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Dr. Broder: Dr. Lawrence Broder of Beleza Medical Spa. Today, weíre going to perform
a DOT Therapy Laser Resurfacing treatment on our patient, Sandra, here. First, weíre
going to just look at Sandraís skin and see what sheís looking for from this treatment.
What are you looking for from this treatment, Sandra?
Sandra: I feel like I have a lot of elasticity problems here. I have likeÖthe skin is coming
up here andÖI just kind of want to tighten that up. I just feel like Iíve lost a lot
of the collagen here thatís actually helping my skin stay firm.
Dr. Broder: Sandra is in her 40s and has some signs of sun damage here, she has some roughness.
She has some of those lines, these lines of expression, like your forehead lines that
are starting to etch into her skin because sheís losing elasticity. She has some surface
pigment irregularities. She has some roughness. These are all signs of sun damage that we
all accumulate during our lives. The other thing that happens is our collagen formation
turns off as we get older, mostly due to sun damage. Weíre looking with this treatment
DOT therapy to re-stimulate it. Basically, what weíre going to do with this
laser is make millions of little perforations in Sandraís skin. The point of that are two
things. One is to re-surface, and the second is to re-tighten her skin. Approximately three
to four days after treatment, your entire upper layer of skin, epidermis, will peel
off in big sheaths. The roughness, the fine lines, pigment, all that stuffís going to
come off. Youíre going to be left with the new skin thatís kind of pink. That will only
last about a week, and then it will go away. That alone usually takes about five off most
of our patientsí faces. The other thing we do is not only resurface the skin, but we
direct laser energy into the deeper layer of skin. The reason we do that is because
when you heat up the deeper layer of skin with the collagen in it, the collagen is made,
it causes the collagen bundles to tighten, to get skin tightening, and induces new collagen
formation. That will start three to four weeks after
the treatment and is more subtle, takes more time, will go on longer, but itís actually
the better result. Three to four days, re-surfacing, new skin, and then three to four weeks after
skin tightening starts. Do you have any questions about that?
Sandra: No. Iím just anxious to see the results. Dr. Broder: Ok. Weíre going to get started.
Sandra has had some local anesthetic on herÖa topical applied to her face for approximately
an hour, and now weíve taken that off. Sheís had some light sedation. As you can see, weíre
not going to do any general anesthesia or anything. Weíre going to get her ready, and
weíre going to put some goggles on. This is the DOT head. This is where theÖyou
can it. Itís hard to see, but the laser shows a grid where it will cause its pattern. You
can see that. Weíre going to start. Ready, Sandra?
Sandra: Yes. Dr. Broder: Ok, here we go. Youíre feel a
line. Weíll do one. Howíd that feel? Sandra: Fine.
Dr. Broder: Weíre going to start doing that. You can see the pattern already on her skin
forming. You can actually as we do this see some skin tightening almost immediately from
the initial heating. This DOT therapy is actually a CO2 laser.
Itís based on the old CO2 lasers. CO2 laser is pretty much considered the gold standard
of re-surfacing lasers. The only problem is the old CO2 laser gave you beautiful results,
but it would have two weeks of down time and require a lot of times general anesthesia
which was so painful. The difference with this laser is instead of taking off all the
skin like the old CO2 laser, it only takes out little portions where the dots are. You
doing all right? In between those little dots it leaves normal
skin. The reason that makes it better is because that allows this old skin to stay on as a
natural bandage so when the new skin is ready it will peel off. That prevents her to have
to dealing with an open wound. It also prevents her from infection and lessens the chance
of scarring. Thatís all by leaving that old skin on, and then also by not taking all the
skin off we could see we can do this under local anesthesia. Doing all right?
Sandra: No pain, no gain. Dr. Broder: Ok. Weíre going to come this
way. Are you in a lot of pain or are you all right?
Sandra: Itís good. I mean it hurts but itís fine.
Dr. Broder: Ok. You can see weíve already done about half of Sandraís neck, same systematic
pattern that we do, a little overlap. Basically, weíre just trying to cover all the skin.
The areas where thereís wrinkles or deeper lines weíll go over, and sometimes weíll
change the settings to go a little deeper. She doesnít have any really major wrinkles.
Look at Sandraís hand. Very similar to her face. This was the same sun damage, rough
skin, pigmentation. You can see the fine lines, the loss of elasticity. Any place where you
have sun damage, the hands, arms, chest, neck, face, we can do DOT therapy on that.
Now we go over the knuckles and also some sun damage on the finger, erase that. We have
finished. We did DOT therapy of the face, neck and hand. How was it, Sandra?
Sandra: It was good. Itís a little painful, but nothing that you canít handle because
you know itís going to be a good result. You know youíre doing something thatís going
to in about seven days itís going to give a great result, and so the pain itís not
as bad as you would think. Then, the numbness that you give before, that definitely helped.
It wasnít nothing I couldnít handle. Dr. Broder: Good, and Sandra was a great patient.
She has a good attitude about this. You can see it was done under a local anesthesia with
just some local and some mild sedation. You can see the dots of all of her skin, her
face, her neck, her hands. You can just see from the initial heating and some swelling
she already looks tighter. All this skin is going to come off, all this top layer of skin.
Sheís going to have that new skin in three to four days. Then, the heating that we did
thatís going to induce the new collagen formation in three to four weeks, and then weíll have
some before and after pictures too. Ok, thank you.
Sandra: Thank you. [End of Audio]
Duration: 09:15 minutes