up to 100 J/cm 3 / up to 35 J/cm ms ms ms ms ms ms ms ms ms ms ms Adj ms Adj ms / Active Contact Cooling. Active Contact Cooling. Active Contact Cooling. Four spot sizes: 1.5, 3, 6 and 10 mm. 23 x 38 mm large spot; 12 x 12 mm small spot. Sapphire contact cooling. Skintel melanin reader. High powered Nd:YAG and Alexandrite with spot sizes ranging from mm. Patented MultiPlex technology blends wavelengths for superior results. Integrated IPL (530, 560, 590 nm) and Zimmer cooling system. High powered Nd:YAG and Alexandrite with spot sizes ranging from mm. Compatible with SmartCool air cooling system. High powered Nd:YAG and Alexandrite with spot sizes ranging from mm. Compatable with SmartCool air cooling system. High powered Nd:YAG with spot sizes ranging from mm. Compatable with SmartCool air cooling system. Upgradable to Elite dual wavelength system. High powered Alexandrite with spot sizes ranging from mm. Upgradable to Elite dual wavelength system. Compatable with SmartCool air cooling system. High powered Alexandrite with spot sizes up to 18 mm for faster treatments. Upgradable to Elite dual wavelength system. Compatable with SmartCool air cooling system. 10 x 14 mm spot size. One year manufacturer warranty guaranteed. Diode: 10 x 14 mm spot sizes. One year warranty included. DEKA Synchro HP Excellium MiniSilk FT Synchro REPLA:Y Synchro FT Motus LD Motus AX Multi-Functional Platform Pulsed Light System Multi-Functional Platform Multi-Functional Platform High Power Diode Laser High Frequency Alex Laser 1064 nm Nd:YAG / 500 nm, 520 nm, 550 nm, 600 nm, 650 nm IPL 500 nm, 520 nm, 550 nm, 600 nm, 650 nm 755 nm Alexandrite / 1064 nm Nd:YAG / 500 nm, 520 nm, 550 nm, 600 nm, 650 nm IPL 1064 nm Nd:YAG / 500 nm, 520 nm, 550 nm, 600 nm, 650 nm IPL 810 nm ± 10 nm 755 nm LP 120 J 180 W (max.), SP 120 J (max.) / 160 J (max.) energy per pulse J/cm J (max.) 125 W (max.) / 120 J 180 W (max.) LP, 120 J (max.) SP / 160 J (max.) energy per pulse 700 J/cm 2 (max.) SP and LP / 160 J (max.) energy per pulse Up to 60 J Up to 30 J From 2 50 ms SP, from ms LP / from 3 8 ms 2 85 ms (1-3 pulses) 2 50 ms (single pulse), 2 40 ms (double pulse) / 2 50 ms SP, ms LP / 3 8 ms ms SP, 2 30 ms LP (1 3 pulses) / 3 8 ms Up to 46 ms 2 50 ms (single pulse), 4 80 ms (Twin pulse) 180 W Nd:YAG laser module with up to 27,000 W pulse peak power; three delivery pulse designs; 11 application handpieces (22 mm and 24 mm available) and optional five filter IPL with enhanced vascular capabilities 500G. Auto Spot Size Recognition system. Top Hat technology; contact or optional external cooling connections; patient database and protocols; no disposables. Interchangeable snap-on filters; integrated contact cooling; lamp water cooling; transportable. 3.1 cm 2 or 6.2 cm 2 spot areas available. IR Filter available for greater skin tightening. 5 Hz and high power (125 W) on Alexandrite emission. 180 W Nd:YAG laser module with up to 27,000 W pulse peak power.three delivery pulses and adjustment feature for Alexandrite and Nd:YAG; 12 application handpieces to 24 mm. Auto Spot Size Recognition. Top Hat technology; contact or optional external cooling connections; patient database and protocols. IPL: five optional filters with enhanced vascular capabilities 500G. No disposables. Nd:YAG and IPL platform with five application specific handpieces. Top Hat technology and Auto Spot Size Recognition; contact or optional external cooling connections; delivery pulse settings available; patient database and protocols. IPL: five optional filters, 30,000 shots guaranteed. No disposables. Transportable device with optional chart; integrated contact cooling; 10 x 10 mm 2 spot area available with up to 15 Hz repetition rate. Motion functionality for virtually painless Tx. Transportable device, integrated Peltier contact cooling; 20 mm spot area available with up to 10 Hz repetition rate. Proprietary new Mòvèo Technology functionality for painless and smokeless hair removal. Note: Data subject to change; please refer to Company Directory for supplier contact information. THE European Aesthetic Guide Volume

110 Hair Removal Comparison Chart Supplier Product Name Device Type Wavelength (nm) Energy Output (Joules) Pulse Length Accessories Ellipse A/S Nordlys Nordlys LIMITED Sirius Ellipse MicroLight HR Multi-Technology Platform Selective Waveband Technology (SWT) SWT SWT nm, nm nm, nm nm, nm nm, nm Up to 21 J/cm 2 Up to 21 J/cm 2 Up to 21 J/cm 2 Up to 21 J/cm 2 Up to 100 ms (adj.) Up to 100 ms Up to 55 ms Up to 55 ms Hair removal is performed using Selective Waveband Applicators: HR 600 (48 mm x 10 mm) and HRL 600 (48 mm x 18 mm) for skin types I-V; HRD 645 (48 mm x 10 mm) for skin types IV-VI. All systems include dual mode filter and programmable pulse technology. Sirius includes patient database; Nordlys and Nordlys LIMITED include patient database, expert pulse adjustment and a unique sub-millisecond SWT pulse. Nordlys offers a dual mode Nd:YAG with SoftCool cooling and a fractional laser (Frax 1550) for treatment of skin resurfacing, acne and surgical scars, and stretch marks. Eunsung Global Corp. Clearlight LD808 Clearlight Diode Intense Pulsed Light 808 nm nm J/cm ms 3 35 J/cm ms 808 nm diode laser and large, 14 x 14 mm spot size. Differentiated handpiece with 15 x 40 mm wide spot size. Fotona d.o.o. SP Dynamis StarWalker Nd:YAG / Er:YAG Nd:YAG Q-Switched / Long Pulse 1064 nm 1064 nm Up to 600 J/cm 2 Up to 160 J/cm ms 250 μs / VERSA3: ms S-11: Nd:YAG scanner: 42 cm 2 Tx area. Nd:YAG handpieces: 3, 6 and 9 mm spot sizes. Handpieces: 2-8 mm spot sizes. General Project Med Flash II CS Laser Touch GP Fast Intense Pulsed Light Multiple Laser Platform Diode nm, nm Nd:YAG 1064 nm 808 nm, 760 nm Up to 600 J at lamp level 18 J 150 J/cm 2 Single pulse: ms, pulsed mode: ms (duration), ms (interval) Width: 3 10 ms Up to 300 ms Handpiece with integrated skin cooling. Spot sizes: 50 x 25 mm, 35 x 15 mm and 15 x 15 mm. Spot sizes: 1.5, 3, 5, 8, 5-12 mm, fractional tip. Contact cooling, Detection Control System, spot size: 16 x 8 mm. Ilooda Co., Ltd. VIKINI Epilia RF VeLux Diode Diode / RF Diode 808 nm 808 nm 755 nm Up to 120 J/cm 2 Up to 60 J/cm 2 5,000 W InMode Diolaze Diode 810 nm 40 J/cm 2 (short), 60 J/cm 2 (long) ms ms / ms ms Single and 1 pps auto repeat Supports various range of pulses with 600 W. Powerful extra cooling handle; 12 x 11 spot sized sapphire tip contact cooling and new optional cooling adaptor. Safe and effective for most skin types; sapphire tip contact cooling. Supports various line scanning types. 50 x 15 mm (10 x 15 mm) spot sized sapphire tip contact cooling with powerful extra air cooling adaptor. Gold standard wavelength with ultra-fast speed / pulsing to tissue and large spot size (50 x 8 mm). No compromising power for pulsing. Virtually painless due to strong built-in cooling (3PC - Pre, Parallel, Post). No consumables. Jeisys cellec SmoothCool IPL IPL nm nm / nm Up to 60 J/cm 2 Up to 65 J/cm ms 1 60 ms Eight interchangeable filters: 420S ( nm), 530S ( nm), 420 nm, 530 nm, 560 nm, 640 nm, 700 nm, 800 nm. Spot size: 40 x 10 mm; contact cooling. 560 ( nm) handpiece: 34 x 8 mm spot size; 700 ( nm) large handpiece: 50 x 10 mm spot size; 700 ( nm) small handpiece: 34 x 8 mm spot size. Contact cooling (below 0 C). Lumenis LightSheer DUET with LightSheer ET and LightSheer HS LightSheer DESIRE with HS with XC with ET LightSheer INFINITY with HS with ET ChillTip Applicator with LR ChillTip Applicator Diode Diode Laser Diode Laser Diode Laser Diode Laser Diode Laser Diode Laser 800 nm 805 nm 805 nm 805 nm 805 nm, 1060 nm 805 nm, 1060 nm 805 nm, 1060 nm LightSheer ET: J/cm 2 LightSheer HS: J/cm J/cm J/cm J/cm J/cm J/cm J/cm 2 LightSheer ET: ms LightSheer HS: ms ms ms ms ms ms ms LightSheer ET: ChillTip, 9 x 9 mm spot, up to 3 Hz, field replacable. LightSheer HS: 22 x 35 mm spot, vacuum-assisted technology, up to 3 Hz, field replacable. HIT handpiece, 22 x 35 mm spot size enables use of low fluence and a unique mechanism of pain reduction, providing safe, fast comfortable treatments. Repetition rate up to 3 Hz; pulse repetition: 1-3 pulses. Sapphire ChillTip handpiece, 12 x 12 mm spot size, providing optimal solution for large and small areas requiring higher fluence levels. Repetition rate up to 3 Hz; pulse repetition: 1 pulse. Sapphire ChillTip handpiece, 9 x 9 mm spot size, designed to treat small areas that require maximum precision and high fluence. Repetition rate: up to 3 Hz; pulse repetition: 1 pulse. Spot size: 22 x 35 mm; comfort management: vacuum-assisted (up to 18inHg); repetition rate: up to 3 Hz; pulse repetition: 1-3 pulses. Spot size: 9 x 9 mm; comfort management: Chilltip contact cooling (2 C); repetition rate: up to 3 Hz, pulse repetition: 1 pulse. Spot size: 9 x 27 mm; comfort management: Chilltip contact cooling (12 C); repetition rate: up to 3 Hz; pulse repetition: 1 pulse. Lutronic SOLARI ADVANTAGE Advantage Power Plus CLARITY IPL Diode Diode Long Pulsed Alexandrite / Nd:YAG Laser nm 805 nm 805 nm 755 nm / 1064 nm 35 J/cm 2 (at 510 nm filter) J/cm J/cm 2 Up to 600 J/cm ms ms ms ms Cut-off filters. Field replaceable handpieces with chilled compression tip: D1-800 (10 x 10 mm); D3-800 (10 x 30 mm). Cart. Field replaceable handpieces with chilled compression tip: D1-800 (10 x 10 mm); D3-800 (10 x 30 mm). D (10 x 10mm). Cart. Nine spot sizes including 2, 3, 5, 8, 10, 12, 15, 18, 20 mm. Note: Data subject to change; please refer to Company Directory for supplier contact information. 110 THE European Aesthetic Guide Volume 15

111 Hair Removal Comparison Chart Supplier Product Name Device Type Wavelength (nm) Energy Output (Joules) Pulse Length Accessories Novaestetyc, Novaclinical (divisions of Novavision Group) PLW IFL Incoherent Fast Light nm Up to 100 J ms Interchangeable filters: 400 nm, 520 nm, 550 nm, 600 nm, 650 nm and 720 nm; biocompatible disposable filters; Suberburst: single, repetition, IFL modes. Quanta System Domino EVO Duetto MT EVO Light A EVO Light B EVO Light C EVO Light A Star EVO Light 4V EVO Q-Plus Star 1 EVO Q-Plus Star 2 EVO Ultralight EVO TWAIN IPL option Eterna Giovinezza Plus New Silk Light (table top) Thunder HR Thunder VT Thunder Thunder MT Alexandrite Alexandrite / Nd:YAG Alexandrite Nd:YAG Nd:YAG / KTP Nd:YAG Light A + Light B Light A + Light C Nd:YAG / Nd:YAG Q-Switch / KTP Nd:YAG Q-Switch Alexandrite / Nd:YAG Q-Switch / KTP Nd:YAG Q-Switch KTP Nd:YAG / Nd:YAG / KTP Nd:YAG Q-Switch / Nd:YAG Q-Switch Pulsed Light Pulsed Light Pulsed Light Alexandrite Nd:YAG Alexandrite / Nd:YAG Alexandrite / Nd:YAG 755 nm 755 nm / 1064 nm 755 nm 1064 nm, 1320 nm 1064 nm, 1320 nm / 532 nm 755 nm, 1064 nm, 1320 nm 532 nm, 755 nm, 1064 nm, 1320 nm 1064 nm, 1320 nm / 1064 nm / 532 nm 755 nm / 1064 nm / 532 nm 534 nm / 1064 nm / 532 nm / 1064 nm nm nm, nm nm 755 nm 1064 nm 755 nm / 1064 nm 755 nm / 1064 nm Up to 120 J/cm 2 Up to 120 J/cm 2 / Up to 500 J/cm 2 Up to 120 J/cm 2 Up to 500 J/cm 2, up to 35 J/cm 2 Up to 500 J/cm 2, up to 35 J/cm 2 / up to 90 J/cm 2 Light A, Light B Light A, Light C Up to 500 J/cm 2 / up to 35 J/cm 2 / up to 37 J/cm 2 (ns), 50 J/cm 2 (μs) / up to 15 J/cm 2 Up to 120 J/cm 2 / up to 37 J/cm 2 (ns), 50 J/cm 2 (μs) / up to 15 J/cm 2 Up to 95 J/cm 2 / up to 500 J/cm 2 / up to 15 J/cm 2 / up to 37 J/cm 2 (ns), 50 J/cm 2 (μs) Up to 25 J/cm 2 Up to 30 J/cm 2 Up to 30 J/cm² Up to 500 J/cm 2 Up to 500 J/cm 2 Up to 500 J/cm 2 / up to 500 J/cm 2 Up to 500 J/cm ms ms ms ms, 5 10 ms ms, 5 10 ms / 2 50 ms Light A, Light B Light A, Light C ms, 5 10 ms / 6 ns, 6+6 ns, 300 μs / 6 ns, 6+6 ns ms / 6 ns, 6+6 ns, 300 μs / 6 ns, 6+6 ns 2 50 ms / ms / 6 ns, 6+6 ns / 6 ns, 6+6 ns, 300 μs ms ms ms ms ms ms ms Spot size up to 20 mm. Twain IPL and Twain 2940 nm options available. Rep. rate up to 7 Hz. Contact skin cooling or cryo air system integrated with handpiece. Exclusive Mixed Technology allows delivery of both wavelengths simultaneously or sequentially. Mixed mode spot size up to 18 mm. Twain IPL and Twain 2940 nm options available. Rep. rate up to 10 Hz. Contact skin cooling or cryo air system integrated with handpiece. Contact skin cooling or cryo air system integrated with handpiece. Alexandrite 755 nm spot sizes: up to 16 mm; rep. rate up to 10 Hz. Pulsed Nd:YAG 1064 nm spot sizes: up to 14 mm; rep. rate up to 10 Hz. Nd:YAG 1320 nm (optional) spot sizes: up to 8 mm; rep. rate up to 5 Hz. TWAIN options available. See above. See above. See above. See above. See above. IPL handpieces available at nm, nm, nm, nm, nm and nm. Skin cooling. Spot sizes: 48 x 13 or 25 x 13 mm. Optimized spot shape handpiece. Spot size up to 24 mm. Scanner area up to 30 cm 2. Rep. rates up to 15 Hz with scanner. Optional Qool-air embedded skin cooling system. Exclusive Mixed Technology allows the delivery of two laser wavelengths sequentially or simultaneously. Optimized spot shape handpiece. Spot size up to 24 mm. Scanner area up to 30 cm 2. Rep. rates with scanner up to 15 Hz for single emission and 10 Hz for the Mixed Technology. Optional Qool-air embedded skin cooling system. Sciton JOULE ClearScan YAG ClearScan ALX BBLs BBL Forever Bare BBL Laser and Light Platform Nd:YAG Alexandrite BroadBand Light BroadBand Light BroadBand Light Various 1064 nm 755 nm nm nm nm Up to 400 J/cm 2 Up to 400 J/cm 2 Up to 400 J/cm 2 Up to 30 J/cm 2 Up to 30 J/cm 2 Up to 30 J/cm ms, 1 10 sec Up to 200 ms Up to 200 ms Up to 200 ms Up to 200 ms Up to 200 ms Configurable up to ten modules. Computerized scanner; 30 x 30 mm Tx; integrated cooling. Same as above. Table top system, SkinTyte II, 420, 515, 560, 590, 640, 695 nm filters, 15 x 45 mm and 15 x 15 mm spot sizes, integrated cooling. SkinTyte II, 420, 515, 560, 590, 640, 695 nm filters, 15 x 45 mm and 15 x 15 mm spot sizes, integrated cooling. FB BBL technology is in motion. SkinTyte II, 420, 515, 560, 590, 640, 695 nm filters, 15 x 45 mm and 15 x 15 mm spot sizes, integrated cooling. Syneron emax/elaser DSL emax/elight DS elōs Plus with Motif Vantage elōs Plus with Motif LHR elōs Plus with Motif HR elōs Plus with Motif HR Plus Diode / RF Electrical Energy Optical Energy / RF Electrical Energy Diode Diode Optical Energy and Bipolar RF Optical Energy and Bipolar RF 810 nm nm 810 nm 810 nm nm nm Up to 50 J/cm 2 / up to 50 J/cm 3 Up to 45 J/cm 2 / up to 25 J/cm 2 Up to 30 J/cm 3 Up to 50 J/cm 3 Up to 25 J/cm 3 Up to 25 J/cm 3 15 x 12 mm spot size. 25 x 12 mm spot size. 33 x 14 mm spot size. 15 x 12 mm spot size. 25 x 12 mm spot size. 35 x 14 mm spot size. Note: Data subject to change; please refer to Company Directory for supplier contact information. THE European Aesthetic Guide Volume

