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Cosmetic IPL Laser Reviews & Comparisons > Help with Lasers / IPL

We are a new practice and ready to purchase our first laser or IPL for hair removal, hyperpigmentation, spider veins, etc. What should we be looking for when purchasing a laser? So far I've come up with the following;

How big the spot size is.
How many hits the head will take before it needs replacing.

What else?
aestheticRN,
There are more than 35 laser companines right now. I would suggest that you speak personally with clinic/physicians or pose questions about specific devices. Palomar, Cutera, ext. all have zelots. Dig before you buy. That's my 2 cents anyway.
07.7 | Unregistered CommenterJabberMD
Rule number one.

NEVER BUY NEW.

Rule number two.

NEVER BELIEVE WHAT THE SALES REP TELLS YOU. IF HE/SHE OPENS THEIR MOUTH, IT IS A LIE

Rule number three.

ASK OTHER DOCTORS ABOUT THEIR EXPERIENCE WITH THE COMPANY AND THE LASER. HOWEVER, DON'T ASK THIS FROM THE DOCTORS THAT THE REP REFERS YOU TOO. THEY ARE IN THE COMPANIES POCKETS.

Rule number four.

TAKE RULES NUMBER ONE TO THREE TO HEART. IT'S ALL TRUE.

My experience is that an IPL is the best first choice.
If you are in an area that has lots of individuals with darker skin, IPL will not be the best first choice for hair removal. You will need an IPL for skin rejuvenation procedures.

I have a palomar. You can get a used medlux for about 35 K. If handpiece needs re-furbishing you can get that from an aftermarket company. I think there is one in chicago. it will be 1/3 of the companies price.

The starlux is a good machine, but has a higher learning curve.

If you are going to do spider vein, get sclerotherapy training.

Good luck.
07.7 | Unregistered CommenterMD
Agree with "MD" however, some companies like Cutera or the new Rhytec or Fraxel are exclusive to their products and will not extend warrently if bought used. For example, the Titan refills you can only get from Cutera (its a computar software on the Xeo system integrated with the handpiece.) but Thermage refills for example you can get from the used laser dealer. Another personal issue I had with used laser was service time, may or may not happen depending on where you are geographically. Large cities probably ok. You must do some homework on the laser company name and how many pulses fired on the used device prior to purchase.
For the most part buying used is a good bet however, like cars depends which used car dealer you go to. The new lasers you will be paying almost double.
One final note: make sure you and staff get plenty of training. 2-3 days may not be enough. I recommend the office spend the money and time to do this. Laser and medical equiptment will not only be the largest investment purchase for the office but safety is utmost importance. Remember it only takes one bad outcome (ie -death after BLT numbing cream in Florida, keloid scarring after Syneron light/RF hair removal on AA patient in California, severe scarring after IPL , blind after unibrow hair removal in Oregon) to end your and your physicians entire life. Good Luck.
07.7 | Unregistered CommenterPCPmd
I have worked with 3 IPL systems before opening my medical spa last year. I went with Lumenis One due to the ability to switch wavelengths/filters, etc easily. However, do not make the same mistake that I made by purchasing the equipment, not leasing. Also did not buy the multi-platform technologies. You will limit yourself and your treatments. I can only do one patient at a time and cannot have hair removal going in another room. Be very careful about the reps. They will tell you ANYTHING!
Thanks for the advice. We have it narrowed down to two IPL's either the Lumenis Quantum IPL or the Palomar Medilux. The Lumenis is about $15k cheaper, both do all the same things, both have a large tx head. Would like to hear from anyone with experience using these devices, how is patient satisfaction, etc.

Can anyone recommend a reputable used dealer in south Florida?

