Episode 66: Optimas Lumecca

Good Morning Team! It’s Saturday, and you know what that means… We’ve got another great episode of Plastic Surgery Untold in store for you. This week we’re talking about Lumecca which is part of the Optimas platform. You may remember the Optimas platform as we’ve discussed it in a previous episode when we talked about our RF Microneedling device, Morpheus 8.

Lumecca is an energy based device known as Intense Pulsed Light or IPL. IPL has many applications including the treatment of hyperpigmented spots on the skin, broken blood vessels, and improving the appearance of scars just to name a few. Many of you may have heard of IPL before, but Lumecca is unlike any other IPL device. “Lumecca delivers up to 3X more energy in the 500-600 nm range which improves efficacy for vascular and pigmented lesions. It is optimized for clinicians to treat a variety of lesions with fewer sessions.” Listen as we do a deep dive into all the benefits this nifty little device can provide. You’ll be surprised at all it can do!

Transcript

Dr. Johnny Franco: All right team. Welcome back to Plastic Surgery Untold, greatest podcast in the world, as voted by us. We got our celebrity crew back. Today we are talking about Lumecca and we’re talking about a little bit about lasers, treatment spots, treating a few, a few things maybe more on the superficial layer than we, we typically talk about. But before we get to the good stuff, let’s get to the really good stuff. What’s going on in your life T bone?

 

Travis Osborne: Oh, man, what’s new?

 

Dr. Johnny Franco: What’s not new?

 

Travis Osborne: “What’s not new?” is right. So, my wife at your Trendy therapist, also her other Alter Ego @yourdementiatherapist. I know …

 

Dr. Johnny Franco: Do we get a kickback for all these unsolicited promos? 

 

Travis Osborne: Sorry…It’s all coming around.

 

(Chuckles)

 

Travis Osborne: No, she launched her business about eight months ago at this point. So, it’s just been growing and getting more clients that are dealing with family members that have dementia, and that are the primary caretakers of those people that are living with dementia, and she’s educating them and providing, you know, a great service for those families. So, we met with her SEO and website team last week. Some really cool stuff on the horizons. She is putting on the horizon. She’s putting together a series of courses right now that are going to be for caregivers and for families that are living with somebody that is struggling with dementia. So really cool to see that kind of get underway and the progress she’s made. So super proud of her.

 

Dr. Johnny Franco: You’re the most supportive husband I’ve ever met in the world.

 

Travis Osborne: I appreciate that… 

 

Sarah Mack: Everyone should take tips.

 

(Chuckles)

 

Dr. Johnny Franco: Watch out your trendy therapist.

 

(Chuckles)

 

Dr. Johnny Franco: At the nurse injector, Austin is coming for you. 

 

(Chuckles)

 

Dr. Johnny Franco: Either hold on your man. 

(Chuckles)

 

Dr. Johnny Franco: G, what’s going on dude? 

 

Gilberto “G-Berto” Saenz III: Yeah, I don’t know if I can top that. 

 

(Chuckles) 

 

Gilberto “G-Berto” Saenz III: You know, not much is going on. My family’s been visiting recently so spending some time with them.

 

Dr. Johnny Franco: Can we say happy birthday to your dad today?

 

Gilberto “G-Berto” Saenz III: Yeah.

 

Dr. Johnny Franco: Happy birthday Papa G!

 

Gilberto “G-Berto” Saenz III: Yeah! Papa G.

 

Dr. Johnny Franco: So, his actual name’s Gilbert?

 

Gilberto “G-Berto” Saenz III: Yeah.

 

Dr. Johnny Franco: But he’s the second year the third? 

 

Gilberto “G-Berto” Saenz III: Correct.

 

Dr. Johnny Franco: Okay.

 

Gilberto “G-Berto” Saenz III: Yeah. It was his birthday, actually yesterday. My niece is celebrating her birthday tomorrow but my brother and sister-in-law planned her birthday yesterday. So, it was kind of like a combined birthday party, which was really cool. She turned two so she’s just a little baby.

 

Dr. Johnny Franco: But you’re not saying that the family tree is not a palm tree.

