Question
Usual setting for Fraxel Restore?
I have completed two Fraxel Restore sessions for facial scars, but I still have many scars on my face. The setting used on me was 45 mjoules. Is this enough, or too low? What is the usual setting for this procedure?
Answers (4)
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1
November 21, 2008
45 may be a little low
Acne scarring and facial scars do need more intense treatment settings for better outcomes. Most of my acne scarring patients will have settings between 50-70 for the milli-joules. As already mentioned, it is NOT common to see a result after 2 treatments with the Fraxel restore. For scarring, it will take between 4-6 treatments for most patients. Even though most patients with facial scars need more intense treatment settings, there are patients that cannot tolerate those settings and will need to turn the settings down. These patients will likely not obtain optimal results and will likely need more treatments for better results.
I have had many patients start at 45 mJ on their first treatment and then I increase the settings on the subsequent treatments. It is hard to make a generalization that 45 mJ is bad for all patients, but it is a little low for scars.
The Fraxel repair laser can go deeper but will have a substantially longer "downtime." Good luck with your procedure.
2
November 21, 2008
Fraxel settings should be determined by an experienced physician
Have you discussed your concerns with your physician? In general, 70mj is the best for acne scars, but there may be a reason for your doctor to be treating you lower (skin type, pain threshold).
The other issue is the treatment level, which can be adjusted and will also impact results and pain perception.
Fractional CO2 may be an option for fewer treatments. One will give more of a result than 5 Restore treatments, but significant healing time and prolonged redness must be anticipated.
Good luck!
Web reference: http://www.drmarylupo.com
3
November 21, 2008
Fraxel re:store for scar treatment
Board Certified
Facial Plastic Surgeon
Facial Plastic Surgeon
Answer by Michael A. Persky, MD
Hi gig,
It takes a series of Fraxel re:store treatments to get optimal results with the treatment of scars. Often after only two treatments the improvement is minimal. It usually takes 4 or more treatments, and sometimes even a few months after the treatment as collagen remodeling continues.
At 45 mj the laser reaches a depth of 1176 microns or 1.176 millimeter. By increasing the energy setting to maximum 70 mj, the depth increases only about 0.2 of a millimeter (1359 microns, 1.359 millimeter).
Fraxel re:pair can go deeper, and may take less treatments, but the wound care and downtime is greater.
The energy level of your treatment can be turned up a bit, but the biggest factor for you will be the number of times you have the treatment. Good luck and be well.
Dr. P
4
November 21, 2008
Fraxel restore settings vary, depending on skin type and condition being treated
Your physician can vary the settings, and we have found that the best results are achieved using high energy (50-70mJ and high density (25-35% coverage). Your social downtime will increase with these settings, but most patients are willing to accept this to gain the better results.
If you have olive skin, your risk of developing brown discoloration (post inflammatory hyperpigmentation) will increase as well (we actually examined this in a clinical study and published the findings). This is almost always a temporary side effect.
You may want to also consider the fraxel repair to address you concerns, as this is an excellent choice to improve scarring (surgical, acne, and traumatic).
Take care,
Dr. Groff
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12/26/08
Hi, I just had my first Fraxel treatment done a week ago. I'm not sure if it was the Restore or Repair but I'm thinking Restore but I will definitely ask before I set up my next appt. in 6 weeks. The doc. nurse did my first treatment and everything went well, I had swelling for a few days and then a lot of redness and broke out a little but that's subsiding now. I asked the nurse what the setting was at and she said 7. I'm thinking that's probably low? I was told to go with at least 4 treatments maybe even 5 for best results. My concern is if I should ask for the setting to be turned up and have the doctor do it next time?