Thanks.
Dear aestheticRN,
I recommend if possible working on the device, few patients, even renting out a laser or working in an office prior to purchase. Heres why: again salesmen , even used laser salesmen want you to ultimately buy their equiptment right? its money.
Problems w/ Quantum : good not best IPL but fluences change with successive treatments in my experience. the older the lamp gets the higher I would go on the fluence. So lets say you punch in 14J . In 3 months after you have used it many times on other patients you may have to punch in 20J to get the same effect of 14J three months ago. When you change out the IPL lamp light to fresh new head 14J will BURN the skin. When you compare your Quantum 14J with another physicians office 14J it is not the same. Not only the lamp but the technique and how much gel each provider used. Thick layer , thin layer ??? Did you press down hard? Light? In summary, the output energy of the flashlamp will degrade as the lamp ages. Inconsistancies in operator and other variables. Other laser companies overcome this inconistency. Check them out.
2) Starlux probably a better IPL than Lumines, Quantum,
exciting is their new IR head for tightening . BUT starlux for hair removal (I don't have this I used a colleagues) is pretty bad. "The most powerful light based system in the world" ???? Check this out:
wavelenght 650-1200 nm; up to 70J max; spot size 12 x 28; rep rate "up to 2 hz" Now lets try a hair removal at typical 30- 40 J at 20msec (which I tried) the speed will be at .3 hz. !!! That means your office will probably be closed by the time you finish one back or leg !! Try it out yourself... SLOW. Point: yes you can have "Max" power but feels like one shot every hour.
You need speed and power.
Final note: It has been said the more you investigate aesthetic systems, the more confused you become. Hopefully understanding the relationship between the system parameters, it will enable you to make the right purchasing decesion.

Fluence = energy (J) / Area (cm2)
Peak Power=Fluence (J/cm2) x 3.14 (Spot Size- in cm/2)2
------------------------------
pulse width

Ask your doctor or nurse:
ND:YAG -------- what does this stand for??? why??
LASER -------- what does this stand for???
Amazing thing is when I ask this to most physicians they dont know ??? yet they fire the thing all day long !!!!!

Bonus question for anyone out there:

k = A * exp (-E a/R*T)

What is this ??? Why is this so crucial in
understanding "tissue tightening" ???

These basic and not so basic questions are important to safety and efficacy in aesthetic medicine. This is why physicians should ultimately be responsible.
08.2 | Unregistered CommenterPCPmd
We have been renting the Palomar Medilux and Starlux and have had high patient satisfaction for hyperpigmentation and removal of fine hair. We have not yet done any legs/backs so I can't comment on speed there. If it's that slow, that's a huge problem!

We have tried to talk to other doc's in our area but none want to comment since competition where we live is so fierce. There must be 6 med spa's in a 5 mile radius of where we are. It's hard to get reliable info. I appreciate your post.

Well, Lumenis is out, we had no idea it had so many problems. It does not seem safe. We looked at Candela Gentlelase but the rep says it does not do hyperpigmentation.
I use the medilux for hair removal all day long.

We do mans back including shoulders and lower back in about 40 minutes at the most. If he can't tolerate it we can go to about 60 minutes.

I'm not sure what you mean by all day long with starlux. Starlux is suppose to have more energy.

I talked to people who had cutera and they hate the thing. They have carpal tunnel form it and patient can't stand it.

Palomar has done good things for me in my office. I know several doctors who use luminus and are happy with it.

All the power fluctuations don't always mean much. In many cases it's academic. Here is just ONE reaseon why:

You sell a laser package to a patient, lets say a package of 5 hair treatments. Your competition says if they buy a package of 5 they get a year after that to get re-treated if they need it.

Well, It may not be re-treatment. It may be a the laser did not do the job in the first place so to keep the patient happy they offer the extended sessions. We do the same. You have to cover yourself and the patient so both parties are happy.

So, yes there may be power fluctuations, the patient may not be able to tolerate the laser, and the dog ate my homework etc....

The point is, most lasers and IPL's get the job done well.

WHAT IS COMES DOWN TO IS PRICE, PRICE, PRICE OF EQUIPMENT and TRAINING OF YOUR STAFF.

Don't get taken by all the technical info. That is how they confuse the issue. Titan does not work any better than Thermage or IR by palomar. Any company can get a bunch of patients and get the results they want and post the pictures of the patients they want.

If I get 100 doctors in a room and all of them do or did thermage, I bet some would love it and some would hate it. I could do the same with titan.

