Things to consider when purchasing an aesthetic laser device

Standalone aesthetic laser vs. multi-technology platforms

Aesthetic treatments have been vastly transformed since the introduction of medical lasers. Dermatologists are now able to treat skin conditions that were once considered incurable. On top of that, the introduction of lasers and other energy-based devices (EBDs) has opened up new financial opportunities for physicians. This set of circumstances has created an influx of competing technologies, manufacturers, and various brands, making it hard, especially for a novice clinic owner, to decide which aesthetic laser to acquire.

Things to consider when purchasing an aesthetic laser device

Many considerations come into play in the process of deciding which aesthetic laser device to use. These include the following:

• The technical specifications of the device, such as laser wavelengths.
• The range of indications that you will be able to provide with your device - the more indications, the better.
• Does the device allow you to create personalized treatments for your patients by combining different technologies within one treatment protocol?
• Technology that is clinically proven and FDA-approved.
• Credibility of the device’s manufacturer.
• Financial aspects – the price of the laser, does it use any expensive consumables?
• Post-sales support - Is the manufacturer able to provide you a warranty, maintenance & service, or clinical and marketing support upon your purchase?

All of the above are highly important. However, aside from these objective questions, there is the matter of what type of laser the physician should be looking for in the first place. Though this question might feel difficult to answer, the past few decades have shown that several types are well-established and are considered somewhat of a gold standard in aesthetic dermatology practice. These include the following aesthetic laser types:

• The 1540nm ER: Glass fractional non-ablative laser for skin rejuvenation and acne treatment.
• The 2940nm ER: Yag fractional laser and CO2 (10,600nm) ablative lasers for skin resurfacing and benign lesion removal.
• The?Q-switched?ND: Yag 1064nm laser is used for pigmented lesions removal, skin rejuvenation, and tattoo removal.

You can find some of the above lasers, like the?CO2 laser, mostly as standalone devices. In this instance, a device is designed to treat a different range of skin conditions. However, some?are available both in standalone laser form and on multi-technology platforms as well. This poses a dilemma for some users, which can be solved if you have the right information and through a simple thought process.

Standalone machines vs. platform lasers

In many cases, standalone lasers tend to have a single wavelength and a small variety of applications. These devices usually treat a narrow range of indications. That is one of the reasons why they are more favorable among experienced physicians who have an established practice. They have the privilege of focusing on certain areas of expertise. A younger clinic owner, one who is still building his or her reputation and clientele, would prefer to acquire a more flexible device, that can answer the needs of all sorts of patients. These platforms offer several applications, various laser types, and sometimes even both laser and IPL or other light-based technology.

Generally speaking, standalone lasers tend to be more robust, and have the reputation of being "workhorses.”. Platform lasers, on the other hand, are cheaper to own, require less office space, and are a bit cheaper to maintain.

The Q-switched Nd: YAG laser is a very popular laser and a good example of a laser that can be found either as a standalone or as part of a platform. Let’s use Two of Alma’s bestselling aesthetic laser devices for this comparison: the ALMA-Q laser and the Harmony XL Pro platform.

We’ve asked Mr. Ohad Toledano, Director of Clinical Excellence for Alma Lasers, for more insights on this comparison.

Harmony XL Pro – Multi-application platform

https://www.youtube.com/watch?v=i__OVyDuz7A

The Harmony XL Pro laser platform boasts various technologies: the Q-switched ND: Yag laser, the 2940nm ER: Yag laser, the 1540nm ER: Glass laser, and various IPL handpieces. It has 65 cleared FDA indications for treatment; is there a case of quantity over quality with such a device?

“Not. The laser itself is almost as good as the?standalone laser,?and the differences are mostly not related to its clinical potential. For example, in a Q-switched Nd:YAG laser, tattoo removal will be as effective in both. However, with a standalone laser, the treatment time will be shorter, and handling it will be more convenient. Yet, results differ in laser specifications, such as pulse width, rather than whether it is a standalone or platform. Secondly, if you use a platform laser, and don’t achieve the results you initially wanted, you can switch to a different technology (or wavelength). This means a seasoned user will be able to get better results by utilizing his experience.

An example of that can be choosing an ablative over a non-ablative one, or IPL vs Laser. I admit there are rare, specific cases (certain lesions) that might be best treated with only a specific laser type. However, with the platform, the value you get from the wide variety and flexibility exceeds the value a standalone laser will give you by being great at treating something specific. To go back to the point made earlier in this article – for a beginner that hasn’t carved his or her niche yet – the platform is great because it enables them to gain more experience treating many skin conditions.”

??What are the benefits that stand out to you in favor of a standalone laser device?

“Within standalone lasers, what you get is the robustness of the standalone and the higher peak power levels. In addition, a standalone laser tends to last longer. A platform laser?uses a handpiece with a small laser rod positioned inside. You will have?to replace this laser rod periodically. The ALMA-Q also represents a more modern approach to standalone aesthetic lasers, as it features up to 7 different handpieces that give it much more flexibility than traditional single devices. So even though it can still work at 1064nm or 532nm via the Q-switch, the specially designed handpieces broaden the range of its capabilities. In addition, the ALMA-Q is unique in the sense that it has 3 different pulse duration settings (nanosecond, microsecond, & millisecond), which is highly unique for a Q-switched laser.”

??Have you had experience treating the same indication with both of these laser devices? What were your impressions?

“Yes. We have been conducting in-depth research on laser?tattoo removal?and superficial pigment removal. ALMA-Q is faster than the Harmony XL Pro and has a larger spot size. Hence, the treatment time is shorter. That is especially great when removing large tattoos. Yet overall, the number of sessions needed to remove a tattoo or a pigment is the same.”

??Any advice for those who find it hard to decide?

“I think firstly you, as a practitioner, must ask: What are your goals? If a physician is focused on treating a specific field of interest, let’s say, vascular pigmentation, then I would suggest a standalone laser. One that focuses on that field of interest. Yet if he/she is seeking to cover as many indications as possible, attracting more clients, then multi-technology will be the better choice.

Generally, we always advise physicians not to lose too much sleep over this matter. This is a growing industry, and many of them will have long and prosperous careers. That means they will get the chance to work with both kinds of devices, sometimes even simultaneously, at their practice. Also, I always tell them to closely examine what kind of training the company that sells the device offers. That is because even the best technology available is not worth much without the expertise of the practitioner.”

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