 

Gilberto “G-Berto” Saenz III: I’m sorry? 

 

Dr. Johnny Franco: The family tree is not a palm tree?

 

(Chuckles)

 

Gilberto “G-Berto” Saenz III: I don’t understand how you’re how you’re getting to that from what I’ve just said.

 

(Chuckles)

 

Dr. Johnny Franco: Ah yeah, nurse Sarah what’s going on with you?

 

Sarah Mack: Just excited about some new stuff in the office really recently.

 

(Chuckles)

 

Dr. Johnny Franco: Like what? 

 

Sara Mack: We got some new kits in for skincare stuff.

 

Gilberto “G-Berto” Saenz III: Oh Cool

 

Sara Mack: I know Christina and I wanted to mention, just to kind of put a little less thought into what products to pick. There are kits that are pre-made that are great for people that are getting filler or getting toxin and we have those put together already in the office. I think that’s pretty great.

 

Christine Bell: Yeah, we have a post procedure one for surgery too.

 

Dr. Johnny Franco: Oh, I need that!

 

Travis Osborne: That’s what I need. I’m not gonna make a decision.

 

Sara Mack: That’s why I love it. 

 

Travis Osborne:  I also don’t know what sunscreen you choose or moisturizer or whatever. That’s the Travis one stop shop…

 

Sara Mack: there you go.

 

Travis Osborne: I’ve been looking for.

 

Gilberto “G-Berto” Saenz III: Well, let me tell you about Austin plastic surgery…

 

(Chuckles)

 

Christine Bell: One Stop shop 

 

Gilberto “G-Berto” Saenz III: like line of products because…

 

Dr. Johnny Franco: Ooh, Yep, there is a sweet line in…We’ll come back to this because I think this is what today’s episode is about. It’s the more superficial treatments that we don’t always get into, because we always think about surgery, injectables, those type of stuff. But, you know, if you don’t start with the basics, you know, some of the other stuff can be a little bit of a diminishing return, especially as some of us mature just a little bit. But Christine, before we get into the good part, tell us you got a birthday party coming up?

 

Christine Bell: I have a birthday party coming up. Yes, but I wanted to mention…

 

Dr. Johnny Franco: Anyone who wants to go, it’s gonna be in the river…

 

(Chuckles)

 

Dr. Johnny Franco: There is a boat, rented. Hit us up on the DM …

 

(Chuckles)

 

Dr. Johnny Franco: We’re gonna be giving away what five, seven passes to join you on the boat. 

 

(Chuckles)

 

Dr. Johnny Franco: Let’s just say only five hit us up on the DM and we will let you know directions, location and where to go. Thank you, Christine.

 

(Chuckles)

 

Christine Bell: Well, one of our previous podcasts you had talked about starting small with like your workout routine and how it would become a habit. And I absolutely hate working out. I’ve never enjoyed it. I’m also a very busy mom, but I had two eon treatments done and a couple of emsculpts and I’m really trying so I’ve been running twice a week with my dog. And it helps with stress and everything. I feel so good when I do it and drinking water and I’ve lost 10 pounds in the past two weeks… 

 

Travis Osborne: Congratulations!

 

Dr. Johnny Franco: Congratulations

 

Christine Bell: Yeah. Seeing the results. I think too is hard because those first two weeks you don’t really see anything, you’re just sore and you’re miserable. And I’m like, “this sucks”, you know and everybody in the offseason cookies and pizza and I’m walking away and you know, so it’s tough, but the reward I think again, like just I feel good, you know, so that being the best, the best part. 

 

Travis Osborne: Honestly, like I think that’s the best part of working out and a good diet and exercise routine is like you feel good, you know, and yes, I think looking good comes secondary to that with that consider tendency and those long term results, but it’s that internal feeling I if I have not gotten to work out, I haven’t gotten to run, Mary will be like, alright, “you need to go run you, you’re a bear this week”, and it’s important to make time for that, 

 

Christine Bell: Yeah, 

 

Travis Osborne: Take care of yourself first, you’re not gonna be able to show up for everything else.