I researched 30 different lasers before I bought the palomar. I had the cutera rep in my office swearing to me how much better his laser was. He was right, it was better for his wallet. 50K better.
08.2 | Unregistered CommenterMD
AestheticRN,
Try em out and see what works best for your office. Most companies will demo out a few patients so make sure you calculate the time it takes not just the results per se. I never mentioned any other laser companies on purpose. Lumines and Palamor are not bad lasers but like any other equiptment have their own "quirks". MD above seems a little upset. Just my personal experience. 40-60 minutes for back or legs is fairly long time to tie up the laser but of course sometimes depends on how much surface area to cover and operator dependent. Our goals for back or legs full max 30 minutes; laser should be running at least 2.0 hz faster than 0.3 hz with the same settings.
Most important though, is what is going to set you apart ultimately from the other offices is: patient comfort, safety and utimately results. In our office the bottom line is not necessarily
money but educating patients even if it means sending them to another office or referring out the plastic surgery. Patients will know honesty and value your time. -- Good luck.
08.2 | Unregistered CommenterPCPmd
Physiology sakes:

The reason why a 1064 nm nd:YAG is safer than 810 diode is because of the "academics" of melanin and hemoglobin curve. In the same manner if you use a IPL based hair removal can really hurt or burn someone especially in summer with tanned skin.

Utimately: foundation of science plays a key role why? safety and comfort - 810 diode certainly more painful than 1064 ; its closer to the skin !
1064 around eyes be careful - two cases of blowing the optic nerve; (blind after hair removal) We have both 1064 and 810 diode in our office as well as the IPL and use each device accordingly.
08.2 | Unregistered CommenterPCPmd
PCPmd,
1064 nm I am assuming "safer" with dark, tanned , or AA skin types. Thanks for the info.
08.2 | Unregistered Commenterlazer
We decided to purchase a Palomar MediLux as our "starter IPL". We got an awesome deal from Mike at MedPro on a new, with Palomar warrenty, 2006 Medilux, all the bells and whistles, handpieces, etc. It was a fantastic and super easy experience buying from them. They went above and beoynd our expectations. Plus,we got it for about $15k less than Palomar sells it for.
I have been trained in laser systems since 1998 and have used the LightSheer for hair removal, Lumenis Quantum and now the Lumenis One. I would strongly recommend against the Quantum. Energies vary a lot and it is almost impossible to change the filters. You have to shut the machine down, unplug the head, plug in the new filter and then recalibrate! With the Lumemis One I change change filters is a split second. In fact I commonly change several times during a session to address various targets on the area being treated. The Lum One is pricey but you are much more likely to give great treatments if you can adjust the settings as easily as you can with it. As far as hair removal, I almost always use the LightSheer. Much better clearance than an IPL system.
One final thought, yes, new is much more expensive, but there is always a reason that someone got rid of the piece of used equipment that you may be purchasing!!??
I recently bought an IPL machine without knowing the return policy. Is there any way to return the machine, it's brand new?
08.12 | Unregistered CommenterRhaki
Laser treatment effectivenes are all about wavelength. I dont care what any company, MD, aesthetician, etc...says, if the energy you are using does not effectively target what you are trying to treat then you are not going to get the results that will keep your client coming back. Spot size is a major player as well, as you stated. Some companies require changes lenses of headpices to get a different spot size. This also requires powering down the system to do this on some systems. "Downtime" is really important. If you are using a yag to target hair and want to switch to an IPL to target brown pigments, how long does that take the instrument to do that? TIME IS MONEY. Also, consider upgrades down the road. Technology is changing fast and the unit you buy today may be worthless in 3 years. I know Cutera gives you full purchase price of there units towards a new one, forever.

Brad Anderson
PSS Equipment Specialist
Anyone has experience with Sciton or Medsurge machines?
Thanks
08.30 | Unregistered CommenterRFojo MD
Anyone has experience with sciton-is it a good machine? Sciton Sales rep told me that they have very little consumable cost?
11.14 | Unregistered CommenterNewMD
I'll agree with MD above.

NEVER BELIEVE WHAT THE SALES REP TELLS YOU. IF HE/SHE OPENS THEIR MOUTH, IT IS A LIE

Find out and detail how:
How many hits under warrantee.
How many hits before rebuild.
How much to rebuild. (Don't take the reps word.)