112 Vascular Technology Comparison Chart Supplier Product Name Device Type Wavelength (nm) Energy Output (Joules) Pulse Length Accessories Candela Vbeam Perfecta GentleMAX Pro GentleLase Pro-U GentleYAG Pro-U Pulsed Dye Laser Long Pulse Alexandrite / Nd:YAG Long Pulse Alexandrite (upgradable to GentleMAX Pro) Long Pulse Nd:YAG (upgradable to GentleMAX Pro) 595 nm 755 nm / 1964 nm 755 nm 1064 nm Up to 40 J/cm 2 Up to 520 J/cm 2 Up to 520 J/cm 2 Up to 520 J/cm ms ms ms ms Eight spot sizes up to 12 mm, including 3 x 10 elliptical and pigmented lesion handpieces. Unique, patented Dynamic Cooling Device maximizes patient comfort and Tx efficacy mm spot sizes. Unique, patented Dynamic Cooling Device maximizes patient comfort and Tx efficacy. Air Cooling Compatible delivery systems available. Same as above. Same as above. Cutera excel V xeo Laser Laser / Limelight 532 nm, 1064 nm 1064 nm / nm Up to 300 J/cm 2 Up to 60 ms 300 J/cm 2 / 30 J/cm 2 Up to 300 ms / Automatic Cynosure, Inc. Icon handpiece MaxG handpiece RevLite SI MedLite C6 Cynergy with Multiplex Elite MPX Elite+ Elite Acclaim Medley Multifunction Laser and IPL Nd:YAG Optimized Light Nd:YAG Nd:YAG Pulsed Dye / Nd:YAG Multi-Wavelength Aesthetic Platform Alexandrite / Nd:YAG Alexandrite / Nd:YAG Nd:YAG Pulsed Light 1064 nm nm, nm 1064 nm, 532 nm, 585 nm, 650 nm 1064 nm, 532 nm, 585 nm, 650 nm 585 nm / 1064 nm / MultiPlex 755 nm, 1064 nm, MultiPlex, IPL 755 nm / 1064 nm 755 nm / 1064 nm 1064 nm mm Up to 700 J/cm 2 Up to 80 J/cm 2 Up to 30 J/cm 2 Up to 14 J/cm 2 Up to 600 J/cm 2 Up to 600 J/cm 2 Up to 600 J/cm 2 Up to 600 J/cm 2 Up to 600 J/cm 2 Up to 35 J/cm ms ms 5 20 ns 5 20 ns ms ms ms ms ms Four spot sizes: 1.5, 3, 6 and 10 mm. Advanced contact cooling and dual filters minimize unnecessary epidermal exposure for enhanced patient comfort. MultiLite handpieces converting to 585 and 650 nm wavelengths; additional MultiSpot handpiece offering 2-8 mm spot sizes. Same as above. PDL, Nd:YAG and patented MultiPlex technology offer superior vessel clearance at lower fluences. Spot sizes range from mm. Compatible with SmartCool air cooling. High powered Nd:YAG and Alexandrite with spot sizes ranging from mm. Patented MultiPlex technology blends wavelengths for superior results. Integrated IPL (530, 560, 590 nm) and Zimmer cooling system. High powered Nd:YAG and Alexandrite with spot sizes ranging from mm. Compatible with SmartCool air cooling system. High powered Nd:YAG and alexandrite with spot sizes ranging from mm. Compatible with SmartCool air cooling system. High powered Nd:YAG with spot sizes ranging from mm. Compatible with SmartCool air cooling. Upgradable to Elite dual wavelength system. Four IPL filters (450, 510, 540, 650 nm) and a full powered laser with Er:YAG, QS Nd:YAG and 810 nm Diode handpieces. One year warranty included. DEKA Synchro VAS-Q Synchro HP Excellium Synchro FT MiniSilk FT Synchro REPLA:Y Multi-Functional Platform Multi-Functional Platform Multi-Functional Platform Pulsed Light System Multi-Functional Platform 595 nm PDL / RightLight Technology 1064 nm Nd:YAG / 500 nm, 520 nm, 550 nm, 600 nm, 650 nm IPL 1064 nm Nd:YAG / 500 nm, 520 nm, 550 nm, 600 nm, 650 nm IPL 500 nm, 520 nm, 550 nm, 600 nm, 650 nm, IR Filter 755 nm Alexandrite / 1064 nm Nd:YAG / 500 nm, 520 nm, 550 nm, 600 nm, 650 nm IPL 8 J / 33 J/cm 2 LP 120 J 180 W (max.), SP 120 J (max.) / 160 J (max.) energy per pulse 700 J/cm 2 (max.) SP and LP / 160 J (max.) energy per pulse J/cm J (max.) 125 W (max.) / 120 J 180 W (max.) LP; 120 J (max.) SP / 160 J (max.) energy per pulse From ms 2 50 ms SP, ms LP / 3 8 ms ms SP; 2 30 ms LP (1 3 pulses) / 3 8 ms 2 85 ms (1 3 pulses) 2 50 ms (single pulse); 2 40 ms (double pulse) / 2 50 ms SP; ms LP / 3 8 ms Powerful PDL with RightLight Technology. Eliminates all vascular anomalies, malformations and superficial erythrosis. Four handpieces (5, 7, 10 and 12 mm) with Auto Spot Size Recognition. Top Hat technology and high energy modality up to 7 J; delivery pulse settings available. 180 W Nd:YAG laser module with up to 27,000 W pulse peak power; three delivery pulse designs; 11 application handpieces (22 mm and 24 mm available) and optional five filter IPL with enhanced vascular capabilities 500G. Auto Spot Size Recognition system. Top Hat technology; contact or optional external cooling connections; patient database and protocols; no disposables. Nd:YAG and IPL platform with five application specific handpieces. Top Hat technology and Auto Spot Size Recognition; contact or optional external cooling connections; delivery pulse settings available; patient database and protocols. IPL: five optional filters, 30,000 shots guaranteed. No disposables. Interchangeable snap-on filters; integrated contact cooling; lamp water cooling. Transportable; 3.1 cm 2 or 6.2 cm 2 spot area available. IR Filter available for greater skin tightening. 5 Hz and high power (125 W) on Alexandrite emission. 180 W Nd:YAG module with up to 27,000 W pulse peak power. Three delivery pulse designs and adjustment feature for Alexandrite and Nd:YAG. Twelve application handpieces up to 24 mm. Auto Spot Size Recognition. Top Hat technology; contact or optional external cooling connections; patient database and protocols. IPL: five optional filters with enhanced vascular capabilities 500G. No disposables. Note: Data subject to change; please refer to Company Directory for supplier contact information. 112 THE European Aesthetic Guide Volume 15

113 Vascular Technology Comparison Chart Supplier Product Name Device Type Wavelength (nm) Energy Output (Joules) Pulse Length Accessories Ellipse A/S Nordlys Nordlys LIMITED Sirius Multi-Technology Platform Selective Waveband Technology (SWT) SWT nm, nm, 1064 nm nm, nm nm, nm Up to 26 J; up to 450 J Up to 26 J/cm 2 / up to 450 J/cm 2 Up to 19 J/cm ms (programmable) ms Up to 15 ms PR and VL applicators enable treatment of smaller red vessels and deeper larger blue vessels. Both are available as a 48 mm x 10 mm and a 98 mm 2 hexagonal small spot for individual lesions. All systems include patient database. Nordlys and Nordlys LIMITED include an expert mode allowing users to adjust pulse length. Nordlys also includes a 1064 nm Nd:YAG with built-in SoftCool technology, automatic spot size adjustment and can treat leg and facial vessels with a diameter of 0.1 mm - 3 mm as well as many other vascular lesions. Additionally, Nordlys and Nordlys LIMITED can deliver short powerful SWT pulses from 0.5 ms. Eunsung Global Corp. Clearlight Intense Pulsed Light nm 3 35 J/cm ms Differentiated handpiece of 15 x 40 mm wide spot size. Fotona d.o.o. SP Dynamis StarWalker Nd:YAG Nd:YAG Q-Switched / Long Pulse, KTP Q-Switched / Long Pulse 1064 nm 1064 nm, 532 nm Up to 600 J/cm 2 Up to 160 J/cm 2, J/cm 2, VERDE: 113 J/cm ms VERSA3: ms, VERDE: ms S-11: Nd:YAG scanner: 42 cm 2 Tx area. Nd:YAG handpieces: 2-20 mm spot sizes. 2 8 mm spot sizes mm spot sizes. General Project Med Flash II CS Laser Touch Intense Pulsed Light Multiple Laser Platform nm Nd:YAG 1064 nm Up to 600 J at lamp level 18 J Single pulse ms, pulsed mode ms (duration), ms (interval) Width: 3-10 ms Handpiece with integrated skin cooling. Spot sizes: 50 x 25 mm, 35 x 15 mm and 15 x 15 mm. Spot sizes: 1.5, 3, 5, 8, 5-12 mm, fractional tip. Ilooda Co., Ltd. Multiple IRIS Secret RF OPS Diode Laser RF Microneedle 532 nm (Fractional), 532 nm (Normal) 70.7 J/cm 2, 832 J/cm 2 25 W 100 ms, 400 ms ms 532 nm Fractional, 532 nm Normal; available to treat vascular lesions in the epidermis. 25 pin sterilized RF bipolar tips (optional 64 insulated pin available); monopolar handpiece for small Tx areas, such as around the eyes; optional smart pen handpiece for acne and thread vein. Jeisys cellec v SmoothCool IPL IPL nm nm / nm Up to 60 J/cm 2 Up to 65 J/cm ms 1 60 ms Nine interchangeable filters: 420S ( nm), 500S ( nm), 530S ( nm), 550S ( nm), 530D ( nm and nm), 560 nm, 640 nm, 700 nm. Spot size: 40 x 10 mm; contact cooling. 560 ( nm) handpiece: 34 x 8 mm spot size; 700 ( nm) large handpiece: 50 x 10 mm spot size; 700 ( nm) small handpiece: 34 x 8 mm spot size. Contact cooling (below 0 C). Lumenis M22 Intense Pulsed Light / Nd:YAG / ResurFX nm / 1064 nm / 1565 nm J/cm² / J/cm 2 / mj/mb 4 20 ms / 2 20 ms Multi-technology, multi-application platform. Upgradable, expandable, 6 IPL filters, novel OPT, optimized presets, spot sizes: 15 x 35 mm and 8 x 15 mm (IPL); 2 x 4, 6 mm (Nd:YAG), 1565 nm fiber laser. Lutronic SOLARI CLARITY PICOPLUS IPL Long Pulsed Alexandrite / Nd:YAG Q-switched Nd:YAG nm 755 nm / 1064 nm 1064 nm, 532 nm, 595 nm, 660 nm 35 J/cm 2 (at 510 nm filter) Up to 600 J/cm 2 Up to 800 mj ms ms 450 ps / 2 ns Cut-off filters. Nine spot sizes including 2, 3, 5, 8, 10, 12, 15, 18, 20 mm. ICD Cryogen or air cooling available. Five different handpieces: 1-6 mm Zoom, 6-10 mm Pico Toning, 2 and 5 mm Gold Toning+, 2 and 3 mm RuVY Touch+, 7.4 x 7.4 mm Focused Dots. Novaestetyc, Novaclinical (divisions of Novavision Group) PLW IFL Incoherent Fast Light nm Up to 100 J ms Interchangeable filters: 400 nm, 520 nm, 550 nm, 600 nm, 650 nm and 720 nm; biocompatible disposable filters; Suberburst: single, repetition, IFL modes. Note: Data subject to change; please refer to Company Directory for supplier contact information. THE European Aesthetic Guide Volume