 

Christine Bell: Exactly, yes. And 40 is freaking me out a little bit…

 

(Chuckles)

 

Christine Bell: Like my bones are cracking and everything hurts…

 

Dr. Johnny Franco: Turn that into the best time of your life. 

 

(Chuckles)

 

Dr. Johnny Franco: Let’s do this. Let’s jump into our topic a little bit. As much as we’d love to talk about Christine’s birthday all day long…

 

(Chuckles)

 

Dr. Johnny Franco: Which is a great topic and maybe we’ll have a little bit more after. And those of you that when you’re lucky tickets to go to her party, please let us know how it turns out. But let’s talk about Lumecca and this type of laser because I think the… and I’ll tell you before when they got into aesthetics, and really interested more about this, I think some people have the perception that all lasers are the same and treat the same things, and that’s not true. I was gonna say not necessarily true, but not true across the board. And to…What does Lumecca specifically do? What does it treat? How is this helpful? Because I think sometimes people want to treat stuff, but they don’t even know what or where to go or what to do.

 

Christine Bell: Yeah, I think…

 

Dr. Johnny Franco: Wanna give us a little background? 

 

Christine Bell: Yeah, I mean, I think a lot of patients don’t refer to it as IPL. I think people know more commonly referred to as Photofacial, or photorejuvenation. IPL stands for intense pulsed light. And it searches for damaged skin cells. So, browns, reds, and it brings it to the surface little brown spots will kind of flake off over time. Helps with redness and all kinds of stuff. So I love this device that we have. Lumecca is super powerful. I think, you know, it’s really important to educate the patient on Sun prior to the treatment and after, and really having to investigate making sure that your patient, you know, knows what’s sun exposure is because people will tell you that they haven’t been in the sun, and I will see tan lines on them. But they were at the beach two weeks ago or whatever…

 

Dr. Johnny Franco: But that ain’t counted…

 

Christine Bell: Right…

 

(Chuckles)

 

Christine Bell: but it does, with laser It does.

 

Travis Osborne: It’s not even past 24 hours..

 

Christine Bell: Yeah, so Summertime is hard. But there are ways to still get your treatments done and be safe about it. But I mean, I’ve been doing IPL for 12-13 years now. And I mean, it’s a game changer. So…

 

Dr. Johnny Franco: There’s a couple of different devices that all use this different intense pulse light, and so different names for them as well. And I think sometimes it’s confusing, because there’s so many different devices, they each kind of have a different name. But maybe we’ll take a step back, and you already alluded to it, and we’ve talked about it on a few other episodes is how important the treatment is before and after. And I think, you know, sometimes people get, are willing to spend all this money on some of these laser treatments, but then they’re not on a good sunscreen, they’re not on a good hydrating treatment stuff and it almost becomes self-defeating because then you come in this cycle and you’re not really getting the results you want, you’re disappointed, you’re spending a lot of money. And when there’s some simple things you could have done to prevent this. And then to maintain, do you want to maybe start from the beginning, like what should people start with? What are they needed to do afterwards? And then maybe we can jump into a little bit more about what are not treated by this. I think sometimes people get confused. And G and Sara can jump in at any time and help us with this.

 

Christine Bell: Yeah. I guess I can go with the skincare stuff…

 

Dr. Johnny Franco: Yeah, that’s great. Let’s start at the beginning.

 

Christine Bell: So, when a patient comes in, and again, I asked them, you know, what’s your biggest concern with your skin? I also go into what are you using at home, so I get a better idea if they’re using good products or you know, not good products. And then just educating them on how sunscreen works. Gilbert and I had a really good conversation about sunscreen last week about the numbers on the sunscreen and how long sunscreen lasts. Because I think just putting …

 

Travis Osborne: That’s what I was gonna say… totally me in the dark

 

Christine Bell: It was really enlightening. But even for me, and I’ve been selling sunscreen forever, but I still you know needed some clarification on the actual number.

 

Dr. Johnny Franco: Before we get to Gilbert, can you give us a little info I feel like this is a good one for people.

 

Sara Mack: Yeah, it’s a great one.