Deciding on tech is always a tough decision.
11.14 | Unregistered CommenterpertMD
I have a Sciton,, works well. Anyone have any experience with their Service contracts? seem very high priced. Is there any other companies servicing these lasers as an alternative?
We own a Sciton as well, and as far as I know there is not third party service organization for sciton.
01.22 | Unregistered Commenterdexter
I have the MediLux system and it just does not work well for Laser Hair Removal. Alot of clients keep on coming back. There is not whole lot you can do as far as physics is concerned to make the system work better for you. It has 6 levels of energy. 6 is obviously the strongest and it works about 60% of the time to be honest.

please respond if any one feels the same about the medilux Laser Hair Removal.
02.10 | Unregistered Commenterjon
We have a sciton and I have been very pleased with it. Their IPL is very good. Don't know about 3rd party service
02.21 | Unregistered Commenterelliot
I am in the market to buy a sciton ( or laser i should say but this one has caught my attention) It seems the sciton has the ability with the filters to do a wide variety of treatments, any one have any comments to help my decision. any negatives? Where should I buy from? If I can't believe the reps, who do I believe or what questions should I ask? Really appreciate any assistance.
02.26 | Unregistered CommenterEP
PCPmd -

If you would clarify something for me regarding the 'blown optic nerves' using the 1064 (which I use heavily every day with great success). How exactly was the optic nerve blown? Was the aim too close to the globe or over the actual eyelid? Otherwise, the dispersion of the beam in the first mm or so of tissue should reduce the intensity significantly. Did the aqueous or vitreous conduct the beam and have it focused into the retina? I hope these questions don't sound too elementary, but our rep and instructors, along with my own understanding of the science behind it, indicated that the only way to damage the vision is aiming directly through the pupil. Essentially the word was to stay outside the bony rim and aim away from the globe. I'm very curious because I do quite a few 'unibrows' and periorbital vascular lesions, but I am absolutely obsessive about aiming away from the globe itself. What can you tell me? Thanks in advance for keeping me on the side of safety.
02.26 | Unregistered CommenterDermaDoc
To Dermadoc
I don't know if this will help but I was recently at a training seminar and was told that the laser bounces off the white bone of the eye socket at refracts back to the eye and can cause severe eye damage, even blindness.
02.26 | Unregistered Commenterep
DermaDoc,
My girlfriend is an opthamologist and did some reading on the 'blown out retina' hype. Here's her research/conclusion.

1. it is not really a matter of treating the 'unibrow'

2. some clinics treat below the eybrow by pulling the skin above the superior orbital rim

3. the danger lies that in many cases, we are treating patients who are tilting their heads back while seated upright

4. when we are in this position we naturally roll our eyes back in our head

5. this position shifts the pigment of the pupil, in some cases, above the protection of laser eye shields or goggles

6. hence, a misquided pulse can target the pigment of the pupil through the eyelid

7.. although rare, it has happened

I opt to not treat under the brow.

Take it or leave it...
02.26 | Unregistered CommenterMidwest
Thanks ep and Midwest, I will be even more keenly aware of those particular issues in the future. Nothing like blinding a patient to ruin your day / life / practice.
02.26 | Unregistered CommenterDermaDoc
How does the Quantum Lumenis One compare with other ipl systems? Is it recommended??
05.8 | Unregistered Commenterlin
lin i think the best IPL is BBL of Sciton!!!Don't think anything else!!
05.8 | Unregistered Commentercharry
WOW, why would i trust you? you are seemingly quite broad in your generalization of what to believe and what not too. As if i am going to believe you for what reason?

Lets think through your "opinion" of not buying new. would you want to take the chance on purchasing a laser that has been on the secondary market which you cannot track its history? think of all the systems that could be on the market from ANY of the natural disasters that have occured over the last couple of years. A new laser costs more but it is totally backed by the manufacturer no matter whom it is. Also, have you ever dealt with ANY of the secondary market vendors for lasers? you buy it and that is it. Where is your customer support, training, and where is the support of the sales rep. and manufacturer to help in the success of your practice? your advice sounds more along the lines of a disgruntled owner, that seemingly was sold a bag of goods by a slick salesperson and has an issue with fessing up to not doing your due dilligence in researching what truly is quality innovation and manufacture.

i have read a few posts on here on sales rep.'s for different companies that seemingly sell you the box and they are never to be seen again. it happens.....no matter what industry you are in. if you believe in the technology which you should if you are investing in it. you have invested in the company not only the laser so go over the sales rep.'s head and talk with management. YOU are the only one that can help yourself if you dont alert someone of the problem. you are just as much at fault as the rep. the squeeky wheel gets the grease.

