One of the really interesting interviews I had at the LCMC2014 (Laser Cosmetic Medicine Conference) held in Melbourne in November 2014 was with Dr Stephen Eubanks who was a guest speaker from Denver in the US. Dr Eubanks presented several topics including body shaping using a new high energy bipolar radiofrequency device, and had me absolutely mesmerized from start to finish. I also had the opportunity to ask him a few questions for our readers.
Trish: Dr Eubanks, there are so many different types of brands of lasers, radio frequency devices and technologies that are available to us now, and you use quite few in your practice. In your opinion, what makes one laser better than perhaps another laser?
Dr Eubanks: Well, I think it is important when you are getting a laser; the number one thing is that it will do what it has promised it will do. And number two, the company will stand behind it if there’s a problem, or a problem with their training; they will support you. What really differentiates all the different companies is their quality, their safety, and their support.
I tend to use a lot of Candela Syneron products because I have worked with their company for almost 20 years and I know that their training and their support if something goes wrong with the laser is superior against other companies.
Trish: Yes, and like you mentioned the maintenance program so you don’t have to worry about when anything goes wrong.
Dr Eubanks: Well, there are 2 groups – radio frequency devices rarely breakdown and so all their companies have good service contracts. The high end lasers often have different problems and must have service on them. That’s where it’s important to have a big support staff.
Trish: Yes, that makes so much sense. So in recent years, cosmetic surgery has become more and more popular. What is the most remarkable increase or advance in a particular type of treatment or surgery that you might have noticed?
Dr Eubanks: Well things that have changed so much for me are the fractional lasers. And fractional lasers are the ones that actually just have pin point application of laser or radio frequency leaving normal tissue uninvolved. What that enables us to do is dramatically reduce the side effects that fully ablative lasers had 10 years ago.
Trish: I had fraxel treatment or fractional laser treatment myself about 5 years ago and out of everything that I’ve ever done that’s the best thing that’s been the most noticeable over time which I’ve noticed in myself.
Dr Eubanks: You are able to be much more aggressive using fractional devices. Then the second thing that is really coming into its own in the last 5 years has been radio frequency devices. They’re very, very different than lasers. Lasers are actually attracted to some target of color, or maybe water. Radio Frequency just has to do with resistance in the skin so any skin color can be treated with radio frequency.
Trish: And is there also tightening of the skin at all with the radio frequency?
Dr Eubanks: Radio frequency does several different things. The device I primarily use is sublative, which is purely fractional radio frequency; it started out as a wrinkle treatment and that’s what it’s really good for, especially around the eyes. This is because you don’t need eye protection, as radio frequency does not go into the eye at all. What it’s really, really effective for is acne scars. It works in different ways than laser. Whereas lasers poke pure holes, radio frequency goes to the skin and moves around the wrinkles and scars; as the radio frequency changes direction it heats up, and that’s how it remodels things like pores and acne scars.
Trish: Great. OK. So a really interesting question and one that I actually get asked all the time, is would you recommend or are there any lasers that people could consider using at home? Like the do it yourself?
Dr Eubanks: See, right at this point I don’t know what user home lasers are really effective for…
Dr Eubanks: I happen to be a big believer in low level laser light – it does a lot of interesting things and there are some home units; I just honestly don’t know how effective they are; if they really are consistently delivering what you need.
Trish: So buyer beware on this one; if you want to get something done, get it done properly or it won’t really do any good.
Dr Eubanks: Everybody says that this machine is perfect for this and that, but there is no data to support many devices yet.
Trish: So getting on to fat freezing. How do you think that this compares to the freezing of fat; we’re talking about the Vela Shape III which is all about fat removal.
Dr Eubanks: Right, so I look at fat removal in 2 ways. One is fat destruction and the other one is fat cell emptying. For fat cell destruction, I still think probably new gold standard in freezing is Coolsculpting and Vela shape III is the gold standard right now for fat cell emptying. Everybody’s going to say well I’d rather destroy it than empty it. When you destroy it there are lots of side effects; there are nerve issues, and the potential of prolonged pain you get when destroying fat with freezing.
Trish: So you mentioned (in your speaker discussion) about the three treatments that people should have; but I did notice a difference with just one treatment. With all those treatments is there any skin tightening that comes along with the fat removal because initially people who lose all that fat have a whole lot of leftover skin?
Dr Eubanks: One thing about Vela Shape III is that it is actually more effective in treating cellulite than it is just removing fat. There is heating of that superficial dermal layer that strengthens and tightens the skin. So one of the real differences between Vela Shape and the others is the ability to make cellulite better and to tighten skin. That is a unique feature in the way that RF (radio frequency) is delivered.
Trish: Alright, that’s great. That’s really, really helpful. Thank you so much.
Dr Eubanks: Alright, very nice to meet you.
Trish: You too.
Dr Stephen Eubanks currently practices medicine in Denver, Colorado in the United States, and specialises in dermatology. He is Assistant Clinical Professor at the University of Colorado Health Science Centre and has been lecturing and teaching laser related courses internationally for the last 18 years.