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Skin Tightening with Fotona SP Dynamis

What is Fotona SP Dynamis?

Fotona SP Dynamis is an advanced and versatile laser which contains two wavelengths (Erbium 2094nm and long pulse Nd:YAG 1064nm). These can be used in many different combinations but what is unique about the Fotona SP Dynamis is that both these wavelengths can be delivered with a prolonged gentle delivery time which gently heats the skin. These prolonged delivery times are unique to Fotona and are not available in any other laser in the world. This gentle heating causes immediate tightening of the collagen as well as switching on new collagen production for several weeks.

What is the “Piano Mode” Nd:YAG Skin Tightening?

Piano mode is unique to the Fotona SP Dynamis laser and involves a very slow, gentle delivery time of the 1064nm long pulse Nd:YAG wavelength. This heats the deeper layers of the skin and leaves the top layer undamaged.The 1064nm wavelength heats water in the skin, but what is unique about the Fotona Piano mode is the prolonged gentle heating of the deeper skin. Research has shown that if the dermis of the skin is warmed to 42.5OC – 43OC this causes immediate tightening of the collagen. In addition, it also produces signals called “heat shock proteins” which then stimulate more collagen production over the next few weeks. The prolonged gentle heat stimulates collagen production which results in tightening of the skin, reduction of pores and softening of wrinkles. Because the heat is delivered slowly, the surface of the skin is not over-heated and therefore patients can have this done without any visible skin surface recovery time.

During the treatment the laser is gently passed over the surface of the skin and feels like a gentle warming of the skin. There is no need for local anaesthetic cream. If the face is being treated, the eyes are covered with goggles.
A very accurate external temperature camera is used to monitor the skin’s temperature throughout the entire procedure to ensure an adequate temperature is reached to stimulate collagen production.

What does the skin look like after the Piano Mode Nd:YAG Skin Tightening?

Immediately afterwards the skin looks slightly flushed, and this effect settles within approximately 15-30 minutes. Some patients see a pleasing immediate tightening which may settle slightly after a couple of days. However, the full effect occurs after a few weeks as more collagen is stimulated. Make up can be worn immediately afterwards and normal activities commenced straight away.

On which parts of the body can the treatment be performed?

The treatment can be performed on all areas of the body. Popular sites include the jawline, neck, abdomen, inner arms and thighs. However, Piano Mode long pulse Nd:YAG cannot be used around the eyes; instead for the eyes, an erbium wavelength delivered in a unique slow delivery called “smooth mode” is used to achieve skin tightening (a technique termed “smooth eyes”, as discussed below).

When do I see an improvement with Piano Mode Skin Tightening?

New collagen is stimulated to develop gradually in the weeks and months after the treatment. We usually recommend a series of treatments, since repeated sessions continue to stimulate collagen production (for example 6 treatments once every 3-4 weeks). It is usually recommended to have the treatment every 3-4 weeks to give the heat shock proteins time to signal production of new collagen.

Is Piano Mode treatment suitable for all skin types?

The treatment is suitable for all skin types and colours as it does not heat the surface of the skin.

What is Fotona Frac3 Nd:YAG Treatment?

Frac 3 is also a setting of the long pulse 1064nm Nd:YAG laser unique to Fotona. This time the 1064nnm Nd:YAG laser is set on a very short pulse duration of high power. This very short pulse duration creates a sudden, short controlled pulse of heat into the deeper layers of the skin which creates a “shockwave-like” effect. This seeks out and heats up “imperfections” in the dermis creating microscopic wounds under the skin in a fractionated way. These microscopic fractionated wounds then stimulate growth factors and new collagen production. The surface of the skin is not affected, so there is no visible recovery time. It is good for “skin cleansing”, as it heats up oil in the pores, and when done repeatedly improves and tightens pores, acne, improves skin texture and achieves some tightening. The laser energy can be delivered in an upwards vector direction to produce tightening of the collagen which provides a “thread-lift-like” upwards pull on the skin.
When Frac 3 is performed immediately before the Piano it is referred to as “Fotona 2D Skin Tightening”. The Frac 3 improves skin texture and tightens the surface of the skin, while the Piano mode gives deeper heating and tightening.

