There are 3 unique features of the Fotona SMOOTH® Er:YAG laser, when used for non-ablative treatments.
- Dual tissue-regeneration mechanism (DTR)
- The unique safety of short-exposure superficial heat shocks
- The unique safety of long-thermal-exposure deep-tissue remodelling
The additional, indirect mechanism of action for regenerating epithelial and deeper lying connective tissues, which is facilitated by the safe delivery of extremely short Er:YAG thermal pulses to the epithelium is complementary to the conventional direct slow stimulation of fibroblasts. This indirect mechanism of action is based on triggering stimulating signal transduction processes for transcription factor activation, gene expression and fibroblast growth, thus leading to new collagen and extracellular matrix formation.
Requirements for the dual tissue-remodelling mechanism limit the range of suitable energy-based devices to short-pulsed lasers with appropriately short penetration depths within the tissue. Other types of energy-based devices, such as radiofrequency or ultrasound devices, have large energy penetration depths into the tissue and are therefore not suitable for the fast-epithelial heat-shock triggering involved in DTR. The requirement for the penetration depth to be below about 6 mm further narrows the choice of energy devices primarily to lasers with a wavelength positioned close to the water absorption peak at 2940 nm.
The Fotona SMOOTH® Er:YAG laser holds a very unique position within the laser devices. Analysis shows that thermotherapy using the Fotona SMOOTH® Er:YAG laser involves not only the additional fast heat-shocking mechanism of tissue regeneration, but also includes a unique self-regulating safety feature. These extraordinary DTR characteristics of the Fotona SMOOTH® Er:YAG laser explains the reported safety and efficacy of Fotona SMOOTH® Er:YAG lasers when used for non-ablative skin tightening.