114 Vascular Technology Comparison Chart Supplier Product Name Device Type Wavelength (nm) Energy Output (Joules) Pulse Length Accessories Quanta System Light B EVO Light C EVO Light A Star EVO Light 4V EVO Q-Plus Star 1 EVO Ultralight EVO Duetto MT EVO TWAIN IPL option Eterna Giovinezza Plus New Silk Light (table top) Quanta A, B or C Quanta D Quanta Star 585 Thunder HR Thunder VT Thunder Thunder MT Nd:YAG Nd:YAG / KTP Nd:YAG Light A + Light B Light A + Light C Nd:YAG / Nd:YAG Q-Switch / KTP Nd:YAG Q-Switch Nd:YAG F.D. / Nd:YAG / Nd:YAG Q-Switch / KTP Nd:YAG Q-Switch Alexandrite / Nd:YAG Pulsed Light Pulsed Light Pulsed Light Diode LBO LBO / Diode D-wmops Alexandrite Nd:YAG Alexandrite / Nd:YAG Alexandrite / Nd:YAG 1064 nm, 1320 nm 1064 nm, 1320 nm / 532 nm 755 nm, 1064 nm, 1320 nm 532 nm, 755 nm, 1064 nm, 1320 nm 1064 nm, 1320 nm / 1064 nm / 532 nm 534 nm / 1064 nm / 1064 nm / 532 nm 755 nm / 1064 nm nm nm, nm nm A: 808 nm, B: 940 nm, C: 980 nm 532 nm 532 / 808 nm, 940 nm, 980 nm 585 nm 755 nm 1064 nm 755 nm / 1064 nm 755 nm / 1064 nm Up to 500 J/cm 2, up to 35 J/cm 2 Up to 500 J/cm 2, up to 35 J/cm 2 / up to 90 J/cm 2 Light A, Light B Light A, Light C Up to 500 J/cm 2, up to 35 J/cm 2 / up to 37 J/cm 2 (ns), 50 J/cm 2 (μs) / up to 15 J/cm 2 Up to 95 J/cm 2 / up to 500 J/cm 2 / up to 37 J/cm 2 (ns), 50 J/cm 2 (μs) / up to 15 J/cm 2 Up to 120 J/cm 2 / up to 500 J/cm 2 Up to 25 J/cm 2 Up to 30 J/cm 2 Up to 30 J/cm 2 25 W 5 W, 8 W 5 W / 25 W 5 W Up to 500 J/cm 2 Up to 500 J/cm 2 Up to 500 J/cm 2 / up to 500 J/cm 2 Up to 500 J/cm ms, 5 10 ms ms, 5 10 ms / 2 50 ms Light A, Light B Light A, Light C ms, 5 10 ms / 6 ns, 6+6 ns, 300 μs / 6 ns, 6+6 ns 2 50 ms / ms / 6 ns, 6+6 ns, 300 μs / 6 ns, 6+6 ns ms ms ms ms 3 2,500 ms or CW 3 2,500 ms or CW 3 2,500 ms or CW 1 2,500 ms or CW ms ms ms ms Contact skin cooling or cryo air system integrated with handpiece (not for Q-switched modules). Alexandrite 755 nm spot sizes: up to 16 mm; rep. rate up to 10 Hz. Pulsed Nd:YAG 1064 nm spot sizes: up to 14 mm; rep. rate up to 10 Hz. Nd:YAG 1320 nm (optional) spot sizes: up to 8 mm; rep. rate up to 5 Hz. Q-switched Nd:YAG 532 nm and 1064 nm with OptiBeam II handpieces for squared, rounded and fractional spot sizes up to 8 mm; rep. rate up to 10 Hz. TWAIN options available. See above. See above. Exclusive Mixed Technology allows delivery of both wavelengths simultaneously or sequentially. Mixed mode spot size up to 18 mm. Twain IPL and Twain 2940 nm options available. Rep. rate up to 10 Hz. Contact skin cooling or cryo air system integrated with handpiece. IPL handpieces available at nm, nm, nm, nm, nm and nm. Skin Cooling. Spot sizes: 48 x 13 or 25 x 13 mm. Same as above. Same as above. Spot sizes 0.5, 1, 1.5, 3 mm. Bare fibers, endovenous kits and teeth bleaching handpiece available. See above. See above. Solid state laser with no consumables. Spot sizes: 0.5 mm, 1 mm, 1.5 mm, 3 mm; scanner (optional) with max. scanning area of 1.8 x 1.8 cm. Optimized spot shape handpiece. Spot size up to 24 mm. Scanner area up to 30 cm 2. Rep. rates up to 15 Hz with scanner. Optional Qool-air embedded skin cooling system. Exclusive Mixed Technology allows the delivery of two laser wavelengths sequentially or simultaneously. Optimized spot shape handpiece. Spot size up to 24 mm. Scanner area up to 30 cm 2. Rep. rates with scanner up to 15 Hz for single emission and 10 Hz for the Mixed Technology. Optional Qool-air embedded skin cooling system. Sciton JOULE ClearScan YAG ClearScan ALX Pro-V BBLs BBL Forever Bare BBL Laser and Light Platform Nd:YAG Alexandrite Nd:YAG BroadBand Light BroadBand Light BroadBand Light Various 1064 nm 755 nm 1319 nm nm nm nm Up to 400 J/cm 2 Up to 400 J/cm 2 Up to 400 J/cm 2 Up to 50 Watts Up to 30 J/cm 2 Up to 30 J/cm 2 Up to 30 J/cm ms, 1 10 sec Up to 200 ms Up to 200 ms Up to 200 ms Up to 200 ms Up to 200 ms Configurable up to ten modules. Computerized scanner; 30 x 30 mm Tx; integrated cooling. Same as above. Endovenous and transcutaneous laser Tx of varicose and other veins. Uses non-proprietary fibers. Table top system, SkinTyte II, 420, 515, 560, 590, 640, 695 nm filters, 15 x 45 mm and 15 x 15 mm spot sizes, integrated cooling. SkinTyte II, 420, 515, 560, 590, 640, 695 nm filters, 15 x 45 mm and 15 x 15 mm spot sizes, integrated cooling. FB BBL technology is in motion. SkinTyte II, 420, 515, 560, 590, 640, 695 nm filters, 15 x 45 mm and 15 x 15 mm spot sizes, integrated cooling. Syneron elōs Plus / emax/elight SR elōs Plus / emax/elight SRA elōs Plus / emax/elaser LV elōs Plus / emax/elaser LVA Optical Energy / RF Electrical Energy Optical Energy / RF Electrical Energy Diode / RF Electrical Energy Diode / RF Electrical Energy nm nm 900 nm 900 nm Up to 45 J/cm 2 / up to 25 J/cm 3 Up to 45 J/cm 2 / up to 25 J/cm 3 Up to 140 J/cm 2 / up to 100 J/cm J/cm 2 / J/cm 3 25 x 12 mm spot size. Same as above. 8 x 5 mm spot size. 8 x 2 mm spot size. Note: Data subject to change; please refer to Company Directory for supplier contact information. 114 THE European Aesthetic Guide Volume 15

115 Emerging Aesthetic Technologies Comparison Chart Supplier Product Technology Applications BTL Industries Croma-Pharma GmbH Cutera BTL Vanquish ME Exilis Ultra 360 BTL X-Wave LFL PDO Arthrex ACP Double Syringe trusculpt 3D enlighten Patented Selective RF Monopolar RF and Ultrasound with Controlled Cooling Acoustic Wave Therapy Absorbable polydioxanone threads Platelet-Rich Plasma (PRP) System Monopolar RF Laser 532 nm, 670 nm, 1064 nm; 750 ps, 660 ps plus 2 ns Cynosure SculpSure 1060 nm Wavelength with Four Applicators and Customizable Attachment System DEKA MonaLisa Touch SmartXide 2 with Hi Scan V2LR Scanning; Fractional CO2 with PSD Eunsung Global Corp. Dr.Skin OctoLine2 AquaClean Beauty Heart Spring Hydra Beauty Jet Clear Smartline EPN Electroporation, Microdermabrasion, Vacuum; 27 W; 2,600 ms Ultrasound, Water Jet Peel; 2.6 W; ms Aqua Peeling Electroporation; ms Electroporation, Cryoelectroporation; 680 ms Multi-Polarity Electroporation, Aqua Peeling Water Jet Peel Electroporation, Iontophoresis, Ultrasound, Cryo Microneedling, Electroporation (0 2 mm needle penetration depth) Body shaping / fat removal device with FDA clearance for circumferential reduction of abdomen and thighs. Advanced technology for body contouring, skin tightening, facial rejuvenation and intimate health / wellness. Applicators for face and body (head to toe treatment) and exchangable single use tips for vulvovaginal procedure. Skin and connective tissue tightening, cellulite treatment, improvement of uneven lipoplasty results and lymphatic system stimulation. Elimination of fine wrinkles, smoothening deep wrinkles, improvement of skin tone, elasticity and texture, delay of aging process and prevention of skin sagging. Improvement in wrinkles, contours, augmentation, androgenic alopecia, alopecia areata, wound healing and overall skin rejuvenation with no compromising on safety and quality. Can be used as a standalone procedure or in combination with other treatment methods (e.g. ablative laser). Body sculpting. Tattoos and pigmentation. Non-invasive body contouring; 1060 nm disrupts subcutaneous fat through a proprietary energy delivery system; contour pockets of bothersome fat in the submental region, flanks, back, inner and outer thighs, minimal absorption in dermis; can be used on all skin types. Feminine rejuvenation - restore natural physiological and mechanical mucosa conditions; improve reduced vaginal lubrication, vulvar itching and painful intercourse. Skin rejuvenation and acne treatment. Skin rejuvenation and acne treatment. Skin rejuvenation and acne treatment. Skin rejuvenation and acne treatment. Skin rejuvenation and acne treatment. Skin rejuvenation and acne treatment. Acne treatment. Skin rejuvenation. Skin rejuvenation and acne treatment. Fotona d.o.o. IntimaLase 2940 nm Er:YAG with SmoothMode Feminine rejuvenation - tightening of internal vaginal tissues. Hironic EasyMo Graft Ultra Vera Automated Follicular Unit Extraction (FUE) Hair Transplant Device High Intensity Focused Ultrasound (HIFU) Supports extraction and implantation processes with automated mechanical technologies: pneumatic for extraction and implantation, rotation power for extraction and positive pressure for implantation. Equipped with a low temperature storage system (1 C - 5 C) to improve the survival rate of follicular units. Non-invasive vaginal tightening to improve vaginal dryness and urinary incontinence. Treatment takes 20 minutes and is painless with no downtime or bleeding. The HydraFacial Company HydraFacial Perk Hydradermabrasion Hybrid Exfoliation Non-laser skincare offering customizable facial procedure to improve appearance of fine lines, wrinkles, enlarged pores, congested skin and brown spots. Targets sensitive zones including the delicate eye and lip areas through liquid exfoliation. Treatment vial transforms into take-home product for extended benefits. Ilooda Co., Ltd. Gynolaser Handpiece CO2 Fractional; 10,600 nm; 30 W Vaginal tightening and urinary incontinence. Lutronic mesoestetic Novaclinical, a division of Novavision Group Lasemd PICOPLUS Petit Lady Genesis m.pen[pro] mct injector EVA (Enhancer of Vaginal Anatomy) 4PLUS/Radio4M Thulium Fractional Laser; 1927 nm Q-Switched Nd:YAG (1064 nm, 532 nm, 595 nm and 660 nm 2940 nm Er:YAG with Dual Mode 10,600 nm CO2 Fractional SmartDrivity Fusion of Highly- Intensive LED, Capacitive and Resistive RF; Transdermal Delivery Microneedling Mesocarboxytherapy Vaginal Dynamic Quadripolar RF (VDR), RF Safety System (RSS), Internet of Medical Things (IoMT) Dynamic Quadripolar RF, RSS, Variable RF, Quadripolar Dynamic Fractional RF, Needled Fractional RF Delivery of cosmeceutical ampoules: Vitamin C, Vitamin A, Tranexamic Acid, CK (Human blood cell conditioned Media + KGF) and RS (Resveratrol). Pigmented lesions, tattoos. Five handpieces: 1-6 mm Zoom, 6-10 mm Pico Toning, 2 mm and 5 mm Gold Toning+, 2 mm and 3 mm RuVY Touch+, 7.4 x 7.4 mm Focused Dots. Vaginal tightening. Urinary incontinence. Vestibule and introitus tightening. Anti-aging, skin rejuvenation, lifting, sensitive skin, eye contour, double chin, arms, bust, buttocks, legs and abdomen. Anti-aging, skin rejuvenation, hair loss treatments, anti-stretch marks, double chin and depigmentation. Anti-aging and skin rejuvenation. Vaginal atrophy, laxity of vaginal introitus, vulvodynia, stress urinary incontinence (SUI), vulvar rejuvenation. Face-lifting, facial wrinkles, neck wrinkles, eye and lip wrinkles, chin shaping, dermo-peeling, hyperpigmentation, acne, resurfacing, hand rejuvenation, stretch marks, localized lipolysis, body firming. PerfAction Technologies, Ltd. EnerJet2.0 Jet Volumetric Remodeling (JVR) Kinetic non-surgical lifting; dermal remodeling for face, neck and decollette; scar tissue remodeling including all types of acne scars, red and white stretch marks, keloid and hypertrophic scars. Quanta System Discovery Pico Picosecond Nd:YAG 532 nm / 1064 nm; Tattoo removal, benign pigmented lesions and skin rejuvenation. Ruby 694 nm; up to 1.8 GW peak power; Pico-Boost Technology; OptiBeam II DivaTight Fractional combined GaAs 1540 nm Feminine rejuvenation vaginal mucosa atrophy, vulvar resurfacing. and 10,600 nm CO2 Sciton diva 1470 nm / 2940 nm Hybrid Fractional Improvement of vaginal tissue. Laser (Ablative and Non-Ablative) Sinclair Pharma Silhouette Soft by Vaupell Polylactic Acid Resorbable Suture with Bi-Directional Cones (8 cone, 12 cone, 16 cone sutures) Facial definition, wrinkle reduction, volume repositioning and collagen regeneration. Soft Medical Aesthetics SoftFil Classic SoftFil Precision SoftFil EasyGuide SoftFil Needle Hypodermic Round-Tip Microcannula Hypodermic Round-Tip Microcannula, Extra Thin Wall Centimetric Graduations and Red Dot on Hub Hypodermic Round-Tip Microcannula with New Patented 2-in-1 Pilot Needle Hypodermic Needle, Extra Thin Wall Centimetric Graduations and Red Dot on Hub Hyaluronic acid injections for body, face, décolleté and hands. Eight sizes: 18G 70 mm, 22G 40 mm, 22G 50 mm, 22G 70 mm, 22G 90 mm, 25G 50 mm, 27G 40 mm, 30G 25 mm Same as above; 15 sizes: 14G 90 mm, 16G 70 mm, 16G 90 mm, 18G 70 mm, 22G 40 mm, 22G 50 mm, 22G 70 mm, 23G 30 mm, 23G 50 mm, 25G 40 mm, 25G 50 mm, 25G 60 mm, 27G 25 mm, 27G 40 mm, 30G 25 mm. HA injections for face and hands. Six sizes: 25G 40 mm, 25G 50 mm, 25G 60 mm, 27G 40 mm. Point per point bolus injections. Six sizes: 25G 40 mm, 27G 13 mm, 27G 40 mm, 30G 04 mm, 30G 06 mm, 30G 13 mm. STORZ MEDICAL AG CELLACTOR ultra Acoustic Wave Therapy (AWT) Cellulite treatment, body shaping and skin rejuvenation. D-ACTOR ultra Syneron Picoway 532 nm, 1064 nm, Short Picosecond Pigmentation, skin irregularities, signs of aging and tattoo removal. Pulses Ulthera, Inc., a division of Merz, Inc. The Ulthera System Cellfina System Micro-Focused Ultrasound with Visualization Tissue Stabilized-Guided Subcision (TS-GS) Neck, chin and brow lifting; chest wrinkles. Treats the underlying structural cause of cellulite dimples on the buttocks and thighs. U.S. FDA cleared and E.U. CE Marked with results that last at least three years. Viveve, Inc. Viveve System Cryogen-Cooled Monopolar RF Treatment for vaginal laxity. WONIK INNOJECTOR Needle-Free Injection System powered by Highly Pressurized Pneumatic Technology Scars, lifting, wrinkles, stretch marks, etc. Note: Data subject to change; please refer to Company Directory for supplier contact information. THE European Aesthetic Guide Volume

