Q: How many sessions are needed, and what is the pricing for the treatment?
A: “So if you do your face and neck, it’s about thirty-five hundred dollars. You do your face alone, is it twenty-five hundred for the face and fifteen hundred for the neck”
If you’re just doing the areas around the eyes and the mouth alone, it’s a thousand dollars. And then there are issues like scarring, and that all really depends on the time it takes to treat it and how many times that you’ve got to treat it. But it’s pretty much the same pricing as some of the tightening devices that are used in the office and maybe a little bit more than some of the older lasers.”
“The really beautiful thing about this device is it has multiple different settings, so we’re able to get very superficial things like pigmentation or deeper things like lines. Depending on what your specific needs are and the time in the chair, the pricing is going to be reflective of that. In terms of how many sessions, it also depends on how aggressive you’re willing to go and how much downtime you’re willing to endure, but usually two to three sessions for optimal results.”
“And it depends on where you are in the treatment timeline. If Angie got a session tomorrow or I got a session, I would probably need two or three because I waited another thirty years to come in and do it. So that counts. Like, what problem are you trying to fix, and how easy a fix is that? So, obviously, easier fixes are cheaper and faster.”
Q: Is UltraClear useful for around the eyes or the upper lips?
A: “I actually had the treatment personally before we bought the device, and I found it to be really tolerable and a really easy recovery. After the first three days, I was wearing makeup and back in the office, and I think it really helps with the eyes and the mouth. It’s very customizable as to how ablative we can go. But overall, the healing is so much faster than the traditional ablative lasers. Three to five days, maybe a week of downtime as opposed to up to two weeks and even longer persistent redness.”
Q: What is an overview of the treatment, type of laser, pain level, aftercare?
A: “Okay. So, yes. The pain is very well tolerated. We use a topical numbing cream in the office for about forty-five minutes to an hour. And, again, because this laser is sort of minimizing the heat damage, it’s very tolerable. We also have a kind of Zimmer cooler and the laughing gas as well that many patients use if you’ve done other lasers at our practice. The downtime for most patients is going to be sort of social downtime at least, you know, three to five days. And then day five is where you really turn the corner, and, you know, you’re a little red; maybe you go out with a tinted sunscreen on, and I would say most patients, even with aggressive treatments, are fully healed within seven to ten days.”
Q: Can I drive home if I use laughing gas?
A: “The half-life of laughing gas is about five minutes. So, yes, you can use laughing gas to help you stay out of pain while you’re doing something and then still drive home.”
“And this is a procedure that you can very well drive yourself to and from.”
Q: How does UltraClear compare to SofWave and level of penetration for each?
A: “So SoftWave is an ultrasound-based device that basically targets the deep collagen of the dermis. It penetrates about one and a half to two millimeters into the skin. And what you want to think about what SoftWave is doing is bypassing all the stuff in the top layer.
So where the pigment lives, the fine lines live, and it’s getting more in terms of the deeper collagen that’s responsible for the tightening and lifting. So, the advantage of something like that is you get a little bit of a pick-me-up, and you have zero downtime. It’s also a nice colorblind procedure that you can do anytime of the year and not have to worry about the sun. What UltraClear is doing is getting the collagen in the skin, getting the top layer of the collagen where we see some of the fine lines, and also hitting the area of the skin that’s responsible for texture and pigmentation.
So that’s why it’s a nice complement to this technology: it doesn’t just improve some of the fine lines you see, but it also helps with clarity. And there is a coring mode that raised some questions. And in coring mode, because it does remove tissue, we have seen a fair amount of improvement in some of our patients who were treated early on, with some good tightening of their skin, especially the lax skin along the jawline. So I do think there’s a little bit of benefit if you use the coring mode of UltraClear and actually tightening of the skin as well.”
Q: Would it be fair to say that UltraClear and Ellacor are sort of accomplishing the same thing, but using a laser to do it?