What does the skin look like after the Frac 3 Treatment?

Immediately afterwards the skin looks slightly flushed and this symptom settles within approximately 5-15 minutes. Some patients see a pleasing immediate tightening which may settle slightly after a couple of days. However, the full benefit occurs after a few weeks as more collagen is stimulated and skin texture and pore size improve. Make up can be worn immediately afterwards and normal activities commenced straight away.

When do I see an improvement with Frac3 Mode Skin Tightening?

New collagen is stimulated to develop gradually in the weeks and months after the treatment. We usually recommend a series of treatments, since repeated sessions continue to stimulate collagen production (for example 6 treatments every 3-4 weeks). It is usually recommended to have the treatment every 3-4 weeks to give the heat shock proteins time to signal production of new collagen.

Is Frac 3 Mode treatment suitable for all skin types?

The treatment is suitable for all skin types and colours as it does not heat the surface of the skin.

What is the Smooth Mode?

The Fotona SP Dynamis also contains a second type of laser called an erbium laser. Erbium laser (2940nm) has been used for a number of years as a laser resurfacing /laser peel and was developed as a safer and gentler alternative to CO2 (carbon dioxide) laser. The erbium laser in the Fotona SP Dynamis is very flexible and can be used at a very light setting (similar to a microdermabrasion, with very little visible skin peeling afterwards) or a strong setting (which results in redness and swelling for several days and pinkness for several weeks, but which is very effective at reducing wrinkles and skin surface imperfections). The erbium in the Fotona SP Dynamis is unique in that the delivery time of the laser energy (called the pulse duration) can be made very long. This results in gentle, prolonged heat delivery to the skin called the “smooth mode” setting, which results in skin tightening. The smooth mode setting can be delivered anywhere on the outside surface of the skin, where it produces immediate tightening and can be delivered in a fractionated beam or full beam. It can also be used inside the mouth to tighten the cheeks and nasolabial folds. When used around the eyes, it can produce tightening of loose skin around the eyes, including heavy eyebrows (a treatment called “smooth eyes”). When used around the lips it can produce some plumping of the lips (a treatment called “smooth lips”).

What does the skin look like after the Smooth Mode Skin Tightening?

If the smooth mode is done at a low setting, there is very slight pinkness afterwards lasting a few minutes and no further signs. If a higher setting is chosen, there may be pinkness lasting 1-2 days followed by some mild flaking of skin a day a day or two later. However, make up can be worn straight away. There may be some immediate tightening visible which becomes more noticeable over a few weeks.

Is Smooth Mode treatment suitable for all skin types?

The treatment is suitable for all skin types and colours but when performed on darker skin types (III- VI), i.e. Mediterranean skin types through to Asian and African skin type, there may be some slight temporary darkening of the treated skin. This fades with time but use of broad spectrum sunblock and, if desired, prescription lightening creams can speed up the resolution of any darkening.

What is “Smooth Eye” Treatment?

“Smooth Eye” treatment uses the smooth mode setting of the erbium laser of the SP Dynamis in a gentle controlled heating technique to tighten the skin around the eyes.
It is done after applying local anaesthetic cream for 45-60 minutes. The erbium “smooth” mode setting gently heats the skin around the eye. Afterwards, the skin looks slightly pink and swollen with some faint speckled grey/white marks where the laser heated the skin. This lasts between 24 hours and one week depending on the setting which was chosen.
The skin around the eyes starts to look tighter a few days later and this can continue to improve over several weeks. The treatment is best done once a month for 3-5 sessions to achieve the optimal results.

What is the 2D, 3D, 4D and 5D Tightening/Laser Face Lift?

