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FRAC3® is a unique non-ablative fractional laser for skin rejuvenation

Laser pulses in acceleration mode. The Accelera pulses create a 3D irregular fractional pattern in the epidermis and dermis, with a thermal effect concentrated at skin defects.
Thermal measurements of the skin surface in vivo and the cross-section of the skin in vitro after illumination with Nd:YAG Accelera pulses are reported. The findings show the formation of separate »fractional« hot islands beneath the skin. Clinical results from the short pulse Nd:YAG laser therapy are also provided. The FRAC3® technology adds another dimension to the safety and self-regulating efficacy of non-ablative laser skin rejuvenation.

Laser’s mechanism of action

Because the remaining healthy tissue around the fractional damage areas can operate as healing centres, fractional laser skin rejuvenation has lately acquired popularity. The existing technique has the problem of only providing partial lighting in the form of a two-dimensional matrix, and the lighted columns below the spots are evenly destroyed. Furthermore, the procedure is non-selective in terms of local skin defects.
Finally, the procedure necessitates the use of a specialized fractional delivery mechanism. Based on Fotona Nd:YAG short pulse mode (Accelera) features, we present a unique skin self-induced FRAC3® laser technique. The procedure creates a three-dimensional fractional pattern inside the epidermis and dermis, with damage islands mostly occurring in minor skin defects and inhomogeneities.

FRAC3
Laser-induced damage islands serve as healing hubs: a) traditional uniform laser therapy, b) traditional two-dimensional fractional treatment, and c) innovative self-induced three-dimensional FRAC3 laser treatment. If the clinical goal is to create selective changes in a certain tissue structure, the wavelength should match the absorbance spectrum of the targeted structure’s greatest absorption compared to surrounding tissue.
However, wavelengths substantially absorbed in skin defects are equally highly absorbed by melanosomes or hemoglobin-containing RBC. These wavelengths can not penetrate deeper skin flaws and can cause undue harm to good skin tissues. As a result, it is frequently preferable to use a laser wavelength that penetrates deeper into the tissue and then performs selective tissue alteration by tailoring the pulse to the thermal relaxation time of the defect. Specifically, over prolonged laser exposure, most of the deposited heat may diffuse away from the target structure, causing nonspecific thermal damage to surrounding structures.
On the other hand, a suitable short laser pulse restricts the heating impact on the target structure, resulting in the greatest temperature differential between the target and neighbouring structures. The idea underpinning the newest FRAC3® minimally invasive skin rejuvenation approach is to use a homogeneously penetrating Nd:YAG (=1064 nm) laser wavelength and target skin flaws by tailoring the laser pulse duration to the cooling times of these imperfections.

CONSIDERATIONS FOR PULSE DURATION

When exposed to a suitably brief laser pulse, energy is deposited in the absorbing structure before much heat is transmitted to the surrounding tissue by conduction. The subsequent temperature rise in the absorbed heat is thus exactly proportional to the optically and thermally homogeneous structure, which is proportional to the laser fluence (in J/cm2) in the target. However, even if the wavelength offers selective absorption of laser energy, a considerable percentage of the deposited heat may diffuse away from the absorbing structure during laser exposure, lowering the peak target temperature and impairing heating spatial selectivity. As a result, the length of the laser pulse, which regulates the spatial confinement of deposited heat in absorbing materials, must be carefully chosen. Only laser pulses much shorter than the desired thermal relaxation period allow for the greatest temperature rise in the targeted structure.
The relaxation time is when the amplitude of a hypothetical temperature rise lowers by a factor of two due to heat diffusion into the surrounding tissue.

EXPERIENCE IN CLINICAL CARE

Clinical data demonstrate that the self-induced threedimensional non-ablative Nd:YAG laser fractional therapy is a safe and effective alternative to more harsh laser procedures. Treatment settings are typically 15-40 J/cm2 with pulse lengths of 0.1-0.4 ms. Photographic assessments demonstrate a reduction in erythema and an increase in skin quality. The brief pulse targeting of the microvasculature is responsible for the improvement in pore size, texture, and colour. Aside from temporary erythema, no negative effects have been recorded.
In the papillary dermis, the ultra-structural study of patients treated with 0.3 ms Nd:YAG laser pulses revealed a reduction in total collagen fibre diameter.
This corresponds to the creation of new collagen. The therapy induces new collagen formation by causing localized thermal damage to the dermis, which triggers a wound-healing response> During wound healing, procollagen and type III collagen fibres with a small diameter are formed initially. A decrease in collagen fibre width has been linked to the synthesis of new collagen, which is expected to improve skin firmness and texture in patients following therapy. Patients under 50 had the best benefits, whereas older patients did not exhibit a decreased collagen fibre diameter.

SOE: SCANNER EFFICACY OPTIMIZED

The FRAC3® therapy technique requires relatively high energy and fluences at short pulse durations, which is challenging to produce with bigger spot sizes. However, manually targeting a small to medium spot-size laser beam to cover a wider skin area hundreds of times might result in uneven coverage, missing spots, and extra warmth due to pulse stacking. The laser must be set with millimetre accuracy across the whole surface, which is impossible because determining the treated area precisely is difficult. SOE (Scanner Optimized Efficacy) technology addresses these issues by automatically placing the 3 mm spot-size laser beam in a flawless nonsequential pattern using computer-controlled laser scanner mirrors. SOE Technology produces FRAC3® laser quick, accurate, consistent, and pleasant treatments. It reduces tiredness and ensures regularity in treatments. SOE Technology is utilized to treat huge regions of varying sizes by rapidly delivering uniform energy at high laser pulse power densities to the whole area. Consequently, laser therapy is safer and more consistent, with no hot patches or energy loss.

CONCLUSIONS

A unique FRAC3® non-ablative fractional laser approach that creates a self-induced fractional thermal damage matrix inside the skin tissues is disclosed. The FRAC3® fractional thermal damage structure builds around existing skin defects and inhomogeneities rather than being imposed on the skin arbitrarily by the external optics. As a result, the procedure is both highly successful and less intrusive. Compared to typical fractional approaches, another benefit of the FRAC3® approach is that the resulting fractional damage islands are not restricted to the two-dimensional column matrix but dispersed in a three-dimensional way across the skin volume. Furthermore, no specific optical instrument is required, resulting in the increased cost-effectiveness of the skin rejuvenation operation.
With its efficacy, selectivity, fast healing time, and cost-effectiveness, the new FRAC3® laser technology is the next step in enhanced laser skin rejuvenation operations, Fotona 4d facelift, acne scars and laser hair removal

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