Michael J. Tomcik, M.D.Michael J. Tomcik, M.D.

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

Michael J. Tomcik, MD

William Ting, MD

WHY CO2

• Gold standard for smoothing, tightening and resurfacing.

• Ablative > Non-Ablative

• CO2 > Erbium > Near Infrared

• Heats the dermis greater than all other wavelengths.

Laser Feature

Mixto SX® Lasering

Encore®Lumenis

Pixel®Alma Laser

Lux 1540Palomar

Affirm®Cynosure

Fraxel®Reliant

Wavelength 10.600 nm 10.600 nm 2940 nm 1540 nm 1440 nm 1550nm

Type of Emission Continuous\

PulsedPulse Pulse Pulse Pulse Continuous

Beam Spot size 0.3 mm 1.3 mm 0.7 mm 0.2-0.3mm N.A. N.A.

Scanned area 20x20 mm 14x14 mm 11x11 mm 10-15 mm 10 mm N/A

Scanner Yes Yes No Yes No Yes

Mode Ablative Ablative Ablative Nonablative Nonablative Nonablative

NecrosisNecrosis

CoagulationCoagulation

15401540 15401540 15401540 COCO22COCO22

COCO22

Why MiXto sx® Microfractional CO2

• Innovative Computerized Pattern Generator

– Microspot - 300u

– Covers 20% of the surface on each pass

– Algorythm avoids heat build-up

MiXto sx® after 24 hours

Why MiXto sx® Microfractional CO2

• Innovative Computerized Pattern Generator

– Microspot - 300u

– Covers 20% of the surface on each pass

– Algorythm avoids heat build-up

Video

Why MiXto sx® Microfractional CO2

• Price

• Two Year Warranty

• Results

Two Controls

• Depth of heating (sx)

• Tissue ablation (power)

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®

• 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.)• 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

Progression Photo’sProgression Photo’s

Before

Post Op - Day 2

Post Op - Day 3

Post Op - Day 9

Progression #1

BEFORE DAY 2 DAY 3 DAY 9

Before

Post Op - Day 3

Post Op - Day 6

Post Op - Day 12

Progression #2

BEFORE DAY 3 DAY 6 DAY12

Before

Post Op – 10 Minutes

Post Op - 24 Hours

Post Op - 3 Days

Post Op - 8 Days

Progression #3

Progression #4Type III – 52 Yrs – Face 2 Passes (Sx 6/Pwr 10)

Neck 1 Pass (Sx 6/Pwr 10)

6 Days – Post Op 30 Days – Post Op

Before/After Photo’sBefore/After Photo’s

Before/After Photo’sType II – 2 passes

Sx 6/Pwr 10

Before/After Photo’sType II – 36 Yrs. – 2 passes

Sx 6/Pwr 10

Before/After Photo’sType IV – 44 Yrs – 3 Passes

Sx 6/Pwr 10

Before/After Photo’sType I – 56 Yrs. – 2 Passes

Sx 6/Pwr 10

Before/After Photo’sType IV – 58 Yrs. – 3-4 Passes

Sx 6/Pwr 10

Patient Selection

1. Realistic Expectations

2. Medical History• Herpes Simplex• Keloids• Pregnant/Breast Feeding• Accutane within 12 months• Committed to Sunscreen – 45 or higher

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• 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

• Proceed cautiously

• Use Eye Protection

• Be less aggressive on neck, chest, hands, arms

• Gradually increase power

• Gradually decrease SX

• Remember – Ablative lasers CAN scar