116 Acne Tx Device Comparison Chart Supplier Product Name Device Type Wavelength (nm) Energy Output (Joules) Pulse Length Accessories Candela Vbeam Perfecta CO2RE Pulsed Dye Laser CO2 Laser 595 nm 10,600 nm Up to 40 J/cm 2 Up to 80 J/cm ms Up to 1100 ms Eight spot sizes up to 12 mm, 3 x 10 elliptical and pigmented lesion handpieces. Patented Dynamic Cooling Device maximizes patient comfort and Tx efficacy. Multi-use CO2RE aesthetic and surgical handpieces; sterile single-use internal and external CO2RE Intima handpieces. Cutera excel V Laser 532 nm, 1064 nm Up to 300 J/cm 2 Up to 60 ms DEKA SmartXide DOT SmartXide 2 DOT/RF SmartXide Touch Synchro HP Excellium Synchro FT Synchro REPLA:Y Fractional CO2 Fractional CO2 plus RF Fractional CO2 plus RF Multi-Functional Platform Multi-Functional Platform Multi-Functional Platform 10.6 µm 10.6 µm 10.6 µm 1064 nm Nd:YAG / 500 nm, 520 nm, 550 nm, 600 nm, 650 nm IPL 1064 nm Nd:YAG / 500 nm, 520 nm, 550 nm, 600 nm, 650 nm IPL 755 nm Alexandrite / 1064 nm Nd:YAG / 500 nm, 520 nm, 550 nm, 600 nm, 650 nm IPL 50 W max. 80 W max. 60 W max. LP 120 J 180 W (max.), SP 120 J (max.) / 160 J (max.) energy per pulse 700 J/cm 2 (max.) SP and LP / 160 J (max.) energy per pulse 63.5 J (max.) 125 W (max.) / 120 J 180 W (max.) LP; 120 J (max.) SP / 160 J (max.) energy per pulse µs µs µs 2 50 ms SP, ms LP / 3 8 ms ms SP; 2 30 ms LP (1 3 pulses) / 3 8 ms 2 50 ms (single pulse), 2 40 ms (double pulse) / 2 50 ms SP, ms LP / 3 8 ms DOT Scanner; freehand handpiece; touchscreen; Stack feature; Smart Track delivery; Smart Pulse; database; CW, PW, traditional and fractional scanning modes available. PSD technology with selectable pulse shape (SP, DP, UP, HP, PW, CW, traditional and fractional scanning modes available); DOT/RF scanner with RF feature; freehand; TFT touch screen; Stack and Smart Track delivery modes, built-in training videos; database with videos and photos. Store user protocols. Optional diode laser module. PSD technology with selectable pulse shape (SP, DP, HP, PW, CW, traditional and fractional scanning modes available); DOT/RF scanner with RF feature; freehand; TFT touch screen; Stack and Smart Track delivery modes, built-in training videos; database with videos and photos. Store user protocols. Optional diode laser module. Multidisciplinary. 180 W Nd:YAG laser module; up to 27,000 W pulse peak power; three delivery pulse designs; 11 handpieces (22 and 24 mm available); optional five filter IPL with enhanced vascular capabilities 500G. Auto Spot Size Recognition. Top Hat technology; contact or optional external cooling connections; database and protocols; no disposables. Nd:YAG and IPL platform with five handpieces. Top Hat technology and Auto Spot Size Recognition; contact or optional external cooling connections; delivery pulse settings available; database and protocols. IPL: five optional filters, 30,000 shots guaranteed. No disposables. 5 Hz and high power (125 W) on Alexandrite emission; 180 W Nd:YAG with up to 27,000 W pulse peak power. Three pulse designs and adjustment feature for Alexandrite and Nd:YAG. 12 handpieces to 24 mm. Auto Spot Size recognition. Top Hat technology; contact or optional external cooling connection; database and protocols. IPL: five optional filters with enhanced vascular capabilities 500G. No disposables. Ellipse A/S Nordlys Nordlys LIMITED Sirius Multi-Technology Platform Selective Waveband Technology (SWT) SWT nm, nm nm, nm nm Up to 19 J/cm 2 Up to 19 J/cm 2 Up to 12 J/cm ms (programmable) ms (programmable) 2.5 ms All systems use SWT with dual mode filter, programmable pulse technology and database. Nordlys and Nordlys LIMITED offer expert adjustment of pulse times and unique submillisecond SWT pulse. Nordlys also offers fractional laser (Frax 1550) for Tx of acne scars. Eunsung Global Corp. Clearlight Intense Pulsed Light nm 3 35 J/cm ms Differentiated handpiece of 15 x 40 mm wide spot size. Fotona d.o.o. SP Dynamis XS Dynamis StarWalker Nd:YAG / Er:YAG Er:YAG Nd:YAG Q-Switched / Long Pulse 1064 nm / 2940 nm 2940 nm 1064 nm Up to 600 J/cm 2 Up to 500 J/cm 2 Up to 160 J/cm ms ms VERSA3: ms F-Runner, fractional Er:YAG scanner: 250 µm spot size, 168 mm 2 Tx area. S-Runner, Er:YAG scanner: 4 mm spot size, 16 cm 2 Tx area. S-11: Nd:YAG scanner: 42 cm 2 Tx area. Er:YAG handpieces: mm spot sizes; Nd:YAG handpieces: 2-20 mm spot sizes. F-Runner, fractional Er:YAG scanner: 250 µm spot size, 168 mm 2 Tx area. S-Runner, Er:YAG scanner: 4 mm spot size, 16 cm 2 Tx area. Er:YAG handpieces: mm spot sizes. Handpieces: 2 8 mm spot sizes. General Project Med Flash II CS Pulsed Light nm Up to 600 J at lamp level Single pulse: ms, Pulsed mode: ms (duration), ms (interval) Handpiece with integrated skin cooling. Partial spectrum lamp with dedicated filter. Spot sizes: 50 x 25 mm, 35 x 15 mm. Hironic Co., Ltd. MIRACLEAR A-Fit Blue Light, Vacuum, IPL Diode/RF nm 1450 nm / 0.5, 0.7, 1.0 MHz 2 11 J/cm 2 Max. 13 J/cm ms 250 ms Small tip: 14.5 x 12.3 mm; normal tip: 26.5 x 14.5 mm. RF needle. Ilooda Co., Ltd Secret RF Fraxis DUO Fraxis RF Microneedle CO2 Fractional / RF Microneedle CO2 Fractional 10,600 nm 10,600 nm 25 W 30 W / 20 W 30 W ms ms / ms ms 25 pin sterilized RF bipolar tips (optional 64 insulated pin available); monopolar handpiece for small Tx areas such as around the eyes; optional smart pen handpiece for acne and thread vein. RF fractional needle handpiece; CO2 fractional handpiece; optional surgical handpiece. CO2 fractional handpiece; optional surgical handpiece. Note: Data subject to change; please refer to Company Directory for supplier contact information. 116 THE European Aesthetic Guide Volume 15

117 Acne Tx Device Comparison Chart Supplier Product Name Device Type Wavelength (nm) Energy Output (Joules) Pulse Length Accessories Jeisys Medical AcGen cellec v SmoothCool INTRAcel ULTRAcel 1 Needle RF / Grid Fractional RF IPL IPL Fractional RF Microneedling Multi-Functional Platform (HIFU / Fractional RF Microneedling / Grid Fractional RF) nm nm / nm Up to 15 W / up to 200 W Up to 60 J/cm² Up to 65 J/cm² Up to 78.4 J/cm² Up to 3 J / up to W / up to 200 W 0 2 sec 1 60 ms 1 60 ms 5 1,000 ms ms / 60 2,000 ms / 0 2 sec 1 needle tip (0.8, 1.2, 1.5 mm): insulated for 0.3 mm at top of tips where RF energy is emitted. Grid RF (7 x 7 and 15 x 5 mm) tips. Nine interchangeable filters: 420S ( nm), 500S ( nm), 530S ( nm), 550S ( nm), 530D ( nm and nm), 560 nm, 640 nm, 700 nm. Spot size: 40 x 10 mm; contact cooling. 530 ( nm) handpiece: 34 x 8 mm spot size; 700 ( nm) large handpiece: 50 x 10 mm spot size; 700 ( nm) small handpiece: 34 x 8 mm spot size. Contact cooling (below 0 C). Invasive tip (FRM) and non-invasive tip (SRR). Bipolar and monopolar available. HIFU: B cartridge (depth: 3.0 mm); C cartridge (depth: 4.5 mm). FRM: FRM tip; SRR tip. GFR: large (15 x 15), small (7 x 7) tip. Lutronic, Inc. SPECTRA SOLARI HEALITE HEALITE II PICOPLUS INFINI eco2 MOSAIC H SPECTRA XT Lasemd Q-switched Nd:YAG IPL LED LED Q-switched Nd:YAG Bipolar Fractional RF CO2 Fractional Laser Er:Glass Nd:YAG based Multi-Platform Thulium Fractional Laser 532 nm, 585 nm, 650 nm, 1064 nm nm 830 nm (with 590 nm); 633 nm; 415 nm available (single wavelength per head) 830 nm (with 590 nm), 633 nm, 415 nm 1064 nm, 532 nm, 595 nm, 660 nm 10,600 nm 1550 nm 1064 nm, 532 nm, 585 nm, 595 nm, 650 nm, 660 nm 1927 nm Up to 1.5 J 35 J/cm² (at 510 nm filter) Focused: Up to 150 mw/cm2; up to 80 mw/cm2; up to 50 mw/cm W, W Up to 800 mj 50 W Up to 240 mj mj 1064: 1.2 J at ns max., 4.5 J at quasi-long max.; 532: 0.4 J max., 585 and 595: 0.25 J max., 650 and 660: 0.15 J max. Up to 20 mj 5 7 ns / 300 µs (Spectra Mode) ms 450 ps/2ns 10 1,000 ms Ultra Pulse: 40 1,000 µs; Super Pulse: 1 5 ms 5-10 ns, 300 ms Variety of handpieces: 3-8 mm Zoom Collimated; 1-7 mm Zoom; 7 mm Fixed Collimated; 585 nm and 650 nm Dye. Cut-off filters. Variety of heads and configurations available: single and dual wavelength heads. Planar and Focused (max. intensity) delivery options. Multiple wavelenghs available: 830 nm (with 590 nm) and 633 nm, 633 nm and 415 nm, 415 nm and 830 nm (with 590 nm). Five different handpieces: 1-6 mm Zoom, 6-10 mm Pico Toning, 2 and 5mm Gold Toning+, 2 and 3 mm RuVY Touch+, 7.4 x 7.4 mm Focused Dots. MFR handpiece with a variety of tips available: 49 tip (7 x 7 needles, scan size: 10 x 10 mm), Comfort / 16 tip (4 x 4 needles, scan size: 5 x 5 mm) Fractional or Insicional handpieces. Variety of fractional handpiece tips available: 120, 300, 500 micron tip. Skin tips, hair tips. Zoom HP, Collimated, Dye, Gold Toning, RuVY Touch, Fractional. Variety of ampoules for cosmeceutical delivery: Vitamin C, Vitamin A, Tranexamic Acid, CK (human blood cell conditioned media + KGF) and RS (Resveratrol). Novaestetyc, Novaclinical (divisions of Novavision Group) 4PLUS/RADIO4M PLW IFL Dynamic Quadripolar RF, RF Safety System (RSS), Variable RF (VRF), Quadripolar Dynamic Fractional RF (4RFH), Needled Fractional RF (4NFR) Incoherent Fast Light nm Up to 55 W Up to 100 J ms Movement sensors, pyrometric temperature detectors, four handpieces: small, medium, large and 4RFH with 32 golden pins and 384 µneedles; Biofeedback. Interchangeable filters: 400, 520, 550, 600, 650 and 720 nm; biocompatible disposable filters; Suberburst: single, repetition, IFL modes. Quanta System Eterna Giovinezza Plus New Silk Light (table top) TWAIN IPL option TWAIN 2940 Youlaser CO2 Youlaser MT Pulsed Light Pulsed Light Pulsed Light Er:YAG CO2 CO2 / GaAs , nm nm nm 2940 nm 10,600 nm 10,600 nm / 1540 nm Up to 30 J/cm 2 Up to 25 J/cm 2 Up to 30 J/cm 2 Up to 95 J/cm 2 30 W 30 W / 8 W ms ms ms ms ms ms / 1 20 ms IPL handpieces: , , , , and nm. Spot sizes 48 x 13 or 25 x 13 mm. Skin cooling. TWAIN IPL pulsed light option available for all systems with TWAIN Universal Connector. Option for ablative fractional resurfacing treatments available for all systems with TWAIN Universal Connector. Scanner area 2.1 x 2.1 cm (max.), 200 µm microspot. Surgical handpieces available. Mixed Technology delivers two wavelengths sequentially or simultaneously. Scanner area 1.8 x 1.8 cm (max.), 300 µm (10,600 nm) and 350 µm microspots (1540 nm). Stacking Pulse technologies deliver very short and repeated shots. Surgical handpieces available. Sciton JOULE ThermaScan BBLs BBL Laser and Light Platform Nd:YAG BroadBand Light BroadBand Light Various 1319 nm nm nm Up to 400 J/cm 2 Up to 30 J/cm 2 Up to 30 J/cm 2 Up to 30 J/cm ms, 1 10 sec Up to 200 ms Up to 200 ms Up to 200 ms Configurable up to ten modules. Computerized scanner; 30 x 30 mm Tx; integrated cooling. Table top system. SkinTyte II, 420, 515, 560, 590, 640, 695 nm filters, 15 x 45 mm and 15 x 15 mm spot sizes, integrated cooling. SkinTyte II, 420, 515, 560, 590, 640, 695 nm filters, 15 x 45 mm and 15 x 15 mm spot sizes, integrated cooling. Syneron emax/elight AC elōs Plus Optical Energy / RF Electrical Energy Optical Energy / Bi-polar RF nm nm Up to 18 J/cm 2 / up to 25 J/cm 3 Up to 18 J/cm 2 25 x 12 mm spot size. 25 x 12 mm spot size. Note: Data subject to change; please refer to Company Directory for supplier contact information. THE European Aesthetic Guide Volume

118 Body Shaping Technologies Comparison Chart Manufacturer Device Energy Source Mechanism of Action Regulatory Status (Europe and USA) Allergan CoolSculpting Cryolipolysis Non-invasively reduces fat through exclusively licensed Cryolipolysis-based technology. Cryolipolysis is based on the principle that fat cells are more vulnerable to energy extraction (cooling) than surrounding tissues. A non-invasive applicator is attached to the targeted procedure area to extract energy from the underlying fat tissue, while protecting the skin, nerves, muscles and other tissue. The cooled fat cells undergo apoptosis (controlled cell death) and are gradually eliminated (phagocytosis) reducing the thickness of the fat layer. CE Mark Class IIA Medical Device. FDA cleared. BTL Industries BTL EXILIS ELITE BTL VANQUISH ME Focused RF with Deep Cooling Selective RF Proprietary Impedance Intelligence handpiece and Energy Flow Control system prevent sparking or tissue burn. Specially designed tip continuously measures skin s impedance and maintains power for maximum delivery of thermal effect to tissues. Non-contact device for fat and circumferential reduction of the abdomen and legs. Patented, non-contact selective RF melts fat away, providing unsurpassed aptient comfort and no costly consumables. CE cleared. FDA cleared. Health Canada cleared. KFDA cleared. CE cleared. FDA cleared. Health Canada cleared. KFDA cleared. CLASSYS CLATUU SCIZER Cryocooling with Vaccum Non-Invasive Macro Focused Scanning Ultrasound Controlled cooling to eliminate targeted fat cells for non-surgical fat reduction treatment. Patented 360 cooling plate increases safety and predictability of clinical outcomes. Dual cooling system (Chiller and Radiator) cools targeted area for better clinical efficacy. Two handpieces provided can be used simultaneously or separately. Non-invasively reduces fat via macro focused scanning ultrasound. Fat cells are destroyed by thermal energy, which is 65 to 70, without damage to the surrounding tissue. Destroyed fat cells are removed by the body s natural metabolism. CE cleared. CE cleared. cocoon medical cooltech Red Monofase, V, Frequency Network Hz, Maximum Power: 1,000 W Based on the principle of the vulnerability of adipocytes to temperature changes. Freezing adipose tissue causes apoptosis. Six handpieces include couplers that allow full body contouring from neck to knees. Applicators work with a smart vacuum and cooling system to ensure results, which are visible from 15 days post treatment. Can operate with two simultaneous applicators per session. Skin is protected by patented Cool Gel Pad technology, which acts as a protective layer. Affected fatty tissue is gradually removed through natural metabolic processes. Directive MDD Class IIa Clas. According to IEC Class I, Type BF Marking CE0051. Also complies with MOH, TGA, CE, Cofepris, KFDA, MDMA, Invima, ANVISA and GOST regulations. Cutera trusculpt 3D Monopolar RF Selective, targeted heating of the subcutaneous tissue. CE cleared. FDA cleared. Cynosure, Inc. Smartlipo Triplex Cellulaze PrecisionTx PelleFirm RF Body Treatment SculpSure Laser Lipolysis Platform Cellulite Laser Platform Small Area Laser Lipolysis and Hyperhidrosis Treatment Pellevé S5 RF Generator (4mHz) Non-Invasive Laser Lipolysis (1064 nm Diode) ThermaGuide temperature sensing cannula and SmartSense accelerometer distribute energy uniformly and monitor subdermal tissue temperature for safer, more effective subdermal energy application nm, 1320 nm and 1440 nm wavelengths target fat, coagulate vessels and deliver tissue retraction. MultiPlex Technology enables blending of two of the three wavelengths. Addition of 1440 nm offers more efficient photomechanical destruction of fat cells, coagulation of small blood vessels and tissue retraction. SideLaze3D side-firing fiber and ThermaGuide thermal sensing cannulas, targeted 1440 nm wavelength addresses three structural defects of cellulite below the dermis: bulges of fat, fibrous septae and skin irregularities. This minimally invasive surgical procedure provides long lasting and clinically significant improvements in the appearance of cellulite up to three years. ThermaGuide temperature sensing cannula; 1440 nm wavelength; SideLaze800 side-firing fiber treats small areas of fat and underneath the dermis to increase collagen production and skin thickness. Treatment of primary axillary hyperhidrosis through the ablation of the axillary glands under the arm. RF monopolar tissue heating with integrated massage head for temporary reduction in the appearance of cellulite. The 1064 nm wavelength s specific affinity for adipose tissue, coupled with minimal absorption in the dermis, efficiently and non-invasively disrupts fat cells in 25 minutes. Over time, the body naturally eliminates the disrupted fat cells with results seen in 6 to 12 weeks. CE cleared. FDA cleared. CE cleared. FDA cleared. CE cleared. FDA cleared. CE cleared. FDA cleared CE cleared. FDA cleared. Health Canada cleared. KFDA cleared. DEKA SmartLipo 6 SmartLipo 10 SmartLipo 18 Triactive nm Nd:YAG Laser Lymphatic Massage and Skin Cooling. Ultrasound; Bipolar and Multipolar RF with / without Vacuum Massage and Skin Cooling Customized µpulsed Nd:YAG wavelength providing physiological contractions and elimination of fat with no inflammatory effects. Controlled photomechanical effect, photo-coagulative action and photo-stimulative course for immediate skin tightening due to flexible pulse design. Platform includes all available technologies for optimal body shaping. Face and body dermodynamic diode laser handpiece with cooling and vacuum. High and low frequency ultrasound; bipolar and multipolar RF application with / without vacuum massage and skin cooling. Graphic tutorial with auto selection of parameters and proper handpiece. Store end user s protocols. CE cleared. FDA cleared. CE cleared. Eunsung Global Corp. Cool Max PowerShape2 Cool Shaping Aurora 3Max Plus 3Max Coolshaping Well Spa Cooling Lipolysis Multipolar and Bipolar RF, Low Level Laser, Vacuum Cooling Lipolysis Multipolar RF, Vacuum Multipolar and Bipolar RF, Vacuum, Ultrasound Cavitation Cooling Lipolysis, Multipolar RF, Ultrasound Cavitation Vacuum and Mechanical Massage Non-invasive transcutaneous delivery of cold to selectively and permanently eliminate fat cells. Combined bipolar and multipolar RF, vacuum and low level laser achieves powerful results. Non-invasive technology uses cold exposure to selectively and gradually lead to the reduction of subcutaneous fat. Multipolar RF energy induces irreversible thermal damage to adipose tissue by creating directionally controlled electrical fields within cutaneous and subcutaneous tissues. Advanced body sculpting system integrates ultrasound cavitation, RF and vacuum technologies. Advanced body slimming system integrates cooling lipolysis, ultrasound cavitation and multipolar RF. Effective treatment for fat and cellulite reduction. Special vacuum suction technology physically stimulates deep into the skin. Two rollers pull up the connective tissues to improve skin folds. CE cleared. CE cleared. CE cleared. CE cleared. CE cleared. CE cleared. CE cleared. Note: Data subject to change; please refer to Company Directory for supplier contact information. 118 THE European Aesthetic Guide Volume 15