A: “Yes. I mean, it uses a laser that basically fires in sequential mode to drill out (vaporize) a hole in tissue instead of using a needle to extract it. There’s really been no comparative studies side by side, but there’s some argument to say that if you use a laser that removes tissue but also delivers heat, you make it a little bit more tightening. I will say that the healing with UltraClear seems to be a little bit less; I don’t want to use the word dramatic.
Ellacor can be disconcerting the first few days when you see a little grid on your face, and the Ultraclear healing is a little bit softer for you as a patient experience.”
Q: How does the healing after UltraClear compare?
A: “Tint and sunscreen three to four days.”
“And then you came to work the next day or the day after?”
“I did come to work the next day.”
“On my face, mind you, but no one said anything.”
“Right. But more importantly, she was comfortable enough to work and, you know, didn’t, like, scare anybody.”
“So comfortable right afterward and during. I found it to be really tolerable. Really tolerable.”
“I was going to say that most of the patients who’ve had this done do feel that while you’re in the chair, it’s more comfortable than even something like a Fraxel. I’ve had multiple patients tell me that.”
“I agree.”
“Even though the downtime is a little bit more robust, not in the number of days, but how red and puffy you get, in the chair, it’s actually a pretty easy procedure.”
“And then what I was going to tag on to that is the puffiness of the day that you get out of the chair. It looks like you’ve had an ablative laser. But somewhere between day two and day four, it just really turns around. And instead of looking red and weepy, it looks sort of pink and healed, and then you just have to wait the color out. So to what Angie was saying, it’s so focused. It can focus that energy exactly where it wants it and not let it get to all the neighboring tissue as much. I think that’s why it heals so fast. But you know you did something the first couple of days. But by the third or fourth day, it’s way down.”
Q: What about pre and post skin care?
A: “We don’t really have any pre-care other than, you know, staying out of the sun, not being treated while tan, or not being treated if you’re planning to go on a hot vacation or something right afterward.
And then the aftercare, we give you a kit. We also recommend Ariessence, which helps with healing. So that night, you’re not going to do a whole lot. And then the next day, we’ll give you ointments, an after-care kit to use, and sunscreen. We’ll go over very, very detailed instructions with you, including white vinegar soaks. Buy the white vinegar. That’s the only thing you need. That’s the only thing we do not provide.
You know, that reminds me. Somebody asked yesterday, can I use any water- bottled water, tap water, distilled water? You just need bottled water. Just have bottled water and white vinegar at home. We will give you everything else you need, including the gauze for your soaks. But do avoid tap water because of the risk of infection? And avoid sleeping with your pet for the first few days. That’s not okay. It’s on the aftercare instructions.
Q: How does UltraClear compare with Fraxel? Why would one do one? Why would you do one over the other?
A: “As many of you know, we’ve had Fraxel for many years, and it’s a great device, and we love it, and we use it all the time. But it’s really good at treating pigmentation.
And then there’s another wavelength that also can treat fine lines, wrinkles, and acne scars. But, you know, there’s not as much downtime. It’s not as large of a sort of tissue injury, so you’re not getting as much as you would get with an UltraClear. And, also, the UltraClear, you’re able to go deeper with the laser coring and then deeper and more superficial.
So you can just do so many different things in an UltraClear that you can’t really do with Fraxel”
“But we still love Fraxel.”
“I would say if you’re looking for predominant pigment improvement, for the amount of downtime, especially if you’re thinking off the face, Fraxel would be the choice.
But if you’re looking for a permanent pigmentation and fine lines, I think then UltraClear is a that’s gonna be a more efficient route for you.”
Q: How long do we need to stay out of the sun after the treatment?
A: “I don’t want extremes of sun exposure for two to four weeks. So if you’re going to Hawaii, you’re going to a beach volleyball tournament, like, do not do this procedure prior to that. But consider the sun like walking your dog, you know, going to and from your car just a couple weeks or something like that.”
Q: Is there any skin cancer benefit like CO2?