ALSO, whomever is reading this be fore warned that this site is utilized by MANY if not ALL manufacturer sales rep.'s and the ADVICE/OPINIONS are sales pitches for their products. (Sciton, Lumenis, Palomar, Synneron, ALMA) PLEASE LOOK AT HISTOLOGY/CLINICALS and do talk with Doctors and not just the ones that own the product but ones that have been doing this for more then a few years. Some technology works but it is NOT always the most reliable, documented, safe, and work past the 3rd treatment.
05.8 | Unregistered Commentertruth
I agree with Truth. You always want to talk to multiple people before purchasing technology that starts at $50,000 and goes up from there.

I wish that there was a way to eliminate the sales reps from our discussions but that is likely impossible.
05.8 | Unregistered CommenterLH
what do you all think of the Cutera Xeo? this is the system that i have used for almost 2 years now and i honestly have to say i am still incredibly happy. I dont see much on Cutera on here which is suprising for the brand marketing (which i get a lot of calls for) and the innovation of their technology.
05.11 | Unregistered Commentertruth
Truth,

I own the xeo with 1064, 600nm IPL and the Titan. I no longer use the IPL and will soon no longer use the Titan once I have used up my current head. I do love the 1064 though. Cutera markets the crap out of things but once you buy they could care less unless they are trying to sell you some "new" upgrade. The only time they are calling my office is to try to sell me something.

I have had my Cutera for 3 years now and have only had a handful of people call requesting Cutera. Currently, I would sell my cutera if I could but I am upside down on the lease. They will not let you buy out early. I was stupid with this lease and should have looked further into other leasing companies.

Truth, are you sure you do not work for Cutera?
05.12 | Unregistered CommenterLH
The Cutera system is hands-down the most versatile as well as effective laser system you will need for your office. The new IPL Limelight handpiece is great for the IPL industry. The "operator" is the only variable in any laser treatment, as the wavelengths and spot-sizes remain constant. I have worked with almost EVERY laser on the market...from The Epilight to the Apogee to the Cynosure to the Lumines to the Lightsheer to the Ruby to the Fraxel to the Coolglide to the V-Beam to the X Trac... and I STILL love the Xeo System with Cutera, It has plenty of wavelenghts and spot sizes to do a variety of treatments to keep everyone busy all day long. How about investing in training time with staff for the best possible outcomes instead of chasing your tails trying to stay caught up with every new bell and whistle that comes along. Believe me, if anyone has exhausted the levels of combination treatments and variations available with the Xeo system and NOT gotten good results...I say Technique Technique Technique!!
Lets put it this way. I own the xeo and have now purchased other equipment to fill in where the xeo fails. I now think there are better systems on the market. It is not just technique. It is definitely equipment as well. We have tried everything to improve outcomes with the Cutera. It has its place but I was not going to invest more money with Cutera. I have already spent $200,000 with them and felt there were better IPL systems on the market that will definitely outperform the Limelight. I did give it a try but just felt it was not enough. Most of my clients are fitzpatrick 1 to 3.

You state as if it is all technique. So that sounds like a manufacturer talking. If the equipment does not perform to the level they "sold" you then it is your fault. I have discussed all of this with cutera and watch all of their webinars. I have spent many hours trying to improve outcomes and still feel there are better choices on the market.

I purchased a new IPL system recently and it has already surpassed the Cutera in benefits to my clients. They are happeir with the new system. I hate to keep beating up on Cutera because I do like their 1064. The 1064 is a tank. You can do about anything to it and it keeps going.