119 Body Shaping Technologies Comparison Chart Manufacturer Device Energy Source Mechanism of Action Regulatory Status (Europe and USA) Eunsung Global Corp. continued Magic Pot Magic Polar Megason Beauty Pot Multipolar RF, Vacuum, LED Multipolar RF Ultrasound Cavitation RF, Ultrasound Cavitation, Low Level Laser, LED RF delivers thermal energy into dermal layer and deep fatty layer in combination with strong vacuum suction technology. Applicator delivers RF energy to localized target areas in the dermal and fatty layers. Non-invasive ultrasound cavitation system delivers energy into the skin without pain. Applicator delivers RF, utrasound cavitation, LED and low level laser energy to localized target areas in the dermal and fatty layers. Fotona d.o.o. SP Dynamis Nd:YAG 1064 nm / Er:YAG 2940 nm Photothermal - heat generated by laser light. Non-invasive fat reduction via photothermal effects combined with non-ablative SMOOTH mode for additional skin tightening. General Project Hironic Co., Ltd. Med Sculpt Med² Contour Dual Wide MC1 Plus MC1 Multipower Micool-A VeraShape ByeLIPO Controlled Elastomassage Vacuum; LED Double Ultrasound (1 MHz); Elastomeric Membrane Assisted Vacuum Tech Double Ultrasound (1 MHz); Elastomeric Membrane Assisted Vacuum Tech Double Ultrasound (1 MHz); Sequential Ultrasound (2.5 MHz); RF; Elastomeric Membrane Assisted Vacuum Tech Cooling Lipolysis Multipolar RF: 0.5 MHz, Vacuum, 580 mm Hg, LED 610 mm 658 nm Diode Ultrasound action plus elastomassage. Deep ultrasound action and lymphodrainage. Deep ultrasound action and lymphodrainage. Multi-technology platform combines deep ultrasound action with RF and lymphodrainage for body shaping and tightening. Cooling energy is delivered to the subcutaneous fat layer without any damage to surrounding tissues. Two Cryolipo handpieces can be used simultaneously. Vacuum-assisted multipolar RF and LED device for obesity care. Low level laser therapy (LLLT) for fat reduction and cellulite removal. CE cleared. CE cleared. CE cleared. CE cleared. CE cleared. FDA cleared. CE cleared. FDA cleared. CE cleared. CE cleared. FDA cleared. CE cleared. CE cleared. CE cleared. CE cleared. InMode BodyFX RFAL Bipolar Radiofrequency, Negative Pressure, Mechanical Massage, Ace Technology Jeisys Medical LIPOcel High Intensity Focused Ultrasound RF Targets fatty tissue for body and cellulite Tx. RF provides precise, optimal heating of skin for contraction and body shaping. Vacuum massage with gentle pressure allows maximum depth. Tissue temperature and impedance monitoring achieves and maintains optimal Tx temperature endpoints for enhanced safety and reduced risk of thermal injury. No consumables. RF assisted lipolysis. Dual electrode configuration allows both internal coagulation (fat) and external skin contraction by maintaining the pre-set temperature for safety and efficiency. Non-invasively reduces fat cells by heating them up to 70 C without epidermal damage via HIFU with contact cooling. Surface temperature maintained at 5 C to reduce pain and deliver high energy. Three different depth cartidges (8, 11, 13 mm) allows treatment of all areas. CE cleared. FDA cleared. CE cleared. FDA cleared. Lutronic ACCUSCULPT encurve Pulsed Nd:YAG: 1444 nm (12 W, 300 mj, 40Hz) Radiofrequency The 600 µm optical fiber-delivered 1444 nm beam achieves effective interstitial lysis of target adipocytes through photothermal and photomechanical mechanisms. High absorption of 1444 nm in fat and water ensures powerful photothermal destructive effect aided by the tumescent approach, providing safety for overlying tissues through thermal confinement phenomenon. High peak powers and 100 µs pulse width create explosive reaction in the water at the fiber tip, causing cell membrane destruction through photomechanical stress. Ideal for laser-assisted facial contouring and fat deposits on the body. Apoptosis-inducing RF penetrates deep into the tissue, targeting adipocytes. Adipocytes oscillate rapidly causing frictional heat, which raises the adipocyte temperature to 45 initiating cells denaturization. This denaturation causes changes in the integrity of the adipocyte membrane, which leads to apoptosis, with expulsion of the intracellular lipid. The body s natural removal process takes over, permanently removing the damaged cells. CE cleared. FDA cleared. KFDA cleared. CE cleared. KFDA cleared. Novaestetyc, Novaclinical (divisions of Novavision Group) 4PLUS/RADIO4 M BODYKA PLUS Dynamic Quadripolar RF Low Frequency Ultrasonic Wave Sonication combined with Sonophoresis Radio4 (Dynamic Quadripolar RF) and VRF (Variable RF) technologies create buffering electrical fields which focus the energy into the specific skin layer heating the tissue. RSS (RF Safety System) technology combines the assisting action of a movement sensor with a pyrometric temperature detector and works as an assistant for the operator, ensuring simultaneous effectiveness and safety. Sonicphor technology combines low frequency ultrasound sonication, sonophoresis and sonoporation for non-invasive and painless treatment. SCP (Sonication Controlled Program) technology combines functions ensuring effectiveness and safety thanks to the precise movement sensor, multi-temperature sensor, auto-tuning and auto-scanning systems. CE cleared. CE cleared. Quanta System Da Vinci Lipo Icoone h Icoone Lipo MT 1064 nm and 1320 nm Nd:YAG Laser Vacuum Vacuum; 915 nm Laser Diode; 1 W; 650 nm LED; 50 mw Laser-assisted lipolysis and liposuction with the exclusive V shape cannula. Simultaneous dermal tightening. Microcellular stimulation of connective tissue via vacuum massage. Microcellular stimulation of connective tissue via vacuum massage and light action. CE medical cleared. CE medical cleared. CE medical cleared. Sciton STORZ MEDICAL AG Syneron Medical Ltd. SkinTyte II ProLipo PLUS CelluSmooth CELLACTOR ultra D-ACTOR ultra VelaShape III with Guided Mode UltraShape Infrared Light 1319 nm Nd:YAG / 1064 nm Nd:YAG 1319 nm Combined Focused and Radial Shock Waves Radial Shock Waves Bipolar RF, Infrared Light, Vacuum and Mechanical Massage Focused Ultrasound Deep dermal heating to stimulate new collagen production. Laser-assisted destruction of fat cells and collagen remodeling. Cutting fibrous septae, emulsifying fat and tightening the dermis to improve the appearance of lumpy and dimpled skin. Acoustic Wave Therapy (AWT). AWT. Combined energies known as elōs precisely target and heat fatty tissue within Tx area. Vacuum and tissue manipulation evens out skin to reveal a smoother, tighter figure. Pulsed (non-thermal) focused ultrasound for permanent fat cell destruction. Thermi Thermi250 Temperature Controlled RF Temperature Controlled Radiofrequency for the temporary reduction of cellulite. Zimmer MedizinSysteme Germany ZWave ZWave Pro ZLipo Radial Shockwave Radial Shockwave Cryolipolysis Unfocused low energy radial waves impact collagen structure and the skin s connective tissue, improving blood circulation and metabolism of fat cells. Effective treatment of connective tissue weakness, stretch marks and cellulite. Same as above. Target fat deposits to reduce them permanently and non-invasively. This method cools fat deposits over a period of time to reach a controlled and safe temperature range. Simple, safe and user-friendly. CE cleared. FDA cleared. CE cleared. FDA cleared. CE cleared. FDA cleared. CE cleared. CE cleared. CE cleared. FDA cleared. Configuration used in the U.S. only. FDA cleared. FDA cleared. CE cleared. CE cleared. CE cleared. Note: Data subject to change; please refer to Company Directory for supplier contact information. THE European Aesthetic Guide Volume

120 Fractional Technologies Comparison Chart Supplier Product Name Device Type Wavelength (nm) Energy Output (Joules) Pulse Length Accessories Cutera xeo pearl xeo pearl fractional enlighten Cynosure Smartskin+ Icon 1540 handpiece 2940 handpiece Emerge Cortex Resurfacing Work Station PicoSure DEKA SmartXide DOT SmartXide 2 DOT/RF SmartXide Touch YSGG YSGG Laser Fractional CO 2 Fractional Non- Ablative Laser Fractional Ablative Laser Fractional Non- Ablative Laser CO2 / Er:YAG Laser Alexandrite Fractional CO 2 Fractional CO 2 plus RF Fractional CO 2 plus RF 2940 nm 2940 nm 532 nm 670 nm, 1064 nm 10,600 nm 1540 nm 2940 nm 1410 nm 10,600 nm / 2940 nm 755 nm 10.6 µm 10.6 µm 10.6 µm Up to 3.5 J/cm 2 <400 mj 30 W Up to 70 mj per microbeam 3 24 mj mj/mb Up to 40 W / up to 1 J mj 50 W max. 80 W max. 60 W max µs 1000 µs 750 ps, 660 ps plus 2 ns ms 10 and 15 ms ms 6 20 ms Adj. to 6 ms / 300 µs ps µs µs µs Micro Lens Array. Customizable settings for tailored results. Control power, pulse, density and stacking options. Choose from six scan patterns. Scanning handpiece with integrated scan pattern controls. Surgical handpiece included. XF microlens provides high, non-ablative coverage for fast resurfacing treatments. XD microlens offers greater treatment depth for challenging conditions. Three light delivery modes: Manual activation for focused Tx areas, AutoStamp for faster treatments and AutoGlide for ease of use and enhanced comfort. Five pre-set parameters for the treatment of pigment, wrinkles or general skin resurfacing. Compact system design to easily store within a practice. Fractional CO 2 combined with Er:YAG with 1.5, 3 and 6 mm spot sizes. One year manufacturer warranty. Picosecond skin rejuvenation and toning for Tx of acne scars, wrinkles and pigmented lesions. Focus lens array and Pressure Wave Technology uniquely enable impressive results with less fluence, leading to increased patient comfort and minimal downtime. DOT Scanner and freehand handpiece; touch screen monitor; Stack feature; Smart Track delivery mode, Smart Pulse; patient database; CW, PW, traditional and fractional scanning modes available. PSD technology with selectable pulse shape (SP, DP, UP, HP, PW, CW, traditional and fractional scanning modes available); DOT/RF Scanner with RF feature; freehand; TFT touch screen monitor; Stack and Smart Track delivery modes; multimedia built-in training videos, patient database with videos and photos. Store user protocols. Optional diode laser module. PSD technology with selectable pulse shape (SP, DP, HP, PW, CW, traditional and fractional scanning modes available); DOT/RF Scanner with RF feature; freehand; TFT touch screen monitor; Stack and Smart Track delivery modes; multimedia built-in training videos, patient database with videos and photos. Store user protocols. Optional diode laser module. Multidisciplinary. Ellipse A/S Nordlys Eunsung Global Corp. Duet RF Fraction CO 2 Fotona d.o.o. SP Dynamis XS Dynamis General Project Laser Touch Med Flash II CS Multi-Technology Platform Bipolar / Monopolar RF CO 2 10,600 nm Nd:YAG / Er:YAG Er:YAG Multiple Laser Platform Nd:YAG Intense Pulsed Light 120 THE European Aesthetic Guide Volume nm 100 mj/mtz ms Frax 1550 is a magnetically coupled roller, skin resurfacing, acne or surgical scars or stretch mark treatments are optimized by pretreating with PR 530 ( ) nm or VL 555 ( ) nm immediately before Frax Nordlys features database, expert pulse adjustment, a unique submillisecond SWT pulse and a dual mode Nd:YAG with SoftCool cooling nm / 2940 nm 2940 nm 1320 nm nm 7 50 W mj Up to 600 J/cm 2 Up to 500 J/cm 2 12 J Up to 600 J at lamp level 70 1,600 ms ms ms ms Width: 3 10 ms Single pulse: ms, pulsed mode: ms (duration), ms (interval) Partical handpiece with easy tip replacement. NS, NC, NCE; 64 pin, 100 pin, 196 pin. Specialized handpiece for optimum functionality. Micro spot beam size more than 70 μm. F-Runner, fractional Er:YAG scanner: 250 µm spot size, 168 mm 2 Tx area. Er:YAG handpieces: mm spot sizes. F-Runner, fractional Er:YAG scanner: 250 µm spot size, 168 mm 2 Tx area. Er:YAG handpieces: mm spot sizes. Spot sizes: 3, 6, 9, 5-12 mm, fractional tip. Handpiece with integrated skin cooling. Partial spectrum lamp. Spot size: 50 x 25 mm. Hironic Co., Ltd. MIXEL CO 2 Fractional 10,600 nm 60 mj Up to 5,000 µs Metal tube; scanner type, scan size 2 x 2 mm to 20 x 20 mm, beam size: 70 µm µm. Max. spot quantity: 40,000. Ilooda Co., Ltd. Fraxis DUO Fraxis Secret RF Multiple IRIS CuRAS InMode Fractora CO 2 Fractional / RF Microneedle CO 2 Fractional RF Microneedle OPS Diode Laser Q-Switched Nd:YAG Bipolar Fractional Radiofrequency 10,600 nm 10,600 nm 532 nm (Fractional), 532 nm (Normal) 1064 nm / 532 nm 30 W / 20 W 30 W 25 W 70.7 J/cm 2, 832 J/cm J/cm ms / ms ms ms 100 ms, 400 ms 5 20 ns; 100 ns; 300 µs RF fractional needle handpiece; CO 2 fractional handpiece; optional surgical handpiece. CO 2 fractional handpiece; optional surgical handpiece. 25 pin sterilized RF bipolar tips (optional 64 insulated pin available); monopolar handpiece for small Tx areas such as around the eyes; optional smart pen handpiece for acne and thread vein. 532 nm Fractional, 532 nm Normal; available to treat vascular lesions in the epidermis. Energy meter including Zoom handpiece; collimated handpiece; optional fractional handpiece. RF Up to 62 mj/pin Up to 2 pps Variable pin configurations (24 coated, 26, 60) and Tx depths allow for a Designer Dermis approach to treatment. Safe on ethnic skin. No pulse counter limitations. Note: Data subject to change; please refer to Company Directory for supplier contact information.

