Active FX - Fraxel re:Pair - Smart Xide: Which CO2 fractional laser to use?

I own ActiveFX and DeepFX (TotalFX) device. I choose it because it was designed for the CO2 platform not a company afterthought in hopes of getting back some of their market share (i.e. Fraxel).

I appreciate the fact that one can customize the depth of the treatment by choosing either ActiveFX (more superficial) or DeepFX (deeper. . .get it). The density and intensity is also easily customized. This allows any of the patient problems (fine wrinkles, deep wrinkles, scarring, dyschromia, enlarged pores, et cetera) to be treated with the appropriate intensity. I can't say that is as easily accomplished with any of the other devices.

I also own the active fx / deep fx device and I'm using it on a daily basis because my clients are referring their friends and there's alot of buzz on the net about fractional CO2.

I agree with Dr. Clinton - the versatility of the machine is a big plus. I can customize for different skin issues, such as acne scarring or pore reduction and for different skin types (caucasian vs. asian for example). I have not seen any other laser that can improve the lines under the eyes or the lines around the lips. It may take two sessions, but the results are alot better than 5 sessions of fraxel.

In terms of the different devices, I chose Active Fx because it has been on the market for a few years and we know that it is safe and effective. Also, Lumenis is a good company with excellent quality of equipment and a good support network of physicians. The Fraxel has also turned out to be a good machine, but it has not been on the market that long, so for safety considerations, I chose the Active Fx. There is another device called the Mixto - this is an Italian device that is cheaper than the others and less versatile. Company support is also questionable since headquarters is in Italy.

Fractional CO2 is a new technology that is still being mastered. Every company is going to claim that their device is a new breakthrough in the market - its really not. Customizeable controls is important. Active Fx and Fraxel have it and another device called Mixto does not. Depth of penetration is not important - all the devices penetrate plenty. Time on the market is important for safety - Smart Xide just came out, so I would be careful of that one.

Hope that helps.

Alexander Rivkin M.D.
Westside Aesthetics

I just had the SmartXide treatment yesterday. I looked at a couple of independent research papers such as this one: http://derm.md/dev/lasering/White%20paper.pdf. I liked this one because it had a chart of all the fractional lasers so you could actually compare what they have and what they do. I found the specifications for the dot laser on another website and used it to see where it fit in with these other CO2 lasers that were tested in this study: http://www.dottherapy.com/smartxide/specifications.html

Given that the Smartxide laser had not been used in North America for that long I checked out web pages in Europe and Asia where the technology has been around for a lot longer. I also spent a lot of time checking out the MixTo and TotalFX treatment and decided against the Fraxel CO2 laser early on as I had a negative experience with their earlier laser (lots of pain, downtime and no results) and learned from talking to doctors and a couple of patients locally who had tried the new Fraxel CO2 laser treatment there was a lot of pain and even more downtime than the older technology.

I loved my treatment with the SmartXide yesterday. I came in and cold cream was put on my face to numb the treatment area. No pills or nerve block needles were used. After 45 minutes the cream was removed and my treatment began. I asked him to be aggressive as I could afford downtime and wanted to make sure that my acne scars (the whole reason for my being there) were addressed. I had read that ActiveFX without DeepFX did nothing for acne scars and I wanted to make sure I got results. The actual laser treatment was a breeze compared to my former experience with the Fraxel laser. A couple of places it pinched and there was a weird burning smell like cinged hair.

After the SmartXide laser treatment a cream was placed on my face. In the mirror I could see white dots all over the place. I was told that they would turn brown and fall off in three or four days. I was also told to expect some swelling. I was given a cream and sunblock to put on my face at home. My face was very hot and felt wind-whiped/sunburnt. I drove myself home and within two hours I would say the burning sensation was gone. Mild swelling started to set in and my face was now flushed red.

I was expecting my eyes to be swollen shut this morning - but pleasantly surprised as I am swollen but not to the point I don't recognize myself or that my eyes are shut. I wouldn't go out in public. The dots from the treatment are now brown and I am still quite red. There is no way you would be able to cover this up with make-up. LOL - not a chance.

It will be a few days before I will know how the treatment really went. So far I am pleased with how it has gone so far.

