Candela Vbeam Perfecta User manual

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VBeam Family
•Patient consultation &
management of
expectations
•Vascular Lesions
•Pigmented Lesions
•Photorejuvenation

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History of the Pulsed Dye Laser
First Invented by Candela in 1988.
First Introduced to Treat Port Wine Stains
in Children.
Pulsed Dye Laser - The GOLD Standard.
Hundreds of Thousands of Treatments
in the last 20 years.
300+ Published Clinical Papers.
True Multi-Purpose Laser.
Efficacious, Consistent, Safe.

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Largest Variety of Treatments
Wrinkles
Port Wine Stains
Hemangiomas
Angiomas
Venous Lakes
Stretch Marks
Acne Bacteria
Acne Redness
Vulvodynia
Facial Vessels
Leg vessels
Rosacea
Poiklioderma
Scars
Warts
Psoriasis

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How is the new VBeam
different from the old
VBeam?

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New Technology
Micro-Pulse Design
8 micro-pulse sequence
More pulses to distribute the total energy
Uniform distribution across entire pulse
Consistency
Enables Higher Purpura Threshold
Total energy divided over 8 pulses
Original Vbeam = 4 micro-pulses
Lower energy density per micro pulse

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Purpura Threshold
NEW Micropulse Technology - Why 8 Pulses Are Better
;Eight equal energy pulses Eight equal energy pulses
;Closely mimics one continuous pulse Closely mimics one continuous pulse
;Still Delivers Required Vessel Coagulation Fluence Still Delivers Required Vessel Coagulation Fluence
FLUENCE
TIME (ms)
Classic PDL Technology
4 pulses, dissimilar distribution
NEW PDL Technology
8 pulses, equal energy

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Patient Consultation

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Patient Consultation
Today’s patient is better educated than ever
thanks to the internet.
Before any treatment, ALWAYS review the
entire process.
They should know exactly what is expected of
them.
They should know what to expect as far as
outcomes.

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Fitzpatrick Skin Types
Does Not Burn
No Change in Color
Dark Hair
Dark Eyes
Very Dark Skin
6
Seldom Burns
Deep Browning
Dark Hair
Dark Eyes
Dark Skin
5
Burns Mildly
Moderate Browning
Dark Hair
Dark Eyes
Dark Olive to Brown Skin
4
Moderate Burns
Usually Tans
Medium Hair
Medium to Dark Eyes
Medium to Olive Skin
3
Usually Burns
Seldom Tans
Light to Medium Hair
Light to Medium Eyes
Light to Medium Skin
2
Always Burns
Never Tans
Red-blonde Hair
Blue-green Eyes
Very light Skin
1
Skin Reaction on over exposure to UV lightTypical Skin Type DefinitionType Skin

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Patient Selection
•The 595nm wavelength works best on skin types I-
IV
•Treatment on darker skin types should be
preceded with a test spot to assess tissue response
•All patients should avoid sun exposure, tanning
beds, and sunless tanning products for 1 month
prior to treatment

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Contraindications
•Accutane use should be suspended for 6 months
prior to treatment
•Photo-sensitizing drugs should be analyzed
•No Pregnancy – Liability issues
•Permanent Make-up or Tattoos
•Active or Open Lesions
•No sun exposure or self tanning agents
•Remember…Pigment is Pigment!!!

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How Does the Laser Work?
•The 595nm wavelength targets oxy-hemoglobin in the
blood vessels
•By varying the pulse duration, treatments can be
performed purpurically (bruising) by rupturing the blood
vessel, or sub-purpurically by slowly heating the vessel
causing coagulation of the blood vessel

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Pulse Duration
The VBeam family has
.45ms, 1.5ms, 3ms, 6ms,
10ms, 20ms, 30ms & 40ms
pulsed durations
The shorter the pulse
duration the more
destructive the energy
becomes
The longer the pulse
duration the more gentle the
energy is delivered thus
“cooking” the target

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Vascular Treatments

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What is Purpura?
A “Laser Bruise” is the result of energy being
delivered very quickly
“Grape Jelly” or Eggplant colored
Purpura can last for several days to weeks
Purpura must be achieved when treating warts,
port wine stains, angiomas, scars, straie and can
occur when treating leg veins
Will require fewer treatments vs. No Purpura

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Purpura vs. No Purpura
The older pulsed dye laser
side effect.
VBeam allows treatment
without purpura.

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Purpura vs. No Purpura

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Clinical Endpoints
Purpuric Treatments (Using a pulse duration of
3ms or shorter):
After the laser pulse is delivered, a bruise will begin to
appear over a matter of seconds and can last 10-14 days
Patient may experience edema for a couple of days
Patient may experience minimal to moderate
discomfort

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Clinical Endpoints
Sub-purpuric Treatments (Using a pulse duration
of 6ms or longer):
When treating diffuse redness or roseacea, a vascular
spasm may be noticed and will disappear over a matter
of seconds
When treateing linear vessels, the structure may darken
and resolve over a matter of seconds
Patient may experience edema for a couple of days
Patient may experience minimal discomfort, much like
a mild sunburn

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Pre-Treatment Instructions
Avoid sun exposure
Cease aspirin, advil, vitamin E and fish oil
supplements as they may increase the
likelihood of bruising (purpura)
Cease Retin-A as it may cause excessive
redness
Always treat “Squeaky Clean” skin