My Favorite Device

Joel L. Cohen, MD

Denver, Colo.

As an aesthetic dermatologist and Mohs surgeon, my favorite device is the Sciton Joule platform. With one platform (and one 220-plug), I can very effectively treat facial etched-lines (especially around mouth and eyes) with full-field erbium 2940 resurfacing. I can minimize general wrinkles, acne scars, and surgical scars with fractional ablative erbium Pro Fractional. I can treat lentigines with broad band light (BBL). I can improve overall photodamage with minimal downtime of about four to five days (pigment, roughness, luminosity, and even get significant temporary pore improvement) with HALO 2.0 (and can combine HALO with BBL for more pigment improvement). I can treat sebaceous hyperplasia, macular seborrheic keratoses, and evening xanthelasma with the single shot small erbium handpiece. And I can minimize rough skin on the lips (actinic cheilitis) as well actinic damage on the face, chest, and hands with erbium micro laser peel (MLP).

I have been using this type of Sciton technology for over a decade, and it is extremely reliable with rarely needed outstanding customer service. And when new technology comes along from Sciton, it tends to be MAJOR innovations like HERO BBL “in-motion” (to avoid spot-size missed-areas or overlap issues) and ProV (vascular and vessels) that are available on a platform still with the continued, time-tested and reliable full-field erbium resurfacing, fractional ablative resurfacing, MLP as well as hybrid fractional HALO—all available as customizable options on the same platform.

Joe Niamtu III, DMD

Richmond, Va.

I literally walked around my office walked into each room or operatory and thought about what is the one device that I use the most in my office, decade after decade, year after year, day after day. It became evident that the Ellman/Cynosure 4.0 megahertz radio wave system (Surgitron Dual EMC/90) would be the king of devices in my practice. There's a lot of misunderstanding about radiowave surgery as people think that it is the same as electrosurgery, but there are many differences. These differences include the fact that the actual electrode tip does not become hot and the device produces much less lateral thermal damage then most incisional modalities such as conventional electrosurgery for laser.

I use the radiofrequency device pretty much all day every day and use it for the following procedures:

• Incisions and tissue trimming and hemostasis with facelift surgery
• Incisions, skin removal, and fat reduction as well as hemostasis with blepharoplasty
• Incisions, skin removal, dissection, and hemostasis with otoplasty
• Myotomy incisions with brow and forehead lifts
• Intraoral incisions with cheek and chin implants and buccal fat reduction
• Earlobe repair for a pressure-less incision on the mobile lobe
• “Scarless” mole removal
  - I have ablated thousands (probably tens of thousands) of moles, warts, DPN’s, etc., over three decades and no other technology has rivaled the cosmetic result achieved with 4.0 Mhz radiowave surgery.
• Reduction of hypertrophic scars
• Surgical excision of rhinophyma

One of the great advantages of this system is incision with simultaneous hemostasis and minimal lateral thermal damage.

Although I use CO2 laser for many incisions, I could not afford that technology in my early practice years and the Ellman unit was much more affordable. I now have four of these devices, so I guess I would term them essential in my practice.