The versatile nature of the SP Dynamis allows it to be used it in several combinations and steps. 2D, 3D, 4D and 5D refer to treatments using two, three, four and five steps and these can be chosen and adapted according to the particular requirements of the patient. These combinations using 2 or 3 or 4 or 5 steps are sometimes referred to as “Laser Face Lifts”. The possible steps are:

  • Step 1: Intra-oral Smooth mode. The erbium laser “smooth mode” is used with a gentle, controlled heating setting inside the mouth to heat the inside of the cheeks. This erbium laser “smooth mode” technology is unique to the Fotona company and delivers the laser energy very slowly, resulting in heating and tightening of the inner cheeks. The Fotona smooth mode erbium technique has been used in dentistry for a number of years and results in a steady firming and tightening of the lower face by building up collagen deep under the skin. When done repeatedly it improves the nasolabial folds and loose skin on the lower cheeks. It is not uncomfortable, and as it is performed inside the mouth there is no recovery time afterwards. For many patients it can act as an alternative to fillers.
  • Step 2: Frac 3. The Nd:YAG laser is used at the Frac3 setting which has a very short but high-powered pulse. This gently but rapidly creates tiny islands of heat below the surface of the skin in a fractionated pattern to heat imperfections under the skin. It is good for improving skin texture and “skin cleansing”, and when done repeatedly improves pore size and acne, and achieves some tightening. There is no recovery time and the treatment can be done before a social event.
  • Step 3: Piano mode. The Nd:YAG laser is used at the Piano mode setting which delivers heat slowly to the deeper skin. Done repeatedly, it gently heats the skin resulting in tightening and firming. The skin looks slightly pink for at most 15 minutes afterwards. Some patients see immediate tightening and this tightening effect improves over several weeks.
  • Step 4: Erbium Resurfacing Mode. The erbium laser is used to give a gentle superficial peel to the skin which helps peel away surface imperfections. The strength of the peel can be chosen according to the patient’s desires for improvement. Most clients have a very light peel, which gives a controlled light peel without heating of the skin and very minimal flaking for a couple of days which gives a “pearl-like” finish to the skin. However, if a dramatic improvement is desired, a stronger erbium peel setting can be used which will give redness and peeling lasting more days but will provide more improvement in surface irregularities and pigmentation. However, very high-strength peels would not be as suitable for darker skin types as they may cause temporary darkening of the skin.
  • Step 5: Fractionated Smooth Mode Tightening. The smooth mode erbium is used in a fractionated way to cause tightening of small fractions of the skin. This can be done at low settings with no recovery time, or stronger settings with more noticeable instant tightening which improves over several weeks. Done at low settings there is no recovery time. When done at higher settings, there may be some slight pinkness for 1-2 days followed by slight flaking for 1-4 days.

The Fotona 2D Tightening uses the second and third step. It can be done on skin at any site and combines the benefit of the Frac 3 and Piano Mode (skin tightening, improved texture, fine lines, pores, acne and skin cleansing) with no significant recovery time.

The Fotona 3D Tightening uses the first three steps (i.e. the 2D step plus the intra-oral smooth mode). In addition to the benefits of the 2D step there is also tightening of the cheeks and nasolabial folds. Like the 2D there is no significant recovery time.

The Fotona 4D or 5D is the same as the 3D but with a 4th or 5th step of the erbium resurfacing and/or fractionated smooth mode. The 4th or 5th step may result in some redness and peeling of the superficial skin that can last from 24 hours to several days depending on what setting is chosen.

Over a few weeks, the skin of the treated area starts to look tighter and of better quality. The treatment is best done once a month for 3-5 sessions to achieve the optimal results. Many clients then like to then do maintenance treatments of every 6 months if under 50 years’ age and every 4 months if over 50 years’ age. Many patients chose the Fotona 3D, 4D or 5D as an alternative to fillers.

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