 

Gilberto “G-Berto” Saenz III: So essentially, you know what the SPF number means is not necessarily a way of determining whether one sunscreen is stronger than another sunscreen. It basically boils down to how much time goes in between reapplying the product. So, the lower the number, the more frequently you have to reapply sunscreen in order for it to be effective. The higher the number, the less frequently you should still be reapplying, but you don’t have to reapply quite as often. So, for example, let’s say, well in dermatology, we would always recommend a bare minimum of at least an SPF of 30. And so, I would tell my patients “ with an SPF of 30, you should be reapplying this sunscreen about every hour, hour and a half more or less, depending on your activities”. If you’re in and out of the water. You want to be reapplying as soon as you come out of the water because even though sunscreen says it’s waterproof or water resistant, it still washes off. So, you want to be reapplying, you know, but if you’re just outside at a barbecue or you know hanging out, you want to be reapplying about once every hour, hour and a half, otherwise, past that point, it’s like you’re not wearing anything at all right?

 

Dr. Johnny Franco: And then a barbecue in Texas right now where you’re sweating, you might as well be in the ocean.

 

(Chuckles)

 

Gilberto “G-Berto” Saenz III: Exactly! With a higher number, like let’s say, an SPF of 50, or 75, you can maybe go like two or three hours in between reapplying. But that’s essentially what that SPF number boils down to.

 

Dr. Johnny Franco: And it does vary from person to person, because if you’re more sensitive to sun, in general, you’re still going to need to apply more frequently, correct? 

 

Gilberto “G-Berto” Saenz III: Correct. And to piggyback on that, you know, there’s a difference in sunscreens too. There are sunscreens that are called physical blocks, and then there are sunscreens that are called chemical blocks. A physical block is going to be a sunscreen that has either zinc oxide, or titanium dioxide as their active ingredients. Whereas the chemical blocks are going to be the sunscreens that you’re maybe more familiar with that have all these other different, you know, chemical names to them, which are still good, but your best ones, in my opinion, after, you know, practicing in dermatology, for as long as I did were the physical blocks because they physically create a barrier between you and the sun. Whereas the others are chemicals that you’re putting on your skin that could possibly be absorbed into the skin to some degree, which then kind of creates some blocking effect, but not the same as those of a physical sunscreen.

 

Dr. Johnny Franco: And I think sometimes people have the misconception that getting a good medical grade sunscreen moisturizer is crazy expensive. But when you look at, let’s take my mom, for example, all the stuff she has in her shelf of like random stuff that she’s picked up from Macy’s, Nordstrom, target and all those are great stores, I shop at all of them. But then you start to get this collection of stuff that doesn’t have any rhyme or reason or any purpose and may not even be the best product for your skin. And then you get yourself into spending just as much money as you would with a couple of quality products that you’re going to lead us through.

 

Christine Bell: Yeah, and I think with some of the medical sunscreens, they’re not that much more. I mean, the sunscreens at Walgreens are $15, $16, if you turn them around on the back not a lot of them have zinc oxide. So, you’re just paying a couple more dollars you know, 25,30 bucks for a really good sunscreen that’s really going to protect you. 

 

Dr. Johnny Franco: Save you a lot of money down the road? 

 

Christine Bell: Yeah, definitely! And you’re protecting your investment. Like you said earlier, you don’t want to pay for all this money to get laser treatments and remove all these sunspots and then you’re going in the sun or not using good product to maintain or help those results last… 

 

Gilberto “G-Berto” Saenz III: Skin cancer for that matter.

 

Christine Bell: Yes, more importantly, yes, absolutely.

 

Dr. Johnny Franco: But in another good point, if you have spots or stuff that you’re not worried about, that you are worried about, you should definitely make sure that you’re bringing them to the attention of you know, you should be getting skin check. Gilbert you can tell us more about that. And then you know bring them to the attention of your you know, if you’re seeing a family practice doctor or getting your any physical, if there’s spots you’re worried about, don’t just brush them off because catching something early really nips it in the bud letting stuff go becomes a big deal.

