Weighing the Costs Vs. Benefits of the MiXto Laser

A new fractional laser technology provides "gold standard" clinical results, expedites cosmetic and general practice treatment while boosting profitability

by  Dr. Mark Kofford, M.D., Ph.D. and Dr. Jeannine Wills-Kofford, owner-operators of the Kofford Clinic and Riviera Laser Studios in Dana Point, California.

Like many medical professionals, we strive to keep informed of best practice technology and procedures so we can continue to deliver cutting-edge clinical results while boosting profitability.  To this end, as the owner-operators of a general medical practice and an aesthetic practice in Dana Point, California (www.rivieralaser.com), we began comparing the costs vs. benefits of new technology for cosmetic laser skin resurfacing and general practice applications a few years ago.

The research indicated that traditional CO2-based lasers were the gold standard of clinical results.  In fact, we had successfully used traditional CO2-based lasers in our practices for years.  But we were familiar with their limitations as well.

While traditional CO2-based lasers had produced superior clinical results for us, in the aesthetic realm, they had left little choice but to completely ablate the patient's whole skin surface.

We could essentially choose how much or how deep to ablate in any one area.  But we couldn't choose, for instance, to ablate just 20 percent of skin in one area to a specific depth and another area to a different depth.  Even with light passes, we basically had to do complete ablations.  But this didn't leave enough healthy cells in the treatment area to initiate rapid healing.  Even at the lightest treatment, a complete face ablation typically required at least seven days of "hard downtime," where the patient's skin could appear crusty or scabby, until new skin growth emerged.

We sought more treatment flexibility to help minimize patient downtime, sensitivity, risk factors and even cost.  We sought to treat a much wider range of patients more effectively.  Our general medical practice posed similar concerns.

Research indicated that the optimum skin resurfacing treatment would combine the best aspects of ablation, which removes skin defects, and thermo-coagulation, which heats skin to stimulate its healing and inclination to be naturally smooth and flat.  We sought a way to make this possible.

What caught our attention was a new fractional laser technology called the MiXto SX® CO2 laser, by LASERING USA of San Ramon, California (www.laseringusa.com), which preserved the benefits of traditional CO2-based lasers but added needed flexibility, combining the best aspects of ablation and thermo-coagulation in an innovative way.

With older CO2 laser skin resurfacing systems, the beam moves across the skin, one spot after another, in linear fashion.  Without adequate time for tissue cooling, it can cause excessive pain from thermal buildup.  Complete facial anesthesia is required, and this aggressive procedure results in long recovery times.

Instead, the MiXto SX® CO2 laser gives doctors more control with its fractional laser technology.  It allows them to carefully regulate the depth of penetration and the amount of heat delivered by the beam.  Its high-speed scanner, driven by a patent pending algorithm, divides the treatment area into four quadrants (“fractions”), and skips the beam from quadrant to quadrant so that each strike is separated by the longest possible interval.  The process is repeated until the entire area is treated.  Dividing the laser energy this way allows maximum time for thermal cooling of the tissue, less pain for the patient, and faster recovery.