A review in the science and experience of using an Optical and Conductive Radiofrequency System

2. Epilation And Photo-rejuvenation With The Aurora DS A review in the science and experience of using an Optical and Conductive Radiofrequency System YourSpeaker:

4. Hair Growth Cycle

5. What Does The Market Look Like? Current Techniques to remove unwanted Hair • 9.8 million women spend a total of over $3.2 billion each year for hair removal services. • The number of women seeking hair removal exceeds the number of men, 3:1. • People are looking for a faster and less painful solution than electrology and more permanent alternative to waxing • Must treat all hair colors and all skin types • Lasers • Electrolysis • Intense Pulsed Light • Waxing • Tweezing • Shaving • Depilatory Creams

6. Follicle Depth And Hair Cycle

7. Electromagnetic Spectrum(in nanometers) Alexandrite CO2 KTP Er:YAG Ruby Nd:YAG Dye Excimer Argon Microwaves TV and radio waves x-rays cosmic rays 488 - 514 532 577-630 694 755 1064 2940 10600 190 - 390 UV VISIBLE INFRARED 700 400

8. Goals For All Contemporary Technology • Efficacy is unimportant without Safety • Safety is unimportant without efficacy • Multiple application platforms suggest greater ROI and flexibility • System should perform regardless of skin type or hair color

9. ELOSTM Technology Efficacy, Safety, Predictability The combination of electrical (Radio- Frequency) and optical energy providing a synergistic, therapeutic treatment Active epidermal cooling Automatic safety and monitoring to protect the patient

10. How Does It Work? First 10 ms Pre-Pulse test + Contact Test + Cooling Test

11. How Does It Work? Light Pulse + Target is Pre-heated + Impedance of target is decreased

12. How Does It Work? RF Pulse Continues while monitoring impedance + Higher RF Current in Zone with Low Impedance + Target is heated more efficiently than dermis or skin

13. Light RF Cooling Review: How Do They Work Together? + +

14. Properties Of ELOS RF Energy • Well known in medicine • Is not absorbed by melanin • All RF parameters (Voltage, Current, Impedance) are measured and controlled during the treatment. Examples: • Contact must be maintained with the skin or the Aurora will not fire. • Skin impedance depends on temperature and can be used for skin heating monitoring

15. Temperature Distribution “RF Heating” Follicle Shaft • RF creates heat in the 30 micron layer of the follicle that surrounds the hair shaft • Heated layer includes hair follicle and bulge

16. Properties Of ELOS Light energy • Light pulse pre-heats the tissue and the target* (*vein, pigmented lesion or hair shaft) A Higher Temperature in the target area will lower the impedance of the target area. • Lower impedance provides an easier path for electrical energy to flow

17. Temperature Distribution “Optical Heating” Follicle • Light heats hair shaft through selective photothermolysis • Bulge and follicle are damaged due to heat transfer from hair shaft • Surrounding tissue temperature is passively increased Shaft

18. Temperature Distribution - Combination Of “Optical Heating” And “RF Heating” • Combination of two types of energy create uniform heating in the shaft and follicle

19. Properties of ELOS Cooling • The Active Cooling in the Aurora DS handpiece, increases the impedance of the epidermis making it resistant to RF heating. • The Cooling also provides additional comfort to the patient

20. Light ~25ms Profile Of Short And Long Pulses Short One pulse of light for 25ms. RF energy Thermal Relaxation Time Time necessary for target tissue to cool down by 50% through transfer of heat to surrounding tissue via thermal diffusion Long TRT 50ms 50ms 200ms

21. Pre-Pulse Test • System is disabled if the following conditions exist: • If cooling temperature is not at the preset setting → “COOLING UP” appears in the display • If skin contact is not established • → “BAD COUPLING” message appears in the display

22. RF Pulse Distribution • RF energy distribution is dictated by the impedance distribution within the tissue. • Tissue with low impedance (warm temperature) conducts higher RF current • Tissue with high impedance (cold temperature) conducts lower RF current.

23. RF Pulse Distribution • Cooling the epidermis raises the impedance on the surface forcing the RF under the epidermis. The result: • Less heating in the epidermis • Greater efficacy and energy efficiency • Greater safety

24. RF Energy Distribution Cold epidermal layer Dermis Pre-heated target

25. Mechanism Of RF Selectivity Electrodes • Current density is 2 times higher in the follicle than in surrounding tissue • Heat generation is 4 times higher in follicle

26. RF Effect At A Depth Of 3.5mm Damaged Normal Human hair follicles at the edge of a treated area.

27. Aurora DS Treatment (Light Brown Hair) Optical pulse at 20J/cm2 with no additional RF energy. Optical pulse at 20J/cm2 and RF energy of 20J/cm3.

28. White Hair (Aurora DS Treatment) After Before

29. Cross Section Of Hair From Scalp: Healthy Hair Follicles

30. Cross Section Of Hair From Scalp: Damaged Hair Follicles After Aurora DS Treatment

31. Before After

32. Light Light Energy • Treatment of hair is a broad band wavelength of 680nm to 980nm CO2 Ruby KTP Er:YAG Alexandrite Dye Excimer Argon Nd:YAG 488 - 514 532 577-630 694 755 1064 2940 10600 190 - 390 980

33. Impedance Safety Limit (ISL) ISL - measures the change in skin temperature every millisecond (comparing baseline to present temperatures) throughout the pulse. If the temperature increases too rapidly (reaching ISL setting) then the pulse is stopped. % Temp 30 20 ISL Change 10 0 Baseline temperature If the ISL is set for 10% the pulse would cut off here

34. Fine, Upper Lip Hairs Three Months After 1 treatment

35. Two Months After 1 Treatment

36. ELOS Technology Pigmented Lesions Vascular Skin Rejuvenation

37. Rejuvenation, Telangectasia, and Pigmented Lesions StudySyneron Aurora DSR System

38. Phase 3 Of Study • Investigation of exact therapeutic benefits and advantages of the Aurora DSR device for Photo- rejuvenation • Photo- rejuvenation and collagen repair or shrinkage have precise spatial and temperature relationships • The nature and spatial configuration of RF energy and the way it radiates through the skin make it especially suited to PR by modifying collagen shrinkage and fibroblast proliferation • The optical energy is especially suited for its effects on epidermal pigmentation and micro- vasculature

39. Treatment Sites • Rejuvenation 22 sites • Telangectasia 8 sites • Pigmented lesions 17 sites

40. Aurora SR TreatmentLentigines After 4 Treatments Before Photo courtesy Dr. S. Laughlin

41. Aurora SR Pigmented Lesions Before After 2 Treatments Photo courtesy: Dr. S. Laughlin

42. Aurora Photo-rejuvenation Treatment After 3 Treatments Before Photo courtesy Dr. S. Laughlin

43. Aurora Photo-rejuvenation Treatment After 4 Treatments Before Photo courtesy Dr. S. Laughlin

44. Aurora Photo-rejuvenation Treatment Photo courtesy Dr. S. Laughlin After 4 Treatments Before

45. Aurora Photo-rejuvenation Treatment After 4 Treatments Before Photo courtesy Dr. S. Laughlin

46. Aurora SR Photo-rejuvenation Before After 4 Treatments Photo courtesy Dr. S. Laughlin

47. Aurora Photo-rejuvenation Treatment Before After 4 Treatments Photo courtesy Dr. S. Laughlin

48. Aurora SR Telangectasia Before After 2 Treatments Photo courtesy Dr. S. Laughlin

49. Aurora SR Telangectasia Before After 5 Treatments Photo courtesy Dr. S. Laughlin

50. Rosacea And Skin Texture Before After