Sponsored by Fotona
Now available on both the flagship SP DynamisTM
(based in the U.S. and Europe) is an excellent option for physicians looking for a topline non-invasive, customizable facial anti-aging therapy that lifts and tightens. Unique in offering a treatment that works from the inside out, and with no downtime, this four-stage laser procedure is perfect for treating busy professionals, as well as the average patient seeking to stave off the need for a more invasive therapy in the future. Fotona4D is also safe for all skin types.
The highly touted Fotona4D protocol is performed using either the SP Dynamis or TimeWalker platforms. While the powerful SP Dynamis features a wide variety of pos- sible therapeutic applications, the capabilities of TimeWalker are more focused, making it a cost-effective option for physicians wishing to limit their use to Fotona4D or to those wanting to provide the protocol in multiple offices less expensively. Both feature the 1064 nm Nd:YAG and 2940 nm Er:YAG lasers which, in different modes of delivery, make up the Fotona4D procedure.
According to Amy Woehrmann, MD, medical director of Glow Medical Aesthetics in Houston, Texas, and former emergency medicine physician, “Fotona4D gives us the ability to provide that full-thickness thermal skin treatment that initiates collagen production on every level of the tissue. I was impressed by the way the erbium component of therapy is what provides the intraoral treatment as well as the final light peel. The ability to provide a multi-vector, multi-modality treatment that protects and resurfaces resonates with patients. It is very easy to explain to patients, smooth and quick to perform and gives us high patient satisfaction.”
Dr. Woehrmann uses the SP Dynamis platform to perform Fotona4D several times per week in her practice. “The device itself is heavily utilized, for applications ranging from body contouring to laser hair reduction. It is a real workhorse, predictable and reliable to the point where I was considering purchasing another one because it is the most used laser in my practice, by far.”
This four-step procedure runs the gamut of each device’s capabilities. The first stage requires the Er:YAG wavelength in SMOOTH® mode, a powerful but gentle long pulse that can even treat mucosal surfaces for intra-oral or vaginal applications. “This ability to treat the mucosa behind the lips or under the cheeks is what excited me the most originally,” Dr. Woehrmann stated. “Perioral wrinkles and fine lines are a regular complaint among my patients, and this provides an additional vector for treating those.”
The Nd:YAG wavelength harnesses the unique proprietary pulse structure of FRAC3® mode for a pseudofractional resurfacing treatment. “I’m always impressed by how this mode works,” Dr. Woehrmann stated. “The unique pulse structure provides peak areas of high heat creating thermocoagulation points in a seemingly random, scattered format just by the way the pulse is manipulated, without ablation or burning. It is one of the things Fotona is known for – getting the most out of these lasers in ways that are creative and innovative.”
To address deeper tissue collagen remodeling, the Nd:YAG is used in PIANO® mode, an ultra-long pulse setting. “This is a lovely mode for bulk heating. You cannot really have this kind of full-thickness procedure without being able to address deeper collagen with bulk heating, and this gives us a safe, effective and convenient way to do so.”
In SupErficialTM mode the Er:YAG adds the finishing touch, a laser peel that can be as light or aggressive as required, and is the place where the most adjustment to the protocol is usually seen. “The customizability of Fotona4D happens right here,” Dr. Woehrmann expressed. “It is appealing to patients because we can go heavy or light with the laser peel at the end, depending on their individual needs and their tolerance for added downtime. This capability is very satisfying for providers like me. The vast majority of my clients prefer the rapid recovery of the lighter peel. People with scarring or dense, thick dermal texture issues are more likely to need the heavier peel.”
The speed and variety of treatment, Dr. Woehrmann explained, is easy on the provider as well as the patient. “Many laser procedures are time consuming, with simple repetitive application of laser energy over the same area,” she noted. “Fotona4D is much more enjoyable to perform. We have several different modes to work with in a particular order as per protocol, which we can do rapidly in succession and be done in no time. Patients like this, but it also reduces the likelihood of operator fatigue.”
Dr. Woehrmann’s clientele includes many busy professionals such as doctors, lawyers, and – being in Houston – energy company executives. “This is a true lunch-time procedure, which makes it great for that segment of our patient base because they can receive a comfortable, effective treatment over the course of an hour and go right back to work,” Dr. Woehrmann reported. “They are happy to come in and undergo treatment. And whenever you have multiple sessions involved in successful therapy, compliance is a key to success. It also helps that we get an immediate ‘glow’ afterward, which drives patient satisfaction in the short term.” At least three sessions, with a few weeks between each treatment, are recommended, with additional sessions depending on the patient’s age or the condition of their skin.
“The procedure lends itself well to augmentation with non-invasive ancillary treatments such as platelet-rich plasma (PRP) to speed healing, and I believe may provide further improvement,” she explained, “which also serves as an add-on.
“I love treating with Fotona devices,” Dr. Woehrmann continued. “They are so easy to use and so capable, we’ve barely scratched the surface of what they can do, but they are still workhorses for any practice, and very reliable. Fotona gives us great guidance on how to successfully perform Fotona4D and other treatments we may wish to offer. Fotona4D itself is so easy to do, and difficult to perform improperly once you’ve been accurately trained because it is so straightforward. We love it, our patients love it.”