Dr. Brode Dr. Lawrence Broder of Beleza Medical Spa. Today, weรญre going to perform a DOT Therapy Laser Resurfacing treatment on our patient, Sandra, here. First, weรญre going to just look at Sandraรญs skin and see what sheรญs looking for from this treatment. What are you looking for from this treatment, Sandra? Sandr feel like I have a lot of elasticity problems here. I have likeร–the skin is coming up here andร–I just kind of want to tighten that up. I just feel like Iรญve lost a lot of the collagen here thatรญs actually helping my skin stay firm. Dr. Brode andra is in her 40s and has some signs of sun damage here, she has some roughness. She has some of those lines, these lines of expression, like your forehead lines that are starting to etch into her skin because sheรญs losing elasticity. She has some surface pigment irregularities. She has some roughness. These are all signs of sun damage that we all accumulate during our lives. The other thing that happens is our collagen formation turns off as we get older, mostly due to sun damage. Weรญre looking with this treatment DOT therapy to re-stimulate it. Basically, what weรญre going to do with this laser is make millions of little perforations in Sandraรญs skin. The point of that are two things. One is to re-surface, and the second is to re-tighten her skin. Approximately three to four days after treatment, your entire upper layer of skin, epidermis, will peel off in big sheaths. The roughness, the fine lines, pigment, all that stuffรญs going to come off. Youรญre going to be left with the new skin thatรญs kind of pink. That will only last about a week, and then it will go away. That alone usually takes about five off most of our patientsรญ faces. The other thing we do is not only resurface the skin, but we direct laser energy into the deeper layer of skin. The reason we do that is because when you heat up the deeper layer of skin with the collagen in it, the collagen is made, it causes the collagen bundles to tighten, to get skin tightening, and induces new collagen formation. That will start three to four weeks after the treatment and is more subtle, takes more time, will go on longer, but itรญs actually the better result. Three to four days, re-surfacing, new skin, and then three to four weeks after skin tightening starts. Do you have any questions about that? Sandr o. Iรญm just anxious to see the results. Dr. Brode k. Weรญre going to get started. Sandra has had some local anesthetic on herร–a topical applied to her face for approximately an hour, and now weรญve taken that off. Sheรญs had some light sedation. As you can see, weรญre not going to do any general anesthesia or anything. Weรญre going to get her ready, and weรญre going to put some goggles on. This is the DOT head. This is where theร–you can it. Itรญs hard to see, but the laser shows a grid where it will cause its pattern. You can see that. Weรญre going to start. Ready, Sandra? Sandr es. Dr. Brode k, here we go. Youรญre feel a line. Weรญll do one. Howรญd that feel? Sandr ine. Dr. Brode eรญre going to start doing that. You can see the pattern already on her skin forming. You can actually as we do this see some skin tightening almost immediately from the initial heating. This DOT therapy is actually a CO2 laser. Itรญs based on the old CO2 lasers. CO2 laser is pretty much considered the gold standard of re-surfacing lasers. The only problem is the old CO2 laser gave you beautiful results, but it would have two weeks of down time and require a lot of times general anesthesia which was so painful. The difference with this laser is instead of taking off all the skin like the old CO2 laser, it only takes out little portions where the dots are. You doing all right? In between those little dots it leaves normal skin. The reason that makes it better is because that allows this old skin to stay on as a natural bandage so when the new skin is ready it will peel off. That prevents her to have to dealing with an open wound. It also prevents her from infection and lessens the chance of scarring. Thatรญs all by leaving that old skin on, and then also by not taking all the skin off we could see we can do this under local anesthesia. Doing all right? Sandr o pain, no gain. Dr. Brode k. Weรญre going to come this way. Are you in a lot of pain or are you all right? Sandr tรญs good. I mean it hurts but itรญs fine. Dr. Brode k. You can see weรญve already done about half of Sandraรญs neck, same systematic pattern that we do, a little overlap. Basically, weรญre just trying to cover all the skin. The areas where thereรญs wrinkles or deeper lines weรญll go over, and sometimes weรญll change the settings to go a little deeper. She doesnรญt have any really major wrinkles. Look at Sandraรญs hand. Very similar to her face. This was the same sun damage, rough skin, pigmentation. You can see the fine lines, the loss of elasticity. Any place where you have sun damage, the hands, arms, chest, neck, face, we can do DOT therapy on that. Now we go over the knuckles and also some sun damage on the finger, erase that. We have finished. We did DOT therapy of the face, neck and hand. How was it, Sandra? Sandr t was good. Itรญs a little painful, but nothing that you canรญt handle because you know itรญs going to be a good result. You know youรญre doing something thatรญs going to in about seven days itรญs going to give a great result, and so the pain itรญs not as bad as you would think. Then, the numbness that you give before, that definitely helped. It wasnรญt nothing I couldnรญt handle. Dr. Brode ood, and Sandra was a great patient. She has a good attitude about this. You can see it was done under a local anesthesia with just some local and some mild sedation. You can see the dots of all of her skin, her face, her neck, her hands. You can just see from the initial heating and some swelling she already looks tighter. All this skin is going to come off, all this top layer of skin. Sheรญs going to have that new skin in three to four days. Then, the heating that we did thatรญs going to induce the new collagen formation in three to four weeks, and then weรญll have some before and after pictures too. Ok, thank you. Sandr hank you. [End of Audio] Duratio minutes