18. I am used to MJ and j/cm2 settings.  What are the MiXto Sx®  settings?  Mixto Sx® uses three (3) treatment settings for ease of use – Watts (power), Index (pulse duration) and treatment density. A conversion chart is available to convert Watts and Index settings to MJ and j/cm2. 

19. What is the Index?  Index is a number that is used to identify the Pulse Width (pulse duration).  The Index range is from 1-8 which relates to a Pulse Width of 16-2.5ms.  An Index of 8 is the equivalent of  2.5ms.  As the Index is lowered the Pulse Width is increased.  For example:  An Index of 1 has a Pulse Width of 16ms.

20. Why is the MiXto better if you’re not going as deep as your competitors?  The MiXto does have the ability to go as deep as our competition when using the 180µ handpiece with the proper Wattage and Pulse Duration, however clinical evidence is showing that while using the 300µ handpiece, at 10-12 watts, 20- 40% density, and an index of 6-5 (3.5-4ms) in enough to produce significant skin tone, color, and skin tightening results while maintaining patient comfort and satisfying their expectations.
 
21. What is the best setting for acne scars?  Use the 300m spot - start with a setting of 12 Watts and Index of 7 with a density of 20%. For sever acne scars a double pass or an increased density of 40% could be chosen if clinically indicated.

22. What are the best settings for Wrinkles and Fine Lines?  The setting will vary according to skin type, area of treatment, severity of the indicated treatment and experience of the physician. 

• Suggested start settings for skin types 1-3
  Cheeks and Forehead: 300m spot – 10 Watts – Index 6 – Density 20%
  Perioral: 180m spot – 6 Watts – Index 6 – Density 20%
  Periocular:  180m spot – 6 Watts – Index 8 – Density 20%
  Neck, Chest, Hands and Forearm:  300m spot – 8 Watts – Index 8 – Density 20%
  
• Suggested start settings for skin types 4-6
  Pre-treatment: 4 weeks in advance with 4% hydroquinone and stop 3 days prior to treatment and continue 7-10 days after.
  300m spot – 8 Watts – Index 8 – Density 20%

23. There are papers written on the MiXto SX® that claim a topical anesthetic is not needed.  Is that true?  There are two schools of opinion on this. One believes that it is better not to use a topical anesthetic for the following reasons.

• A topical anesthetic will hydrate the skin and compromise treatment results.
• When a topical anesthetic is used a higher power and index setting is needed to achieve the desired results.
• Without a topical anesthetic the patient provides pain threshold feedback. This safely prevents overly aggressive treatments that may cause adverse out comes.

The other school of opinion feels it’s necessary to apply a topical anesthetic because it makes the treatment virtually pain free and allows the physician to be more aggressive for better outcomes.

24. If I were to use a topical anesthetic, what should I use?   Most doctors prescribe 500mg of Tylenol 30 minutes prior to treatment. A topical anesthetic equivalent to 4-7% lidocane is commonly used.  Lasering USA offers a 4% lidocane product.   Doctors performing an advanced treatment use a combination of a local nerve block, topical anesthetic and prescribe an oral pain medication.

25. Any other important patient preparations?  In order to have the best treatment outcome, it is important to have the skin clean and dry.  Most doctors will prescribe an anti-viral and antibiotic such as acyclovir and cephalexin taken one day (1) before and continued seven (7) days after treatment.

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