121 Fractional Technologies Comparison Chart Supplier Product Name Device Type Wavelength (nm) Energy Output (Joules) Pulse Length Accessories Jeisys Medical INTRAcel PRO INTRAcel IntraGen Edge Fractional ULTRAcel Lumenis UltraPulse ActiveFX UltraPulse DeepFX UltraPulse TotalFX AcuPulse MultiMode Superficial AcuPulse MultiMode Deep UltraPulse SCAARFX Lutronic ACTION II Lasemd eco2 INFINI MOSAIC HP Novaestetyc, Novaclinical (divisions of Novavision Group) 4PLUS/RADIO4M Quanta System YouLaser CO 2 YouLaser MT TWAIN 2940 Discovery Pico Q-Plus Evo Sciton ProFractional Halo Syneron Profound elōs plus/etwo Sublative Rejuvenation CO 2RE Picoway Resolve Fractional RF Microneedling Fractional RF Microneedling Grid Fractional RF Fractional CO 2 Laser Multi-Functional Platform (HIFU / Fractional RF Microneedling / Grid Fractional RF) Fractional CO 2 Fractional CO 2 Fractional CO 2 Fractional CO 2 Fractional CO 2 Fractional CO 2 Fractional Er:YAG Laser Thulium CO 2 Fractional laser Bi-Polar Fractional RF Er:Glass Patented Dynamic Quadripolar RF, RF Safety System (RSS), Variable RF (VRF), Quadripolar Dynamic Fractional RF (4RFH), Needled Fractional RF (4NFR) CO 2 CO 2 / GaAs Er:YAG Picosecond Nd:YAG Nd:YAG Q-Switched / KTP Nd:YAG Q-Switched / Ruby Q-Switched Er:YAG Hybrid Fractional Laser (ablative and non-ablative) Bipolar RF 460, 5 khz Fractional Bipolar RF CO 2 Resurfacing System Nd:YAG 10,600 nm 10,600 nm 10,600 nm 10,600 nm 10,600 nm 10,600 nm 10,600 nm 2950 nm 1927 nm 10,600 nm 1550 nm Up to 50 W Up to 50 W Up to 200 W mj Up to 3 J / up to W / up to 200 W mj mj mj mj 5 30 mj mj Normal: 50 J, Long pulse: 180 J Up to 20 mj Up to 240 mj 50 W Up to 120 mj 10 ms 5 sec 5 1,000 ms 0 2 sec ms ms / 60 2,000 ms / 0 2 sec < 1 ms < 1 ms < 1 ms 300 µs SuperPulses 300 µs SuperPulses < 1 ms 49 tip (insulated). Insulated (except 0.3 mm) at end of tips where RF is emitted. SRR Tip / 16 Tip (non-insulated). Bipolar and monopolar available. Invasive tip (FRM) and non-invasive tip (SRR). Bipolar and monopolar available. Insulated except for 0.3 mm at end of the tips where it emits the RF energy. Full tip (15 x 15 mm) and small tip (7 x 7 mm). Spot size: 120, 350, 800 μm; surgical tip; surgical handpieces (50 and 100 mm). Platform device features HIFU RF microneedling and non-invasive RF technology. HIFU: B cartridge (depth: 3.0 mm); C cartridge (depth: 4.5 mm). FRM: FRM tip; SRR tip. GFR: large (15 x 15), small (7 x 7) tip. Single, minimal downtime Tx for wrinkle/pigment results. Fractional CO 2 Tx for wrinkles, scars and deep collagen treatment. Blended fractional CO 2 Tx for customized patient outcomes. Incisional and resurfacing accessories available. Incisional and resurfacing accessories available. Fractional CO 2 Tx for surgical and acne scars, as well as conspicuous and complex lesions. High energy: 150 mj/pulse; deep Tx up to 4.0 mm; optimal ablation/coagulation ratio. Normal: 250 µs, Fractional, Zoom, Shining Peel and Petit Lady handpieces. Long Pulse: 1,000 ms Roller set, comb tip set, square tip set, Lasemd ampoules and cosmetics. Fractional or Insicional handpieces. Variety of fractional handpiece tips available: 120, 300, 500 micron tip. Ultra Pulse: 40 Variety of handpieces and tips available. MFR handpiece: 49 tip 1,000 µs; Super (7 x 7 needles, scan size: 10 x 10 mm), Comfort / 16 tip (4 x 4 Pulse: 1 5 ms needles, scan size: 5 x 5 mm); SFR handpiece: 144L tip (12 x ms - 1,000 ms electrodes, Dual Channels, scan size: 20 x 20 mm), 64S tip (8 x 8 electrodes, Single Channel, scan size: 10 x 10 mm). 10 x 10 mm, 8 x 8 mm, 6 x 6 mm, 5 x 10 mm, Contact tip, Hair tip. Up to 55 W Movement sensors, pyrometric temperature detectors, four handpieces: small, medium, large and 4RFH technology with 32 golden pins and 384 µneedles; Biofeedback. 10,600 nm 10,600 nm / 1540 nm 2940 nm 532 nm / 1064 nm 1064 nm / 532 nm / 694 nm 2940 nm 1470 nm / 2940 nm 10,600 nm 1064 nm, 532 nm 30 W 30 W / 8 W Up to 100 J/cm J (ps), 0.4 J (ns) / 0.8 J (ps / ns), 2 J (μs) Up to 37 J/cm 2 (ns), 50 J/cm 2 (μs) / up to 15 J/cm 2 / up to 30 J/cm 2 (ns), 50 J/cm 2 (ms) Up to 400 J/cm mj/mtz / 50 mj/ MTZ Max. output voltage 84 VRMS; 5 W per channel Up to 100 mj/pin / up to 62 mj/pin Up to 453 J/cm mj ms ms / 1 20 ms ms 370 ps, 6 ns, 6+6 ns / 450 ps, 6 ns, 6+6 ns, 300 μs 6 ns, 6+6 ns, 300 μs / 6 ns, 6+6 ns Variable Up to 5 ms ms ps Scanner area: 2.1 x 2.1 cm (max), 300 µm microspot, Stacking Pulse technologies deliver short and repeated pulses. Various surgical handpieces available. Exclusive Mixed Technology delivers two wavelengths sequentially or simultaneusly. Scanner area 1.8 x 1.8 cm (max), 300 µm microspot (10,600 nm) and 350 µm microspot (1540 nm). Stacking Pulse technologies deliver short and repeated pulses. DivaTight option for vaginal and vulvar treatments. Various surgical handpieces available. Option for ablative fractional resurfacing treatments. Spot size up to 8 mm. Available for all laser systems equipped with a TWAIN Universal Connector. Peak power up to 0.8 GW at 532 nm and 1.8 GW at 1064 nm. Exclusive Pico-Boost technology (patent pending) allows emission in pico, nano or micro seconds. OptiBeam II technology for fractional, squared and round flat top spots up to 8 mm. Twain options available. Q-switched Nd:YAG 532 nm, 1064 and Ruby 694 nm, with OptiBeam II handpieces for fractional, squared and round flat top spot sizes up to 8 mm; rep. rate up to 10 Hz at 532 / 1064 and up to 3 Hz at 694 nm. TWAIN options available. Q-Plus Evo models: Q-Plus A (Nd:YAG 532 / 1064 nm); Q-Plus C (combined Nd:YAG 532 / 1064 and Ruby 694 nm); Q-Plus R (Ruby 694 nm). Expandable module/density 1.5% to 26%. Delivery of ablative and non-ablative wavelengths in single pass. Dynamic Thermal Optimization (DTO) for precise energy delivery. Roller tip adaptors; optical navigation; integrated Zimmer cooling advanced mode for precise and independent control of depth and density. Pre-programmed modes and integrated smoke evacuation system. Seven independent bipolar channels. Dermal: five independent pairs of bipolar microneedles; Sub-Q: seven independent pairs of bipolar microneedles. elōs: 64/44 pins. etwo: standard 64 pin tip with 12 x 12 mm spot. Focal 44 pin tip with 11 x 3 mm spot. Reusable, tapered fractional and surgical Tx handpieces. Four digital super pulsed fractional treatment modes including CO 2RE Light, Mid, Deep and Fusion. Classical ablation and CW Surgical Mode. Two handpieces, 1064 nm and 532 nm. Note: Data subject to change; please refer to Company Directory for supplier contact information. THE European Aesthetic Guide Volume

122 Dermal Filler Product Comparison Chart Manufacturer Product(s) Key Component Description Regulatory Status Adoderm VARIODERM Fine Line VARIODERM Basic VARIODERM Plus VARIODERM Subdermal VARIODERM Lips and Medium VARIODERM Mesolift Hyabell Lips Hyabell Basic Hyabell Deep Hyabell Ultra Non-animal Hyaluronic Acid Non-animal Hyaluronic Acid Non-animal Hyaluronic Acid Non-animal Hyaluronic Acid Non-animal Hyaluronic Acid Non-animal Hyaluronic Acid Non-animal Hyaluronic Acid Non-animal Hyaluronic Acid Non-animal Hyaluronic Acid Non-animal Hyaluronic Acid 6 mg/ml; for superficial wrinkles and lip augmentation. 12 mg/ml; for medium wrinkles and lip contour. 18 mg/ml; for deep wrinkles and volume. 27 mg/ml; for volume augmentation and facial contouring. 12 mg/ml; special formulation for lip augmentation and medium wrinkles mg/ml; effective smoothing of superficial wrinkles. 12 mg/ml; for lip augmentation and lip contour. 16 mg/ml; medium wrinkles and lip contour. 20 mg/ml; deep wrinkles, especially of the face. 24 mg/ml; very deep wrinkles, face contouring, volumizing. CE marked, marketed in Europe and other countries. CE marked, marketed in Europe and other countries. CE marked, marketed in Europe and other countries. CE marked, marketed in Europe and other countries. CE marked, marketed in Europe and other countries. CE marked, marketed in Europe and other countries. CE marked, marketed in Europe and other countries. CE marked, marketed in Europe and other countries. CE marked, marketed in Europe and other countries. CE marked, marketed in Europe and other countries. Allergan CosmoDerm CosmoPlast HydraFill Softline HydraFill Softline Max Surgiderm 18 Surgiderm 30 Surgiderm 24XP Surgiderm 30XP Juvéderm Ultra Smile Juvéderm ULTRA 2 Juvéderm ULTRA 3 Juvéderm ULTRA 4 Juvéderm VOLUMA Juvéderm HYDRATE Purified Human-based Collagen + Lidocaine Non-animal Hyaluronic Acid Non-animal Hyaluronic Acid Non-animal Hyaluronic Acid Non-animal Hyaluronic Acid Non-animal Hyaluronic Acid Non-animal Hyaluronic Acid plus lidocaine Non-animal Hyaluronic Acid + Lidocaine Non-animal Hyaluronic Acid Non-animal Hyaluronic Acid Purified human-based collagen 35 mg/ml. Purified human-based collagen 35 mg/ml, cross-linked with glutaraldehyde. *All collagen products contain 0.3% lidocaine. Non-animal, cross-linked cohesive hyaluronic acid 24 mg/g. Non-animal, cross-linked cohesive hyaluronic acid 24 mg/g. Non-animal, cross-linked cohesive hyaluronic acid 18 mg/g. Non-animal, cross-linked cohesive hyaluronic acid 24 mg/g. Non-animal, cross-linked cohesive hyaluronic acid 24 mg/g. Non-animal, cross-linked cohesive hyaluronic acid 24 mg/g. Non-animal, cross-linked cohesive hyaluronic acid 24 mg/g. Non-animal, cross-linked cohesive hyaluronic acid 24 mg/g. Non-animal, cross-linked cohesive hyaluronic acid 24 mg/g. Non-animal, cross-linked cohesive hyaluronic acid 24 mg/g. *All Juvéderm ULTRA products contain 0.3% lidocaine. Non-animal, cross-linked cohesive hyaluronic acid 20 mg/g mg/g plus mannitol 0.9%; 1 x 1 ml syringe. Worldwide. Worldwide. CE marked. CE marked. CE marked. CE marked. CE marked. CE marked. CE marked. CE marked. CE marked. CE marked. Worldwide. CE marked. Anteis S.A. Merz Pharmaceuticals GmbH Belotero Hydro Belotero Soft Belotero Balance Belotero Intense Belotero Volume Hyaluronic Acid The complete Belotero HA filler range offers extended portfolio Belotero is CE certified and FDA cleared. for rehydrating skin, smoothing and filling, treating lip augmentation and restoring facial volume. Can be used individually Available in 56 markets worldwide. or in combination to tailor an aesthetic solution to the skin s structural and functional needs with predictable and natural outcomes. With CPM Technology, Belotero Soft and Belotero Balance are the only two HA filler products on the market that can be injected with the blanching technique, with no risk of Tyndal effect. AQTIS Medical, a Sinclair Company ELLANSÉ (-S, -M, -L, -E) PCL in CMC gel carrier 30% polycaprolactone (PCL) particles suspended in 70% aqueous carboxymethylcellulose (CMC) carrier. Collagen stimulator. CE marked. Approved in Australia, Mexico, Russia, South Korea and other countries. Contura International A/S Aquamid Aquamid Reconstruction Polyacrylamide Gel (PAAG) 2.5% cross-linked hydrophilic PAAG and 97.5% non-pyrogenic water. CE-marked, sold in more than 30 countries worldwide. Croma-Pharma GmbH Princess RICH Princess FILLER Princess FILLER Lidocaine Princess VOLUME Princess VOLUME Lidocaine Princess VOLUME PLUS Lidocaine Non-animal Hyaluronic Acid + Glycerol Non-animal cross-linked Hyaluronic Acid Non-animal cross-linked Hyaluronic Acid Non-animal cross-linked Hyaluronic Acid Non-animal cross-linked Hyaluronic Acid Non-animal cross-linked Hyaluronic Acid Stabilized hyaluronic acid 18 mg/ml + glycerol 20 mg/ml. Cross-linked hyaluronic acid 23 mg/ml. Cross-linked hyaluronic acid 23 mg/ml + 0.3% Lidocaine. Highly cross-linked hyaluronic acid 23 mg/ml. Highly cross-linked hyaluronate acid 23 mg/ml + 0.3% Lidocaine. Highly cross-linked hyaluronate acid 25 mg/ml + 0.3% Lidocaine. CE marked. CE marked. CE marked. CE marked. CE marked. CE marked. Galderma EMERVEL Restylane Restylane Touch Restylane Perlane Restylane Sub-Q Restylane Lipp Restylane Vital Macrolane VRF30 Macrolane VRF20 Hyaluronic Acid NASHA Non-animal Hyaluronic Acid 20 mg/ml. NASHA gel a non-animal hyaluronic acid, stabilized with BDDE. The differentiation is in the size of the NASHA particles, to assure a tissue-tailored range of products. Restylane 100,000 particles per ml. Restylane Touch 500,000 particles per ml. Restylane Perlane 10,000 particles per ml. Restylane Sub-Q- 1,000 particles per ml. Concentration 20 mg/ml. CE medical marked Restylane is approved worldwide with the exception of Japan. Restylane Perlane, Restylane Sub-Q and Restylane Touch are approved worldwide with the exception of Japan and U.S. U.S. approval in progress. Restylane Lipp approved in Europe. Hironic JUVINA Light JUVINA Moderate JUVINA Deep JUVINA Deep Plus JUVINA Light Comfort JUVINA Moderate Comfort JUVINA Deep Comfort JUVINA Deep Plus Comfort Non-animal, cross-linked cohesive Hyaluronic Acid Non-animal, cross-linked cohesive Hyaluronic Acid Non-animal, cross-linked cohesive Hyaluronic Acid Non-animal, cross-linked cohesive Hyaluronic Acid Non-animal, cross-linked cohesive Hyaluronic Acid plus Lidocaine Non-animal, cross-linked cohesive Hyaluronic Acid plus Lidocaine Non-animal, cross-linked cohesive Hyaluronic Acid plus Lidocaine Non-animal, cross-linked cohesive Hyaluronic Acid plus Lidocaine 20 mg/ml for superficial lines, worry lines, crows feet and neck wrinkles. 20 mg/ml for deep nasolabial folds, facial contouring and augmentation. 20 mg/ml for severely deep lines, facial contouring and augmentation, and chin. 20 mg/ml for forehead, chin and nose. 20 mg/ml plus 0.3% lidocaine for superficial lines, worry lines, crows feet and neck wrinkles. 20 mg/ml plus 0.3% lidocaine for deep nasolabial folds, facial contouring and augmentation. 20 mg/ml plus 0.3% lidocaine for severely deep lines, facial contouring and augmentation, and chin. 20 mg/ml plus 0.3% lidocaine for forehead, chin and nose. CE marked. CE marked. CE marked. CE marked. CE marked. CE marked. CE marked. CE marked. Note: Data subject to change; please refer to Company Directory for supplier contact information. 122 THE European Aesthetic Guide Volume 15