Lately it seems as though Cutera has stuck a few sales people on the site and I feel that it is not as rosey as Skinscience and truth seem to think it is. The Cutera system is not a bad system I just think there are better options for less money. Cutera is expensive.
05.13 | Unregistered CommenterLH
I am definitely NOT a sales rep for Cutera, just a believer in the technology of the Cutera system. I do believe in the 1064, it is truly a work-horse and can be used for so many procedures from the Genesis for Rosacea, fine lines and wrinkles, retexturizing the skin, to zapping veins, and doing hair removal on type 5-6 and some 4's. Although the 770 with the ability to program the program to fit the patients skin type is also nice. I DO believe I prefer the Diode...maybe the Soprano from Alma lasers for the hair removal fine tuning...I believe better hair removal is achieved. The Titan if done correctly has given me outstanding results with many happy patients.The limelight is great, and Levulan is a great addition to the IPL for outstanding results... I feel operators of the IPL are STILL too worried about pressing the parameters for a really good result to take place. Again, if the patient goes into the procedure with the expectation that they are NOT going to look picture perfect for the first week after the IPL procedure, UNTIL the scabbing of the brown spots has formed and flaked...everyone feels alot better about GETTING some results achieved treatments. The Cuters has the capability of getting results if used properly. Sorry....technique, technique, technique. If you want MORE of a result from the IPL than the Cutera delivers then it isn't called an IPL any longer...maybe a LASER treatment..a.k.a. Fraxel??
I just attended a marketing workshop by Cynosure. They produce a machine ("Apogee Elite") that contains both the 755 and 1064 wavelengths. They say this makes it the most versatile machine for people starting out. They also say that no other company's machines contains the cool-air cooling system that they have. They were incredibly convincing (of course) that this cool-air technology is state-of-the-art and the best cooling system that's out there. (There's no need for pre-cooling and post-cooling: the -4 degree air blows out as you laser the skin, and the radius of the cold air covers both pre and post-lased skin. Does anyone have any thoughts on this machine?

One other thing that the marketing physician said is that he doesn't believe in IPL. He said he thinks 1064 can do anything that IPL can do, but better. (And he used this statement as a testament to his honesty, because Cynosure sells IPL too, and yet he would never encourage buying that.) Any thoughts on that?

Thanks.
05.13 | Unregistered CommenterMDmd
Mdmd,

The cool air system they are referring to is the zimmer chiller. A lot of lasers use this system for their cooling. See Fraxel, Syneron and many other others. They have the zimmer chiller oem'd for them. There is nothing special about it, although I have to say I do like it. We own one and use it about everyday for other procedures.





05.13 | Unregistered CommenterDexter
MDmd,

I think the Apogee as above would be a great choice if all you are going to do is hair. As for the 1064 doing everything that can be done by IPL he is saddly mistaken. I own a 1064 and can guarantee that it does not do the same as an IPL as I have both and feel that I need both. We also own a zimmer and use it every day. Make sure to look around before you purchase. Make absolute sure that what you purchase can grow with you. With that system alone you will need to purchase other technology in the future.
05.13 | Unregistered CommenterLH
Dexter and LH,

Thank you for informing me that the "SmartCool" air system is indeed a Zimmer chiller used by other systems/companies. The MD speaker seemed firm on the fact that this was unique to Cynosure. Hmmm.

The MD at the conference also said that the 1064 is great for sun-damaged/ aging skin on the face ("laser facial"), emphasizing that it has been proven to stimulate collagen remodeling in the skin, which IPL has not been proven to do. He also said that the 1064 is great for spider veins and telengectasias (in addition to hair removal for the darker skin types. Do you agree?

Also, LH, when you say, "With that system alone you will need to purchase other technology in the future," which system do you have in mind? I appreciate your sharing your opinion.

I am at the infantile stages of researching lasers, but the more I read, the more I think I ought not to get involved with them. It is a confusing and risky business.

Thanks for your input.
05.13 | Unregistered CommenterMDmd
The first thing you must remember is that the person speaking to you is being paid by Cynosure. So always keep that in mind even if the person is an M.D. Also, do not be sold that this is a business where money will fall off of trees. As you can see on this site there are a lot of physicians that have gotten into financial troubles with this stuff. The reps will tell you all sorts of anecdotes to people making tons of money. I have been doing it for 3 years and built the business from the bottom up. It is just starting to look like I can cut back on my other clinic hours. I have had 3 competitors enter the market. So if you are not sure do NOT do it. I do it because I find it to be fun and I enjoy going to my aesthetic clinic.