A: “So, actually, there’s a huge body of evidence growing that fractional lasers. So most of this has been done with fractional, non-ablative, like a Fraxel laser, but there’s also now a fractional CO2 laser. There are even studies for V-beam showing that there’s a lifetime reduction in basal cell cancer. So if anything, UltraClear, I think, would be no different. There are probably skin cancer benefits for preventing basal cells down the road, as well as actinic keratosis.
So I would say, yes, there are skin cancer benefits like a CO2 laser.”
Q: What is the longevity results in months six or nine?
A: “You know, I think it depends a lot on how much damage you sort of walked in with because it’s cumulative. All of that UVA exposure and all of that damage is cumulative. So you could go sit in a dark closet, you know? You have to wear sunscreen. But even if you go sit in a dark closet, the spots are gonna come back because you’ve got all this banked damage. So it takes about ten or fifteen years to sort of see from the time you get the sun damage to the time it shows up in your face. So if you’re getting somebody early or in their early thirties, they haven’t banked up a lot of damage. So if you do something like this, you’re going to look good for a really long time.
And then somebody who does have some banked-up damage – you’re going to have to do it over time until you pace that out.
Does that make sense?”
“And I always tell people, you know, it sets the clock, we set the clock back, but then the clock moves forward again. And it moves forward for different people at different rates.”
Q: What is the difference between UltraClear and Erbium?
A: “UltraClear is an Erbium-based fiber. It’s similar. The difference between this technology is the way the pulses are very rapid, so it’s much more comfortable than a traditional Erbium is.”
Q: How soon after Botox and filler can you do UltraClear, and can you get UltraClear if you’ve had filler?
A: “Yes. You can get UltraClear if you’ve had filler.
And how soon after it? I sort of like doing the energy-based treatments first if you’re thinking about doing them all around the same time, but there’s no harm in doing it if you’ve already had that. I wouldn’t, for instance, come in and get filler and then do the UltraClear in a week or two weeks because you might melt some of the filler if that’s what you’re getting. If you’re using something like Sculptra or some sort of biostimulatory thing that increases collagen, I’d wait about a month to let the collagen form and then do the laser device.”
Q: Does this work with Asian skin and melasma?
A: “So I’ll say that this would not be my first choice for melasma. We have several choices in our office that might be more suitable. Regarding Asian skin and skin of color, there are modes of the device that are safe. So if you have, let’s say, acne scarring, and you’re a darker, Fitzpatrick skin type or you have fine lines, you can start with the UltraClear in a safe manner.”
Q: Does it sting or burn afterward?
A: “It will feel quite warm afterward for a few hours, and then it dissipates. No one’s called us for pain medication. It really goes away quite readily, and it’s very comfortable after that.”
“You look worse than you feel for sure. And, you know, with most of these fractional lasers, you shouldn’t actually be in significant pain a day or two out. In fact, if it hurts, there’s something wrong. Most should be very, very comfortable.”
Q: What are the main side effects after treatment?
A: “Well swelling, peeling, a (temporary) brown grid, redness. Depending on how aggressively we treat the eyes or the mouth, maybe a little bloody crust.”
“But those are all expected side effects that all resolve within the week. Sometimes some patients can have a pink glow for a week or two after the procedure. And then sometimes after these treatments, people’s skin barrier can be impaired, so they can be dry. But we have strategies to mitigate all of that in the office. So if that’s something you’re concerned about and you want to be proactive about, just let us know during consultation.”
“We can work with you to make that better quicker.”
Q: Dense dark spots, is this better than the Enlighten?
A: “I would say I would still choose Enlighten for individual brown spots. If you have brown spots you can draw a circle around, I would still pick the Enlighten.”
Q: How is this different from HALO since both are ablative?
A: “Halo is what’s called a hybrid ablative laser, so it’s actually a nonablative laser and an ablative laser in one. The ablative part of the Halo is actually Erbium as well, but it only goes about a hundred microns or point one millimeters into the skin. The UltraClear can go about seven times that depth. So the UltraClear is a more aggressive device than the Halo.