123 Dermal Filler Product Comparison Chart Manufacturer Product(s) Key Component Description Regulatory Status IBSA Farmaceutici Italia Merz North America, Inc. (part of Merz Pharma GmbH & Co. KGaA) mesoestetic VISCODERM ALIAXIN EV ALIAXIN GP ALIAXIN FL ALIAXIN SR PROFHILO Radiesse Radiesse Lidocaine Mesohyal HYALURONIC Mesohyal NCTC Mesohyal X-DNA Mesohyal VITAMIN C Mesohyal ORGANIC SILICON Mesohyal DMAE Mesohyal OLIGOELEMENTS Mesohyal CARNITINE Mesohyal ARTICHOKE Mesohyal BIOTIN Mesohyal MELILOT mesofiller global mesofiller intense Non-animal, non-cross-linked, Ultrapure Hyaluronic Acid Non-animal, Ultrapure Hyaluronic Acid Patented thermally-stablized hybrid cooperative complex, non-animal, non-cross-linked Hyaluronic Acid CaHA CMC Non-animal, non-crosslinked Hyaluronic Acid Non-animal, non-cross-linked HA plus Biorevitalizing Cocktail Non-animal, non-cross-linked HA plus Sodium Deoxyribonucleotide Non-animal, non-cross-linked HA plus Vitamin C Non-animal, non-cross-linked HA plus Organic Silicon Non-animal, non-cross-linked HA plus DMAE Non-animal, non-cross-linked HA plus nine Oligoelements (Zn, Mn, Mb, Ni, Co, Se, Cu, Mg, Vn) Non-animal, non-cross-linked HA plus L-carnitine Non-animal, non-cross-linked HA plus artichoke extract. Non-animal, non-cross-linked HA plus biotin; Group B Vitamins and Mineral Salts Non-animal, non-cross-linked HA plus Melilot Extract, Troxerutin and Mineral Salts Non-animal, reticulated HA (20 mg/ml) Non-animal, reticulated HA (25 mg/ml) Natural HA available in 8, 16, 20 mg/1 ml, 16 mg/2 ml, 24 mg/1.5 ml, 50 mg/2.5 ml. Each formulation in the ALIAXAN line is composed of a combination of different molecular weight HA for specific functions. 25 mg/1 ml cross-linked HA, 2 x 1 ml syringes. ALIAXIN SR combines 2.5 mg non-cross-linked HA plus 22.5 mg cross-linked HA, 2 x 1 ml syringes for true HydroLift action. NAHYCO Hybrid Technology: 32 mg low molecular weight and 32 mg high molecular weight Ultrapure HA resulting in stabilized hybrid cooperative complex with a total HA concentration of 64 mg/2 ml. No chemical agents used. The principal component is synthetic calcium hydroxylapatite (CaHA) suspended in an aqueous sodium carboxymethylcellulose gel matrix consisting primarily of water (sterile water for injection) and glycerin. Radiesse Lidocaine is enhanced with 0.3% integral lidocaine hydrochloride. Moisturizing and rejuvenation of the skin. Intensive cell biorevitalization. Cell membrane protection. Antioxidant and brightening effects. Skin tissue regeneration and restructuring. Firmness and elasticity. Stimulation of the extracellular matrix. Lipolytic. Draining, anti-cellulite, detoxification. Reactivation of hair metabolism. Microcirculation. Medium-depth wrinkles; increase, outlining and moisturization of lips, cheeks, marked nasolabial folds, perioral area, marionette lines and hands. Deep wrinkles, facial bioplasty, nasal remodeling, cheekbones, very marked nasolabial fold, severe marionette lines, double chin, mandibular area. CE marked. CE marked. CE marked. CE marked. CE marked. CE marked. FDA approved. CE marked. FDA approved. CE marked. CE marked. CE marked. CE marked. CE marked. CE marked. CE marked. CE marked. CE marked. CE marked. CE marked. CE marked. CE marked. CE marked. Sinclair Pharma SkinTech Pharma Group S.L. (Aesthetic Dermal) Perfectha FineLines Perfectha Complement Perfectha Derm Perfectha Deep Perfectha SubSkin - 1 x 3 ml and 3 x 1 ml RRS HYALIFT 35 RRS HYALIFT 75 RRS HYALIFT 75 PROACTIVE RRS HYALIFT 35 Syringe RRS HYALIFT 75 Syringe RRS HYALIFT 75 PRO Syringe RRS HA INJECTABLE RRS HA SKIN RELAX with BoNtA 568 RRS HA TENSOR LIFT RRS HA WHITENING RRS HA EYES RRS HA STRIMATRIX RRS HA CELLUTRIX XL HAIR RRS SILISORG RRS SILISORG HA RRS SILISORG TENSOR Biodegradable cross-linked Hyaluronic Acid of nonanimal origin Non-animal Hyaluronic Acid Non-animal Hyaluronic Acid Non-animal Hyaluronic Acid + biorevitalization solution Non-animal Hyaluronic Acid + biorevitalization solution Non-animal Hyaluronic Acid + biorevitalization solution Non-animal Hyaluronic Acid + biorevitalization solution Non-animal Hyaluronic Acid + biorevitalization solution Non-animal Hyaluronic Acid + biorevitalization solution Non-animal Hyaluronic Acid + biorevitalization solution Non-animal Hyaluronic Acid + biorevitalization solution Non-animal Hyaluronic Acid + biorevitalization solution Non-animal Hyaluronic Acid + biorevitalization solution Non-animal Hyaluronic Acid + biorevitalization solution Non-animal Hyaluronic Acid + biorevitalization solution Organic Silicium + biorevitalization solution Non-animal Hyaluronic Acid + Organic Silicium + biorevitalization solution Organic Silicium + biorevitalization solution 20 mg/ml of hyaluronic acid; used for superficial, moderate and deep wrinkles, non-surgical rhinoplasty, lip augmentation and contouring, facial contouring (jaw line redefinition, cheeks, chin, malar area) and volume loss. Perfectha SubSkin is also used for hand rejuvenation. Viscous long chain hyaluronic acid for dermal filling, biorevitalization and skin hydration. 5 ml/vial, 2 or 6 vials/box. Highly viscous long chain hyaluronic acid for dermal filling, biorevitalization and skin hydration. 5 ml/vial, 2 or 6 vials/box. Viscous long chain hyaluronic acid for dermal filling. Used for internal hydration and biorevitalization; contains antioxidants and numerous amino acids. 5 ml/vial, 2 or 6 vials/box. 3 ml syringe for dermal filling, biorevitalization and skin hydration. 3 ml syringe of highly viscous long chain HA. 3 ml syringe with antioxidants and numerous amino acids. For internal hydration and biorevitalization. Long chain hyaluronic acid for dermal filling associated to a multi factor biorevitalization solution. Specially used in photo or chrono skin aging. 5 ml/vial, 2 or 6 vials/box. Soft gel of long chain hyaluronic acid for dermal filling and anti-aging biorevitalization. Specially indicated for relaxing skin. 3 ml/vial, 2 or 6 vials/box. Long chain hyaluronic acid for dermal filling associated to a multi factor biorevitalization solution. Specially indicated for enhancing skin tension. 5 ml/vial, 2 or 6 vials/box. Soft gel of long chain hyaluronic acid for dermal filling and biorevitalization. Specially indicated in cases of skin pigment problems. 3 ml/vial, 2 or 6 vials/box. Very soft gel of hyaluronic acid for dermal filling and biorevitalization. Specially indicated for improving eye contour appearance. 1.5 ml/ampoule, 2 or 12 ampoules/box. Soft gel of long chain hyaluronic acid for dermal filling and biorevitalization, specially used in cases of atrophic depressions such as stretch marks and skin flaccidity. 10 ml/vial, 6 vials/box. Soft gel of long chain hyaluronic acid for dermal filling and bio-revitalization. Specially used in cases of cellulitis depressions. 10 ml/vial, 6 vials/box. Very soft gel of long chain hyaluronic acid for dermal filling and biorevitalization. Specially used in cases of hair loss. 3 ml/vial, 6 vials/box. Dermal filler made of organic silicium specially used in case of aging skin, atrophic skin and cellulitis depressions. 5 ml/ampoule, 12 ampoules/box. Dermal filler made of organic silicium associated with non-animal long chain hyaluronic acid, specially used in cases of aging skin, atrophic skin and and cellulitis depressions. 5 ml/ampoule, 12 ampoules/box. Dermal filler made of organic silicium specially used in cases of aging skin, atrophic skin and cellulitis depressions; enhances skin firmness. 5 ml/ampoule, 2 or 12 ampoules/box. CE marked. KFDA. CE marked. KFDA. CE marked. KFDA. CE marked. KFDA. CE marked. KFDA. CE marked, marketed in Europe and other countries. CE marked, marketed in Europe and other countries. CE marked, marketed in Europe and other countries. CE marked, marketed in Europe and other countries. CE marked, marketed in Europe and other countries. CE marked, marketed in Europe and other countries. CE marked, marketed in Europe and other countries. CE marked, marketed in Europe and other countries. CE marked, marketed in Europe and other countries. CE marked, marketed in Europe and other countries. CE marked, marketed in Europe and other countries. CE marked, marketed in Europe and other countries. CE marked, marketed in Europe and other countries. CE marked, marketed in Europe and other countries. CE marked, marketed in Europe and other countries. CE marked, marketed in Europe and other countries. CE marked, marketed in Europe and other countries. Note: Data subject to change; please refer to Company Directory for supplier contact information. THE European Aesthetic Guide Volume

124 Dermal Filler Product Comparison Chart Manufacturer Product(s) Key Component Description Regulatory Status TEOXANE Laboratories TEOSYAL MESO TEOSYAL First Line TEOSYAL Global Action TEOSYAL Touch Up TEOSYAL Deep Lines TEOSYAL Kiss TEOSYAL Ultimate TEOSYAL Ultra Deep TEOSYAL Puresense First Line TEOSYAL Puresense Global Action TEOSYAL Puresense Deep Lines TEOSYAL Puresense Kiss TEOSYAL Puresense Ultimate TEOSYAL Puresense Ultra Deep TEOSYAL Puresense Redensity [I] TEOSYAL Puresense Redensity [II] TEOSYAL RHA1 TEOSYAL RHA2 TEOSYAL RHA3 TEOSYAL RHA4 Non cross-linked non-animal Hyaluronic Acid Cross-linked non-animal Hyaluronic Acid Cross-linked non-animal Hyaluronic Acid Cross-linked non-animal Hyaluronic Acid Cross-linked non-animal Hyaluronic Acid Cross-linked non-animal Hyaluronic Acid Cross-linked non-animal Hyaluronic Acid Cross-linked non-animal Hyaluronic Acid Cross-linked non-animal Hyaluronic Acid Cross-linked non-animal Hyaluronic Acid Cross-linked non-animal Hyaluronic Acid Cross-linked non-animal Hyaluronic Acid Cross-linked non-animal Hyaluronic Acid Cross-linked non-animal Hyaluronic Acid Non cross-linked non-animal Hyaluronic Acid Mix of non cross-linked and cross-linked non-animal Hyaluronic Acid Mix of non cross-linked and cross-linked non-animal Hyaluronic Acid Cross-linked non-animal Hyaluronic Acid Cross-linked non-animal Hyaluronic Acid Cross-linked non-animal Hyaluronic Acid 15 mg/ml: Hydratation of the face, neck and decolleté CE Marked. 20 mg/ml: Correction of fine lines and wrinkles in thin skin CE Marked. (crow s feet). 25 mg/ml: Filling of moderately pronounced wrinkles. CE Marked. 25 mg/ml: Ideal for touch up as complement tp first TEOSYAL CE Marked. injection. 25 mg/ml: Filling of highly pronounced wrinkles. CE Marked. 25 mg/ml: Harmonization of the lip contour and volume. CE Marked. 22 mg/ml: Volume recovery for wide areas (face oval, cheeks, CE Marked. temples). 25 mg/ml: Volume creation for targeted areas (cheekbones, CE Marked. chin) and correction of deep wrinkles in thick skin. 20 mg/ml + Lidocaine 0.3%: Correction of fine lines and CE Marked. wrinkles in thin skin (crow s feet). 25 mg/ml + Lidocaine 0.3%: Filling of moderately pronounced CE Marked. wrinkles. 25 mg/ml + Lidocaine 0.3%: Filling of highly pronounced CE Marked. wrinkles. 25 mg/ml + 0.3% Lidocaine: Harmonization of lip contour and CE Marked. volume. 22 mg/ml + Lidocaine 0.3%: Volume recovery for larger areas CE Marked. (face oval, cheeks, temples). 25 mg/ml + Lidocaine 0.3%: Volume creation for targeted areas CE Marked. (cheek bones, chin) and correction of deep wrinkles in thick skin. 15 mg/ml + Lidocaine 0.3% + DRC (Dermo-Restructuring CE Marked. Complex, made up of eight amino acids, three minerals and one vitamin): Redensification and hydration of the face, neck and decolleté. 15 mg/ml + Lidocaine 0.3% + DRC: Correction of the eye circle, CE Marked. tear trough, palpebromalar groove, minimal palpebral or malar bags. 15 mg/ml + Lidocaine 0.3%: Filling of lines, superficial wrinkles, CE Marked. fine wrinkles and skin cracks, correction of areas of skin that are or marked by signs of aging on the face, neck and neckline and skin hydration. 23 mg/ml + Lidocaine 0.3%: Filling of line wrinkles on the face, CE Marked. damaged skin such as mild or moderate nasogenian folds, peribuccal and glabella wrinkles. 23 mg/ml + Lidocaine 0.3%: Treatment of deep wrinkles on CE Marked. the face, such as nasogenian folds, vertical lip lines, deep lines and creases, cheek augmentation and to restore the shape of the face. 23 mg/ml + Lidociane 0.3%: Cheek and upper cheek CE Marked. augmentation, redefining the contours of the face and filling deep wrinkles in thick skin on the face. Laboratoires VIVACY STYLAGE Hydro STYLAGE HydroMax STYLAGE S STYLAGE M STYLAGE L STYLAGE Special Lips STYLAGE XL STYLAGE XXL STYLAGE S Lidocaine STYLAGE M Lidocaine STYLAGE L Lidocaine STYLAGE Special Lips Lidocaine STYLAGE XL Lidocaine Non-animal non cross-linked HA plus Mannitol Non-animal cross-linked HA (patented IPN-Like technology) plus Sorbitol Non-animal cross-linked HA (patented IPN-Like Technology) plus Mannitol Non-animal cross-linked HA (patented IPN-Like Technology) plus Lidocaine and Mannitol 14mg/g; for treating moderate dehydration and skin laxity. 12.5mg/g; for treating intense dehydration or skin laxity. 16 mg/g; for fine to deep medium wrinkles. 20 mg/g; for medium to deep wrinkles. 24 mg/g; for deep to very deep wrinkles mg/g; for lip volume augmentation and contour definition. 26 mg/g; for facial volume restoration. 21 mg/g; for large volume restoration or creation. 16 mg/g; for fine to deep medium wrinkles. 20 mg/g; for medium to deep wrinkles. 24 mg/g; for deep to very deep wrinkles mg/g; for lip volume augmentation and contour definition. 26 mg/g; for facial volume restoration. CE marked number 0344 and sold in more than 75 countries worldwide. Zimmer MedizinSysteme Germany ZFill refresh 2 ZFill contour 2 ZFill deep 2 Non-animal Hyaluronic Acid Hyaluronic acid gel with glycerin. For mesotherapy, lasting hydration and revitalization. Hyaluronic acid gel implant. For correction of superficial and deeper facial lines, lip contours and lip volume. Stabilized with BDDE. Hyaluronic acid gel implant. For correction of deep lines and wrinkles, sunken areas of skin, facial contours and increased volume. CE marked. Note: Data subject to change; please refer to Company Directory for supplier contact information. 124 THE European Aesthetic Guide Volume 15