Every doctor thinks their CO2 machine is the best. Think about it. It is what they have to sell you. They are not going to tell you that the other guys laser is better and send business away. Do you own research. Also, and I can't stress this enough, the doctor doing the treatment is equally important. The SmartXide and other CO2 fractional lasers have multiple settings. Your treatment should be tailored to your needs and skin color. Do not go to a clinic that has no experience with your needs or skin color. Do not be their guinea pig. I have olive toned skin. I went to a doctor who treats hundreds of olive toned skin patients each year. I have no open wounds or ozing - I know he didn't burn me unlike the doctor who did my Fraxel treatments where I did have open wounds and red blood dots all over.

Good-luck with your treatment.

Allison

It is now two days since my SmartXide laser experience. No change in the swelling. I look about the same as yesterday. Maybe there is less swelling; I am not sure. I just know that it is not increased. My coloring is returning to normal. In fact, when I woke up I thought "wow - the red is almost gone". I then washed my face with cool water and then put on the moisturizer the doctor's office gave me and boom - redness totally returned. This experience is so much better than my Fraxel experience two years ago. I was all prepared for my eyes to be swollen shut and in pain and this is just not like that at all. I hope I get the results I am looking for given that I am not experiencing any pain or ugliness even remotely comparable to my previous Fraxel experience.

I could not believe how much the swelling in my face had gone down when I woke up this morning. The redness is almost completely gone and the brown dots are coming off and leaving silky smooth skin.

I visited the doctor's office today and received an A-OK on everything moving along as it should be on day three from my SmartXide laser treatment. If it was not for the white glowing sunblock and the scatterd patches of brown dots I would say I look almost normal enough to go back to work.

I think it is still too early to tell whether the acne scars I was concerned with have been addressed. It looks promising but there is probably still some swelling going on which smoothes everything out.

I would definitely do this laser treatment again just on the basis that my skin tone looks even where the dots have peeled off. It worked way better than those Fraxel treatments on that one point alone. ALSO, it seems to have corrected the flushing I used to get when I washed my face post fraxel (mind you it is probably too early to tell if that indeed has been corrected).

So far on day three I am happy.

Allison

I've had the fraxel re:pair done 10 days ago. Impressive results already around the eyes and forehead. The doctor used both the fraxel repair and the active fx around my eyes. My face is beginning to show some signs of lifting but I think it's too early too tell. I was really swollen for, oozing yellow stuff, and very red for three days after the treatment. The first day there was a lot of bleeding. It's been 10 days and my face is almost back to it's normal color and the swelling has pretty much subsided.

Day 4 post my SmartXide laser treatment. This morning my skin was gorgeous. Almost all the dots are gone. No redness although some blotchiness. I think I probably still have swelling and I like it which means I think I would like to try some fat injections or some sort of filler in the future -LOL. My skin tone is amazing. All those little discolorations that come from age and acne scars are gone. My freckles on my nose are gone too!

What isn't gone is some of the lines under my eyes (they actually look worse) and a couple of deep lines around my mouth. Apparently, I have a dimple I never noticed before this treatment as it was part of a set of acne scars on my face. It is smooth on my lower cheek until I smile and then a dimple forms.

I totally can go out in public and no one would be the wiser about my having had a facial laser treatment. In fact last night I flew home and my skin at that time was passable with makeup. No weird looks at the airport. Today I am planning on going back to work.

I think it is still to early to tell if I have gotten the results I wanted as there may still be some swelling. How much I don't know. Right now the acne scars are history. Yet, I know from my previous experience with Fraxel I thought the scars had improved but once my skin had healed every single spot was accounted for and had not softened never mind disappeared.

If I get a 50% improvement from the SmartXide laser on my acne scars I will definitely do it again. The healing process after the SmartXide laser treatment was quick and I have no nerve pain or other pain which I had experienced with the Fraxel laser treatments I had previously.

So far I am still satisfied.

Allison

Is the Active FX better then the Fraxel repair? im a bit confused..
Which of these have the maximum results?.. i have scarring on my cheeks.. but also want to do the whole face....

for acne scar what is better active fx or fraxel plz let me know
thank you

Rather than just ActiveFX, I would consider TotalFX which uses both DeepFX and ActiveFX together. TotalFX (ActiveFX + DeepFX) results are much better for scarring and rejuvenation than any other treatments I have seen to date.

You need to make sure your provider has the device with this capability. Many of the lasers have not been upgraded to be able to perform DeepFX.

You should be able to get decent results with any of the fractional CO2 devices currently on the market. I'm sure that the Fraxel device is going to be pretty good. . .it just hasn't been on the market long enough to see how safe it's going to be. I think one may be taking a gamble with Mixto since it's not customizable and good customer support may be hard to find. I definitely agree with Dr. Rivkin.