It can definitely do a better job at fine lines.”
“But because of the way that it can target more specifically where it wants to lay that energy, that aggressive use of energy, and then without it, like, sort of seeping into everything around it. And that accounts probably for the quick recovery. Would you say so?”
“Yes. You can control how much residual heat you put behind. Residual heat isn’t always a bad thing. But in skin of color, you don’t you don’t want to deposit a lot of residual heat, so you can tune that down in this laser to treat all skin types safely.”
Q: In terms of downtime, does the skin shed like a chemical peel?
A: “And I would say, yes. Depending on what mode you do, you can definitely have a pretty robust peeling with this.”
Q: Can you use this for acne scarring, or how does it compare to Fraxel?
A: “Well, because it’s more ablative, I think it’s more effective in treating acne scars, but it will have more downtime than a Fraxel. And regardless of what modality we use to treat acne scars, it’s always going to be a multiple treatment, multiple session situation.”
Q: Can UltraClear treat upper lip wrinkles or under eye wrinkles?
A: “And, we have seen good results already around the eyes and on the upper lip.”
“Upper lip lines are like the bane of existence. And it’s nice to be able to say, yes, there is something we can do.”
Q: Can it help reduce very old, mature scars?
A: “You know, it’s worth a shot, but I’ll tell you what I tell patients about scars is, scars are like training a puppy versus training an old Saint Bernard. A new scar is very easy to train.
So if you have a new scar, you can, with a laser, you can basically get it to do what you want it to do”
Older scars, particularly ones that are several years out or older, are harder to make better regardless of the treatment modality.
It’s worth a shot, but you have to kind of temper your expectations appropriately.”
Q: Is it possible to get the same results with UltraClear as you would get with a CO2 laser?
A fractional CO2 laser, I would say yes.
A fully ablative CO2 laser is one that’s a very, very deep peel, and that takes two, three weeks to heal well. The UltraClear also has a fully ablative mode that you could potentially do, but we’ve had that active ablative erbium in our practice for five or six years now.
It’s just that for most of us with busy lifestyles, the active recovery (with fully ablative CO2) can be tough. And then more importantly, with the fully ablative lasers, most patients have two to three months of persistent redness, and that’s often not desirable. So what’s nice about something like an UltraClear is, you can get pretty nice results, and the redness may last for a couple weeks at most. But you can definitely approach what you get with the fractional CO2. I would say absolutely.
Q: Can you repeat the price and sessions?
A: “So face and neck for a single session is thirty-five hundred. Face alone is twenty-five hundred. Neck alone is fifteen hundred. Around the eyes is a thousand. Around the mouth is a thousand. How many treatments you’ll need will depend on, you know, your personal needs as well as your tolerance of downtime. The more downtime you’re willing to tolerate and the more aggressive the treatment, the fewer treatments you’ll need to achieve the same clinical benefit.”
Q: Can UltraClear be used on the body?
A: “So I think this is something we’re still exploring. You know, the neck is technically the body. We’ve been treating lots of necks. There is a coring mode that, you know, in some of the clinical studies they’re looking at to see if it’s useful on the body, but you’ll have to give us another six to twelve months before we can give you more definitive information on that.”
“I guess you could look at what’s going on with Ellacor and body treatments because it should follow that same”
Q: Was this developed in the US and how long has it been available to patients?
A: “This is, I believe, an Israeli company. So it’s been imported but it’s been in the United States for at least four or five years. In 2021.”
“So this is laser coring.”
“Right? Well, the laser coring elite is newer. But this technology has been, you know, the platform has been in the United States for four or five years now, but they’re constantly building on the platform.
So it’s not necessarily new. It’s been up for four or five years.”
Q: Can fractional laser be used over hair-bearing areas, including the scalp, eyebrows, and beard?
A: “Any fractional laser is safe to do over hair-bearing areas, including scalp, eyebrows, and beard, so there’s no concern about that.”