 

Christine Bell: Yes, I’m a huge advocate for that if I have ladies in the office that have multiple spots, I usually ask them “Have you been to a derm?” and try to just have that conversation it’s probably wise for you to get a spot check once a year, you know, just because I’ve seen a lot of that stuff come through and I’ve seen you know, most surgeries and stuff on random places, ears, scalps, you know, places you don’t think about. So that’s super important. But I think as far as the Lumecca goes, the reason we want to protect our skin before a laser treatment. If you go get a suntan or sunburn before Lumecca, your skin’s compromised already. And the last thing we want to do is take heat or light to compromise skin, we can cause a burn. so, you’re just at higher risk for bad things to happen, you know, so it’s really important I think to be honest with your provider, there’s nothing wrong with rescheduling a week later or even doing…We did a test spot on a lady the other day just because she was super nervous about it. And you know, she was fine. So, but yeah. Sunscreen’s super important. Vitamin Cs to help antioxidants help reverse and sun damage and free radicals you know, pollution things like that. So, it doesn’t have to be 10 products. But you know, two or three good medical grade products will help you relax, your results last longer. And you know, you just want healthy skin. I think a lot of derms like to prep patients’ skin even before these treatments. I think to see like what we can get out of the product, you know, putting somebody on a retin-A, getting them to exfoliate, getting them to hydrate, prior to the treatment just for the best results, you know, we don’t want to just do the laser treatment on you and send you on your way you know, your money needs to go a lot farther than that. So…

 

Dr. Johnny Franco: And just to finish the topic on sun and sun exposure and sunscreen, how about after the treatment? Because your risk for causing problems for yourself if you get one of these treatments, and then go out and lay by the pool the next day?

 

Christine Bell: Yeah, I definitely ask them what are their plans…

 

Dr. Johnny Franco: What do you recommend for people? 

 

Christine Bell: I mean, I don’t want them in the sun for two weeks prior two weeks after you know and I mean that’s laying out in the sun and the two and from the store, yeah. Put sunscreen on, wear a hat. Just Be diligent with it. But as far as like going on a cruise the following weekend? Absolutely not. You’re just going to, you know, cause more damage and just reverse everything that we just did you know…

 

Dr. Johnny Franco: Anything that you do differently in terms of sunscreen, other than just being careful with the not laying out at the pool or other stuff you guys would recommend after treatments like this? If not, then that’s okay.

 

Gilberto “G-Berto” Saenz III: No, I mean, that’s pretty…

 

Dr. Johnny Franco: Just being diligent. 

 

Gilberto “G-Berto” Saenz III: Just being diligent, you know. So, these are some protection, sunscreen use, you know, sun avoidance.

 

Christine Bell: Yeah. And that with the Lumecca, you do get, I like to call them coffee grounds, because that’s just what it looks like. But the spots get darker almost immediately during the treatment, and then over the course of a few days, they rise to the surface of the skin and you can feel a little texture, they feel a little rough, so moisturizing those and not picking them off. I have patients that just could not help themselves and pick the scab off too early. And that is part of the healing process. So, when that happens, you’re causing hypo pigmentation, you can take the pigment out of the skin, which is super hard to correct later. So, you know, I’m very verbal. I mean, it’s almost a warning, like, do not pick your skin do not do these things. And we send them home with little post care cards. They don’t have to remember all this. But yeah, just treat your skin gently and wear the heck out of your sunscreen. So…

 

Dr. Johnny Franco: But so, if I’m doing this procedure, and I’m planning like my life and stuff. I mean, how much downtime do I have? Can I do stuff? What am I going to look like? What should I plan? If I have a wedding that I want to go to, you know, can I do this the day before? Should I not…get yourself where we’re at? 

 

Christine Bell: Yeah, Sarah has had this done. So yeah, tell us a little bit.

 

Sara Mack: So, I’m someone who struggles with hyperpigmentation and brown spots on my face. I have been putting it off for a while. And now that I’m finally in the middle…

 

Dr. Johnny Franco: And we’re gonna get back to pigmentation on the face and melasma because they’re different, right?

 

Christine Bell:  Yes! 

