You are newly working with the FOTONA laser at the AFI clinic. What is the instrument used for?

The FOTONA Nx Line the latest state-of-the-art multi-functional laser, with which we are able to treat not only medical lesions, as it can also be used in purely aesthetic and corrective dermatology. It contains two types of beams, namely erbium (Er:YAG) and neodymium (Nd:YAG). The erbium beam is used mainly for vaporisation and ablation of surface structures that protrude above the surrounding surface; we most frequently treat age warts, skin fibromas and raised scars.

In the case of Er:YAG, a special SMOOTH mode is used to firm up the skin by heating the deeper layers of the skin without disrupting its integrity. This stimulates the connective tissue cells (fibroblasts), which start to produce new, firm, elastic and parallel collagen and elastin fibres. It thus serves for firming and rejuvenating flabby areas (e.g. around the eyes and mouth, directly on the lips). Unlike in the case of Nd:YAG, the beam has no effect on the surface of the skin, but rather penetrates into the deeper layers and targets the colour pigment (mainly melanin and haemoglobin), and it is most commonly used for the treatment of vascular manifestations such as haemangiomas, venous lakes on the lips, port wine stains (congenital vascular birthmarks) and dilated blood vessels in the face (rosacea) or elsewhere on the body (varicose veins on the lower limbs).

Nd:YAG has a rejuvenation mode similar to that of Er:YAG (SMOOTH), namely the PIANO mode, which targets even deeper structures. By stimulating those structures, we are able to achieve even greater firming of the tissue and better elasticity (tightening), i.e. rejuvenation.

What are its benefits?

Unlike invasive methods (injection and surgical), it isn’t necessary to use a needle, cannula or scalpel. In the case of rejuvenation treatments (SMOOTH and PIANO modes), we aim mainly for prevention, when we stimulate the natural functioning of the body’s cells without the use of any foreign material. We are able to re-stimulate and restart those cells’ abilities, which have diminished in the process of aging. We thus strive to convince the body that it is younger.

In the case of the ablation modes, we remove growths layer by layer in order to ensure that the resulting scar is as aesthetically acceptable as possible; in comparison with surgical methods, it is nearly invisible. However, it is important to point out that medicine always takes priority, so we can proceed with laser treatment on a client only if the given area has been dermatoscopically checked by a dermatologist and is completely free of any signs of a dangerous malignant growth.

Is treatment painful for the patient?

In the case of protruding skin lesions, the ablation mode is perceived as intensive scraping, which is tolerated without problems in most cases; it isn’t necessary to apply any local or injectable anaesthesia. In the case of more extensive manifestations, I’m inclined to use numbing products in order to ensure the greatest possible comfort for the client; we may use a numbing cream (EMLA) or injected anaesthesia. In the case of a larger number of small manifestations spread out over a larger area, I also use direct cooling with dry ice, which numbs the skin.

When it comes to the removal of vascular lesions, I would like to mention a revolutionary innovation that uses incorporated cooling with water mist, which is evenly sprayed over the treated surface and cools the tissue, so the treatment of vascular manifestations is almost painless. In comparison with the Nx Line, treatment of vascular lesions with other types of lasers is relatively painful. I would liken it to being pinched with a stretched rubber band.

How to make an appointment

We perform the procedures at the AFI clinic in Prague 6 – Veleslavín.
You can make an appointment via the client line at +420 222 300 300 or at the clinic’s reception desk.

Price list of services - Aesthetic Dermatology 

MUDr. Jana Krabcová, Ph.D., dermatovenerologist at Canadian Medical