Do not buy a 1064 for collagen stimulation. There are much better choices out there. You will have a lot of disapointed clients. Cynosure does have there own intigrated cooler but it is the same thing as the Zimmer. I have the Zimmer then I can use it with multiple procedures.

The 1064 is good for telangectasias and spider veins but does not work well for fine vascular netting. The 1064 works well for hair removal on darker skin types but not very well on lighter skin types. The 755 will be the laser to use on lighter skin types. The 755 can also work on pigmented lesions in lighter skin types.

The first question you need to ask yourself is what are your future plans. If you only want to do hair removal and smaller veins then this system is OK. But if you see any form of resurfacing then think about something else.

There are a lot of systems that are upgradable the Cynosure is not as far as I know. You need to purchase seperate lasers. You need to look at a lot of systems. Do not decide on the first one. I would recommend to look at the upgradable systems to include: Cutera, Sciton, Palomar and Candela. There are others as well but make sure to look at multiple platforms and see which fits your current and future plans.

You need to look at upfront costs, consumables, future costs as well as warranty. These things can add up. I was amazed after I learned what they want for yearly service warranties it can be over $1000/month. Another thing to do is not just simply agree to the first offer they give you. You can talk them down on price. If they refuse then move on to another company. The competition is pretty stiff and there are a lot of options out there.

Once you have ranked your platforms start calling physicians that use them. Most physicians will be willing to talk to you about the benefits and the downfalls of certain platforms.I would also look on the internet and talk to physicians with your chosen platform and not just names given to you by the company.

Just for a disclaimer: I currently own Cutera xeo(1064 and 600nm IPL) with the Titan, Sciton profile erbium yag for resurfacing, Sciton BBL with the ST, Reliant Fraxel and Thermage. My stable is full and I will not be adding anything until I add something like the smartlipo.

I would even watch the info you get from this site. There are a number of sales reps posting.
05.13 | Unregistered CommenterLH
I have been reading this blog for a while and would like to add my two cents: everyone on here is posting their OPINION. I see no references to published clinical articles or scientific facts, only peoples' opinions. When I buy anything expensive I look for information from the leaders in the specific industry or third-party reviewers, not opinions from the average joe. Think about it: how many people are going to spend 100,000 on a piece of equipment and complain about it? Not many, especially doctors. They'll most often sink with their ship!

All of the content in these posts are not matters of fact, and some even second-guess themselves. Like this LH person: in a post dated 5/12 they stated "Currently I would sell my Cutera if I could." Then on their last post dated 5/13 they listed Cutera as the first upgradeable system they would look at!!! If yesterday they say they would sell their system if they could and today they are recommending that you should look at that very same system should you be listening to anything they are saying????

Do yourself a favor and reasearch what the industry leaders are using, buy a laser textbook or two and learn about the science, and take what you hear from the average joe with a grain of salt.
LOL... I'm just laughing at that "Like this LH person" comment.

miss beauty thinks this is all about opinions, not facts. She's right of course but still misses the point. Most of the opinions here are by experienced end users who are in this business. There are not scientific studies about which laser is the best. There are also no studies about which is the best car, house, medical treatment, or wife.

If you're reading this site then you are already ahead of the game. Of course you should be careful. There are some comments on this site about certain technologies that raise my eyebrow and make be wary about who posted them. I know for a fact that there are Cutera, Thermage, and other reps that read the site regularly.

But you would be smart to read what LH posts as he/she is a regular and thoughtful.
Miss Beauty,

I wanted to just give you a piece of advice. If you are looking to these so called "industry leaders" for your advice you need to know that they are most likely the biggest beneficiaries of corporate (laser companies) kickbacks. Your opinion on this tends to highlight your naivety about this market. If they are on the podium and speaking about one technology in particular then it is an almost certainty they are being paid or have received a kickback in the form of a free laser or significant discounting. Obviously this will skew their opinion.
The fact is the most honest answer you will get from anyone comes from the average joe like LH. They paid full price and are not receiving kickbacks. I'll take their opinion over the podium any day. It would be my advice that you do the same.