125 PRODUCT PROFILES Exilis Ultra 360 The Exilis Ultra 360 represents one of the world s most advanced technologies for body contouring, skin tightening, facial rejuvenation and intimate health wellness. Its two applicators and various exchangeable tips enable the treatment of more than 20 body areas making the system arguably the most versatile platform on the market. With its unique combination of monopolar radiofrequency, ultrasound and adjustable cooling, the system can selectively focus energy to various tissue layers as required. It effectively stimulates the growth of collagen and elastin, enhancing the power of skin to lift and tighten all over the body. Halo Halo is the world s first Hybrid Fractional Laser that delivers a non-ablative and ablative wavelength to the same microscopic treatment zone. Combining these two wavelengths creates a strong synergistic effect, resulting in ablative results with non-ablative downtime. The non-ablative wavelength of 1470 nm is tunable from 200 to 700 microns, the optimal depth for treating the epidermis and papillary dermis. The 2940 nm Er:YAG laser provides pure ablation with no bulk heating, tunable from 20 to 100 microns. BTL Industries: or visit Doublo Gold Doublo Gold is a new model of Hironic s Doublo series, delivering HIFU energy to different skin layers from 1.5 mm to 4.5 mm under the epidermis to non-invasively and effectively lift skin and remodel the collagen layer. The Doublo series is internationally recognized with over 1,700 systems installed worldwide. Doublo Gold is approved by the KFDA. Treatment time is shortened by two times compared to Doublo-S. Doublo Gold upgrades the user-friendly functions with continuous shot mode and a shot interval control system. The Doublo technology holds 11 patents and was named a World-Class Product by the Department of Commerce, Industry of Korea. Sciton: or visit Hironic: or visit INNOJECTOR INNOJECTOR features micro-jet vortex technology to induce collagen synthesis. This vortex technology delivers millions of micro compounds pneumatically, penetrating deep into the skin. A recently published paper confirmed that INNOJECTOR s vortex stream reaches beyond the SMAS layer.* * Lasers in Surgery Investigating Skin Penetration Depth and Shape Following Needle-Free Injection at Different Pressures: A Cadaveric Study. WONIK Corporation: or visit CoolSculpting CoolSculpting by Allergan is the number one most requested, non-surgical body sculpting procedure. The groundbreaking CoolSculpting technology uses a patented cooling process to target and eliminate fat cells, without downtime, anesthesia, or pain medication during treatment. Millions of CoolSculpting treatments have been performed worldwide. mesohyal mesohyal is a wide-range of class III medical devices with CE marking for intradermal administration of face and body mesotherapy treatments. It is used for the personalized correction of skin aging and the most specific figure concerns. All mesohyal products combine non-crosslinked hyaluronic acid with high-tolerance active substances and recognized therapeutic efficacy. ZELTIQ Aesthetics: or visit mesoestetic: or visit THE European Aesthetic Guide Volume

126 PRODUCT PROFILES Nordlys Nordlys combines Selective Waveband Technology (SWT ) with a powerful short pulse to rival pulse dye lasers. Vascular applicators are available in two sizes to allow for easier treatment of individual lesions. The Nd:YAG has built-in SoftCool cooling resulting in almost painless vascular treatments. The 1550 nm non-ablative fractional laser FRAX 1550 enables skin resurfacing and treatment of acne scars, surgical scars and striae, all using a silent ergonomic console. EnerJet2.0 Jet Volumetric Remodeling (JVR) technology simultaneously delivers kinetic energy and a healing compound with minimum epidermal damage, enabling ideal compound spread and a controlled deep micro trauma for immediate hydration, volume and long lasting skin remodeling. This single, innovative, non-thermal and non-surgical solution is suitable for all skin types and all areas of the body. EnerJet2.0 is ideal for kinetic non-surgical face-lifts, scar tissue remodeling and dermal thickening. EnerJet2.0 solutions are proven to deliver superior, immediate and lasting clinical results, and are appropriate for all skin types year round. PerfAction Technologies, Ltd.: or visit Ellipse A/S: or visit CELLACTOR SC1»ultra«and D-ACTOR»ultra«line The CELLACTOR SC1»ultra«and D-ACTOR»ultra«line offers an Acoustic Wave Therapy (AWT ) system for cosmetic and dermatological disorders such as cellulite, annoying fat pads, striae, scars, wrinkles and lymph congestion. The high energy acoustic waves penetrate the adipose deposits and initiate metabolic activity in the subcutaneous fatty tissue. Radial acoustic waves are applied to the skin s surface, to improve the elasticity of the connective tissue, or to smooth out wrinkles and folds. This non-invasive treatment stimulates the growth of collagen and produces a natural lifting and toning effect. STORZ MEDICAL AG: or visit Hyabell The new range of Hyabell dermal fillers offers a long lasting improvement and a convincing safety profile. The pre-incorporated lidocaine (0.3%) facilitates the injection procedure and reduces pain, thus enhancing patient satisfaction. Hyabell fillers have considerably better viscoelastic properties and softer extrusion forces than other hyaluronic acid dermal fillers available, due to the innovative monophasic particle technology (MPT) production process. The optimized physical properties allow better clinical results. Adoderm GmbH: +49 (0) or visit encurve The encurve is an easy and comfortable way to reduce fat through apoptosis-inducing radiofrquency. Working via controlled delivery of energy deep into the adipose tissue, encurve utilizes a specialized frequency (27.12 MHz) combined with the ideal 300 Watts of power to selectively target and heat adipocytes to the optimal temperature causing denaturation of cells, leading to death of adipocytes. SCIZER SCIZER is a non-invasive body contouring system using Macro Focused Scanning Ultrasound with minimal to no pain for the patient. Treatment eliminates fat cells without downtime or anesthesia, and can provide immediate and long-term results. Lutronic: or visit Classys: or visit THE European Aesthetic Guide Volume 15

127 PRODUCT PROFILES Lip & Eyelid Lip & Eyelid is a newly developed medical device (CE, Class IIa). This phenol-based chemical peel acts at the level of the reticular dermis (deep peel). As a safe and cost-effective method, treatment guarantees excellent long-term results with amazing rejuvenation, eliminating deep wrinkles and creating the Tridimensional lifting effect, thus receiving a high degree of practitioner / patient satisfaction according to an aftermarket clinical survey especially for rejuvenation of the upper lip area (bar code treatment) and post-operative scars. enlighten enlighten is reportedly the first multi-wavelength aesthetic platform designed to treat superficial to complex benign pigmented lesions, unwanted tattoos and skin revitalization concerns. By combining three clinically proven wavelengths (532 nm, 670 nm, 1064 nm), picosecond and nanosecond pulse durations (750 ps + 2 ns), high pulse energy and CUTERA s signature skin revitalization procedures PICO Genesis and PICO Genesis FX enlighten safely and effectively treats a wide-range of skin concerns on all skin types in fewer treatments than traditional short pulsed technologies. Skin Tech Pharma Group: or visit HydraFacial HydraFacial is the only hydradermabrasion procedure that uses patented technology to cleanse, extract and hydrate. Packed with vital nutrients like antioxidants, peptides and hyaluronic acid, the super serums create an instantly gratifying glow and it is the unique serum delivery that puts HydraFacial into a category of its own. Cutera: or visit The HydraFacial Company: or visit Cellfina System The Cellfina System combines highly advanced, proprietary technology with a well-established procedure called Subcision to treat the underlying structural cause of cellulite with precise and reproducible results. The Cellfina treatment is a U.S. FDA cleared and E.U. CE marked minimally-invasive procedure that effectively improves the appearance of cellulite for at least three years. With a single, minimally invasive treatment, patients in the clinical study reported 93% patient satisfaction at three years. Merz Aesthetics: or visit global.cellfina.com Belotero The complete Belotero HA filler range offers you an extended portfolio for rehydrating skin, smoothing and filling, treating lip augmentation and restoring facial volume. The Belotero range integrates smoothly into an anti-aging regimen that enhances confidence and self-assurance. It is designed with CPM technology that enables outstanding skin integration. The range proposes an advanced bespoke aesthetic solution with predictable and natural outcomes for optimal patient satisfaction and trust. The Belotero range received the award for Best Injectable Product of the Year. Anteis S.A. - Merz Pharmaceuticals GmbH: or visit or LIPOcel LIPOcel is an advanced technology for body contouring and fat reduction with high intensity focused ultrasound (HIFU). The LIPOcel procedure guarantees high safety by using a non-invasive method, so as not to damage the peripheral tissues, and transmits energy precisely only to the subcutaneous fat layer. Jeisys Medical: or visit THE European Aesthetic Guide Volume

128 PRODUCT PROFILES MOTUS AX The new MOTUS AX 755 nm high frequency alex laser system offers totally painless and smokeless hair removal procedures to all types of patients. Utilizing DEKA s proprietary new Mŏveō Technology, MOTUS AX provides a high comfort procedure with excellent tolerability. MOTUS AX allows for no stress procedures for users also. The easy and full parameter controls (three levels: Soft, Medium, High) and countdown selectable energy levels give physicians the ability to tailor treatments on all patients and for all skin types. VECTRA H1 The VECTRA H1 handheld imaging system enables clinical-quality three-dimensional (3D) imaging at any practice, delivering precision optics for high-resolution 3D images in an intuitive, lightweight and easy to handle image capture system ideal for facial aesthetics and clinical documentation. Face Sculptor software provides aesthetic simulation tools for facial contouring, skin rejuvenation, rhinoplasty, chin augmentation and more. Analytic tools enable measurements of volume and contour plus visualization of texture, vascularity and pigmentation. Canfield Scientific, Inc.: or or visit DEKA: or visit Croma Injectables Croma Injectables enable practitioners to defy the signs of aging and enhance individual beauty with immediate, lasting and natural results. Through hydration, augmentation, volumization and contouring, Croma Injectables restore the fundamentals of a youthful appearance. The portfolio is comprised of Princess RICH, Princess FILLER*, Princess VOLUME* and the new Princess VOLUME PLUS**. Croma Injectables are manufactured in accordance with the highest quality standards based on non-animal derived hyaluronic acid. *also available with lidocaine **contains lidocaine Croma-Pharma GmbH: or visit Silhouette Soft Silhouette Soft is a re-absorbable suture with bi-directional cones for redefining the face, reducing wrinkles and repositioning volume with minimal downtime for the patient. This unique 30-minute treatment, performed under local anesthesia, results in an immediate lifting effect and a progressive regeneration of collagen for results lasting up to 18 months. Silhouette Soft is made in the U.S. and is currently distributed in more than 70 countries. Sinclair Pharma: or visit SculpSure SculpSure is the first and only FDA cleared hyperthermic laser for non-invasive lipolysis of the submental region, abdomen, flanks, back and inner and outer thighs. The 1060 nm wavelength s specific affinity for adipose tissue, coupled with minimal absorption in the dermis, allows SculpSure to treat all skin types in 25 minutes and without downtime. Four versatile applicators can be customized into a variety of treatment configurations to meet patients needs. Following treatment, the body naturally eliminates the disrupted fat cells with results seen in as quickly as six weeks and optimal results usually seen in 12 weeks. Cynosure: or visit InMode InMode has innovative non-invasive and minimally invasive options, from the revolutionary InModeRF device featuring Radiofrequency Assisted Liposuction (RFAL) technology, to fractional skin resurfacing (Fractora), skin tightening (Forma and Plus), ultra-fast diode hair removal (Diolaze), peak power photofacial for skin pigmentation and vascular lesions (Lumecca), and cellulite reduction / body contouring (BodyFX). With InMode you can choose all or a combination of the most in-demand applications based on your unique patient demographics. Our technology continues the legacy of providing superior satisfaction for both the patient and the practice. InMode: or visit THE European Aesthetic Guide Volume 15

129 PRODUCT PROFILES primelase HR excellence This diode laser platform reportedly offers the highest peak power on the market (4800 W), with four different wavelengths (755 nm, 810 nm, 940 nm and 1060 nm) and three spot sizes (20 x 9, 30 x 9 and 30 x 17 mm 2 ). The latest udpate is a new applicator with combined wavelengths (810 nm, 940 nm and 1060 nm), which permanently and safely removes all types of hair in all skin phototypes. Thanks to the exclusive Ultra Short Pulse (USP) Technology, primelase HR excellence delivers ultra short pulses with high energy fluences to remove even residual hair. PicoWay PicoWay now with Resolve is a dual wavelength (532 nm and 1064 nm) picosecond sys-tem with both non-fractional and fractional capabilities, treating a wide-range of pigmented lesions and tattoos. PicoWay s unique mode of action is based on delivering ultrashort picosecond pulses of energy to the tissue. These bursts of energy create a photoacoustic impact, which breaks up the pigmentation into smaller, more easily eliminated particles. cocoon medical: or visit PowerShape2 PowerShape2 is a non-invasive system that combines bipolar radiofrequency (RF), low level laser and vacuum in one platform for safe and convenient treatments. RF delivers thermal energy deep into the dermal layer and applies electromagnetic waves to initiate physiological processes. Low level laser increases blood circulation and boosts metabolism, while vacuum massage alleviates minor muscle pain, etc. PowerShape2 provides three different handpieces for the treatment of various regions. Syneron Candela: or visit Eunsung: or visit THUNDER SERIES This cutting edge laser offers up to two wavelengths 755 nm and 1064 nm in single or combined emission via Proprietary Mixed Technology. This combination represents the new gold standard for hair removal, dermatological vascular lesions and skin rejuvenation treatments. A new Optimized Spot Shape is designed to overcome the limits of overlapping traditional spot shapes. This platform can be also equipped with a brand new scanner OptiScan TH. This option takes advantage of its AutoMotion Technology to allow a wide-range of tailored and automatic treatments with maximum patient comfort. Quanta System: or visit PROFHILO s IBSA S patented BDDE-free thermally stabilized hybrid cooperative complex is made up of 64 mg high and low molecular weight Ultrapure hyaluronic acid (HA) in a 2 ml syringe. Studies have shown optimum results in the malar / submalar areas for remodeling skin laxity using the BAP technique with just five injection points on each side of the face. PROFHILO s high spreadability and cohesiveness have also proven very effective in areas difficult to treat with fillers alone such as the forehead, hands and neck. StarWalker Combining four complementary laser wavelengths and the widest range of aesthetic procedure modalities, the StarWalker functions as a highly versatile, multipurpose Q-switched laser system for safe, minimally invasive pigment, vascular and collagen treatments. Its third-generation technology provides high power and treatment capability (up to 10 J of Q-switched energy) in an advanced, compact and award-winning design. StarWalker s energy, four colors and proprietary FracTAT procedure also make it an industry leading tattoo removal laser system. IBSA Farmaceutici Italia S.r.l.: or info@ibsaderma.com or visit Fotona: or visit THE European Aesthetic Guide Volume

130 PRODUCT PROFILES 4PLUS 4PLUS is the innovative solution for treatment of the most popular face and body conditions: face lifting and contouring, body tightening and reshaping, and fractional resurfacing. Its exclusive technologies are based on the Dynamic Quadripolar energy emission, which focuses action on specific tissue layers epidermis, dermis or hypodermis and VRF technology, which allows energy to be focused deep in the skin, leaving the outer layer safe from any temperature increase. The Radiofrequency Safety System and IoMT (Internet of Medical Things) exalt its high potential. Bi-SOFT Delivery System In its continuing quest for innovative excellence in the medical aesthetic market, Laboratoires VIVACY has developed and patented a unique delivery system for their next-generation dermal fillers Bi-SOFT Injection Technology. This new syringe, offering greater precision, comfort and control, is specifically designed to support physicians in their daily practice and improve the patient experience during aesthetic treatments. Novavision Group S.p.A. Italy: or visit or Aquamid Aquamid Reconstruction is a non-absorbable hydrophilic gel consisting of 97.5% water and 2.5% crosslinked polyacrylamide. It is designed for soft tissue augmentation for aesthetic and reconstructive purposes and acts by adding volume to soft tissue. Aquamid gives an immediate, natural look and feel, and integrates completely into subcutaneous tissue. It does not degrade over time, and the aesthetic results will remain for years. The efficacy and safety of Aquamid have been documented in several international clinical studies. Laboratoires VIVACY: or visit Contura International A/S: or visit Viveve System The Viveve System is a non-surgical device that remodels vaginal tissue in a single, 30-minute, in-office procedure. This treatment satisfies patient demand for a painless solution to vaginal laxity. Vaginal laxity is associated with decreased sexual sensation and urinary incontinence. The system uses patented Cryogen-Cooled, Monopolar Radiofrequency (CMRF) technology to renew and replenish the collagen scaffolding. Viveve was the first of any energy-based device company to complete a sham-controlled study of an elective vaginal procedure. Viveve, Inc.: or visit Fraxis DUO Fraxis DUO combines CO 2 laser and microneedle RF fractional technologies for optimal results in the treatment of scars and photo-aging. CO 2 fractional enables intense superficial stimulation, while microneedle RF fractional provides more global and deeper stimulation. Such complementary effects could encourage physicians to combine the two technologies to achieve excellent results in the treatment of stretch marks as well. ZLipo ZLipo is an innovative Cryolipolysis system that makes it possible to target fat deposits and reduce them permanently and non-invasively. This method cools fat deposits over a longer period of time to a controlled and safe temperature range. ZLipo convinces with its simple and safe handling. By combining Cryolipolysis and shockwave, Zimmer offers the perfect combination treatment for significantly better fat reduction. Studies have shown that shockwave after Cryolipolysis ensures improved fat loss, stimulates lymphatic drainage and tightens skin. Ilooda Co., Ltd.: or visit Zimmer MedizinSysteme: or visit THE European Aesthetic Guide Volume 15

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