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Michael J. Tomcik, M.D. MiXto sx ® Microfractional CO2 Laser at the Advanced Laser and Skin Care Center. Michael J. Tomcik, MD William Ting, MD. WHY CO 2. Gold standard for smoothing, tightening and resurfacing. Ablative > Non-Ablative CO2 > Erbium > Near Infrared

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mixto sx microfractional co2 laser at the advanced laser and skin care center

MiXto sx® Microfractional CO2 Laser at the Advanced Laser and Skin Care Center

Michael J. Tomcik, MD

William Ting, MD

why co 2
WHY CO2

Gold standard for smoothing, tightening and resurfacing.

Ablative > Non-Ablative

CO2 > Erbium > Near Infrared

Heats the dermis greater than all other wavelengths.

slide5

CO2

CO2

CO2

1540

1540

1540

Necrosis

Coagulation

why mixto sx microfractional co 2
Why MiXto sx® Microfractional CO2

Innovative Computerized Pattern Generator

Microspot - 300u

Covers 20% of the surface on each pass

Algorythm avoids heat build-up

why mixto sx microfractional co 21
Why MiXto sx® Microfractional CO2

Innovative Computerized Pattern Generator

Microspot - 300u

Covers 20% of the surface on each pass

Algorythm avoids heat build-up

why mixto sx microfractional co 22
Why MiXto sx® Microfractional CO2

Price

Two Year Warranty

Results

two controls
Two Controls

Depth of heating (sx)

Tissue ablation (power)

choosing your settings
Choosing your settings

Baseline*- 8 sx, 8 power

Face*- may do multiple passes

Acne/Chicken Pox - 6 sx, 11 power

Tightening - 5 sx, 10 power

Neck, Décolletage, Hands and Arms* - generally one pass

6 sx, 10 power

*These are only recommended as guidelines, each patient needs to be evaluated individually.

benefits of mixto sx
Benefits of MiXto sx®

Versatile (Face, Neck, Décolletage, Hands and Arms)

Easy and fast

Face (20 – 40 minutes)

Neck (15 - 30 minutes)

Chest (20 – 30 minutes)

Each Hand (10-15 minutes)

Topical anesthetic

BLT (20%, 6%, 4%)

TLC Pharmacy, Hermosa Beach - 310-798-5400

All skin types

benefits of mixto sx cont
Benefits of MiXto sx® (cont.)

Minimal Discomfort

Moderate Sunburn sensation – 30 minutes – 3 hours

Erythema and Edema – 1 – 3 days

Tightening and Itching – 7 days

Minimal Risks for:

Hypo/Hyper Pigmentation

Scarring

Minimal downtime

Face – 3-6 days

Neck and Hands – 7-10 Days

Chest – 10 – 21 Days

slide20

Progression #1

DAY 2

DAY 3

DAY 9

BEFORE

slide25

Progression #2

BEFORE

DAY 3

DAY 6

DAY12

slide31

Progression #3

10 Minutes

24 Hours

Before

3 Days

8 Days

progression 4
Progression #4

Type III – 52 Yrs – Face 2 Passes (Sx 6/Pwr 10)

Neck 1 Pass (Sx 6/Pwr 10)

30 Days – Post Op

6 Days – Post Op

before after photo s1
Before/After Photo’s

Type II – 2 passes

Sx 6/Pwr 10

before after photo s2
Before/After Photo’s

Type II – 36 Yrs. – 2 passes

Sx 6/Pwr 10

before after photo s3
Before/After Photo’s

Type IV – 44 Yrs – 3 Passes

Sx 6/Pwr 10

before after photo s4
Before/After Photo’s

Type I – 56 Yrs. – 2 Passes

Sx 6/Pwr 10

before after photo s5
Before/After Photo’s

Type IV – 58 Yrs. – 3-4 Passes

Sx 6/Pwr 10

patient selection
Patient Selection
  • Realistic Expectations

2. Medical History

    • Herpes Simplex
    • Keloids
    • Pregnant/Breast Feeding
    • Accutane within 12 months
    • Committed to Sunscreen – 45 or higher
pre operative
Pre-Operative

No Asprin or Anti-Inflamatory Drugs – 3 days prior/post

Famvir – 500 mg – T.I.D. – 10 days

Keflex – 500 mg – T.I.D. – 7 days

TriLuma Cream – 4 weeks prior to treatment every second to third day for skin types II, III, IV.

post op
Post-Op
  • Immediate
    • Hydrating Gel (Cicalfate - Avene, Aloe Vera Gel, etc.)
    • Sunscreen - SPF 45 or higher
    • Fan
  • 7 Days
    • Hydrate – Luke Warm Shower – 5 X a day
    • Lubricate
      • Elta M.D.
      • Aquaphor
    • Sunscreen - SPF 45 or higher
  • General
    • No financial decisions for 24 hours
    • Avoid Sun Exposure
      • Sunscreen, Broad Brim Hat, Scarf
    • Avoid Strenuous Exercise 3 – 7 days
    • Call office for any pain greater than a mild sunburn
physician recommendations
Physician Recommendations

Proceed cautiously

Use Eye Protection

Be less aggressive on neck, chest, hands, arms

Gradually increase power

Gradually decrease SX

Remember – Ablative lasers CAN scar