Dexter
05.16 | Unregistered CommenterDexter
By the way, my post below is not an opinion. It's a fact.
05.16 | Unregistered CommenterDexter
To:Miss beauty,
From: "this LH person"


I know I said I would sell my Cutera system if I could because I have another system that I can add a 1064 to. The 1064 is the only part of my xeo that I like. I wish I would have found this site before I bought my system. Also, just because the Cutera would not be my current choice does not mean that it would not be an good choice for someone else. I have advanced far past what the Cutera can do.

If you are looking at investing well over $100,000 you should look at ALL of your options and that is what I was suggesting. I would not expect MDmd to take my word on it. I would want he/she to look at what best suits them for their current practice and in their future. I am trying to help others not make the same mistake I made. Yes, I admit that I made a mistake because I listened to the "sales rep" and no I will not go down with the ship. In this industry you must be willing and able to make changes on the fly. Just to let you know my clinic has a growth rate of 52% this year even with more competition in my area. I will also be adding a second site in the near future not bad for being "this LH person" huh.

I honestly hope that you do not think I am dumb enough to not look at the science behind these lasers. Now, I want you to ask yourself a question. Just because it is in a journal, does it make it fact? You must always read these journals (of which I guarantee I read more than you) with a grain of salt. If you were to own what all of the industry leaders are using then you would own just about every system out there and that would get very expensive. There is no true consensus on which system is best. If you were to look at just hair removal you would hear industry leaders talk about the 1064, 810 diode, 755 Alex and then multiple IPL systems even systems with bipolar radiofrequency. It would depend on who you talked to and their experience as to which is the best.

I can look at an article and make an educated guess as to who "wrote" it just based on the technology used. Look at Saddick, Goldman, Goldberg and many more. These "industry leaders" are being paid by a manufacturer to do research for them. So do you think this makes the "industry leaders" a little biased? I think I will stick with my friends here on this site long before I trust these "industry leaders".

Dexter and Jeff thanks for the backup. I have enjoyed our discussions on this site and look forward to more. I also appreciate the trust you have placed in me and my comments. I hope I can be of assistance to others that read this site. I have learned a lot while in my aesthetic business and hope that I can pass on a little insight and I hope that others will as well. I think it helps to hear others insight into this business and not all of it will work for everyone. I also like to listen before I attack others. So miss beauty next time I would approach your posts a little more thoughtfully. I would have probably have asked the question as to why on 5/12 did I say I want to sell my system and then on 5/13 suggest someone to look at the Cutera system. I would have politely explained it as I have above. I think this is very logical. I do not want to sell anyone anything or completely disuade tham from looking at a system that would have worked very nicely for them.

The next question I have for everyone is should I change my author signature from LH to "this LH person"?
05.16 | Unregistered CommenterLH
LH,

Your posts are very helpful and I look for them daily as I visit this site. I think the longer one reads this site they will realize you have more info and knowledge than most and it comes directly from your experience. One comment to add to yours that many poeple forget and that is the idea that just because it is in journal does not mean it is fact. Many if not all of this forget this especially if we want to believe something or have been sold a good story. This goes for almost anything. I once had a prof. tell us he read 4 papers (before internet) daily and he would ask us why. Everyone thought he was a quack until he read us the same story one day out of 3 papers. Each one had a different slant, the same quotes used in different contexts etc. etc. Just because you have someone telling you something in print always question the source and there possible motives and then find out from someone like yourself who has real world experience. The truth will prevail. I think you should change your signature to
THIS IS LH
05.16 | Unregistered CommenterMedspabuzz
LH,
I would like to speak with you and or exchange emails if possible. I am currently testing Cutera and Sciton. I have looked at Syneron and Palomar as well. I have agreed to purchase the Cutera system, however am having second thoughts as the Sciton system seems to have stronger reviews. I need to speak with someone who has used both systems.
Thank you for your help.
LA
05.17 | Unregistered CommenterLisa
Lisa,

I would be more than happy to talk with you about our experience with Sciton as well. We have not owned Cutera, but we did a lot of research when comparing the two. If I can help let me know.
05.17 | Unregistered CommenterDexter

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