 

Dr. Johnny Franco: So, I just don’t want to confuse people. But we’ll talk about that. But continue because sometimes, not all spots on the face or the are the same…

 

Sara Mack: And I think that’s a good point to make. Maybe Gilbert can help us out with that too, in a minute as far as what is treatable and what’s not true. But personally, I have been crazy with staying out of the sun crazy with covering my face because I did do a peel for my pigmentation that I did one treatment of Lumecca and personally somebody who feels that they return so easily, it takes a lot shorter of a time than you think. If I were to go out in the sun for 20 minutes, I have like 10 new spots. So, I think it’s just being really diligent about knowing your skin to knowing how quickly it returns, because you don’t want to spend thousands of dollars on these treatments, only to turn around and ruin it the next week.

 

Dr. Johnny Franco: But so from a cliff notes standpoint, if I have a big event that I’m worried about, what’s the closest amount of time that I should do like you know, one of these IPL treatments prior to that?

 

Sara Mack: I would say two or three weeks.

 

Christine Bell: To be on the safe side, two weeks. Everybody’s different and I don’t know if it has something to do with age and cell turnover, but some of my younger patients’ spots flake off really quickly within a matter of days and then you know, my mom’s in her 60s and her spots hung on for two weeks and it’s still there.

 

Sara Mack: When we did my treatment I definitely had a few that fell right off and others took about seven to 10 days. So, I think two weeks out is good because the other thing to think of with the Lumecca, it’s a great treatment, but it darkens them initially and so you don’t want to have a wedding in a week and now your spots that you don’t like are 10 times darker because you’re waiting on them to fall off so…

 

Christine Bell: It’s one of those treatments that looks worse before it gets better. 

 

Sara Mack: Absolutely I think that’s a point to make.

 

Christine Bell: Yeah,

 

Dr. Johnny Franco: And for T-bone here, this has to be a procedure that we don’t need celebrity anesthesia. Is that correct? 

 

Sara Mack: Yeah, there is…

 

Dr. Johnny Franco: Because makes me super happy if that’s true.

 

(Chuckles)

 

Sara Mack: Yeah, you do not topically numb for Lumecca.

 

Dr. Johnny Franco: And you’re also not asleep? 

 

Sara Mack: Yeah, you’re not asleep, you’re awake. It does feel just like a very tiny little rubber band though. It’s very tolerable. And then to Gilbert’s point, we do have Pronox in the office so if you need a little bit more help with discomfort you can do some Pronox. How does it feel that you’ve been replaced by a machine that you can suck on?

 

(Chuckles)

 

Travis Osborne: How am I supposed to get a G five if…

 

(Chuckles)

 

Sara Mack: We don’t need you?

 

Travis Osborne:  Yeah. This is ridiculous. 

 

(Chuckles)

 

Travis Osborne: I’ll be there for moral support. If anybody needs anyone to come in and hold their hand during the procedure, let me know

 

Sara Mack: Sometimes they just like you tp tap on their phone or we could come to do this.

 

(Chuckles)

 

Dr. Johnny Franco: Yeah, can we have Travis come in and do a little distraction technique?.

 

Travis Osborne: Yeah. We call it “There-There Anesthesia” 

 

Sara Mack: Okay, Perfect! We need you there.

 

(Chuckles)

Dr. Johnny Franco: So, come into celebrity anesthesia doing a little “there-there anesthesia” …

 

Travis Osborne:  That’s right. 

 

Sara Mack: Perfect!

 

Dr. Johnny Franco: So, nothing but the best for our patients. 

 

(Chuckles)

 

Christine Bell: Tell that to conference.

 

Dr. Johnny Franco: Can we give her… Do you mind? Maybe between the two of you Christine. Who’s a good patient for, a good candidate for a Lumecca IPL treatments. Who’s not? because we alluded to a minute ago, not all spots on the face are the same. Some are very well treated, others are not.

 

Gilberto “G-Berto” Saenz III: Yeah, So at the foundation of it all. Essentially, people with lighter skin tones are excellent candidates. Darker skin tones cannot be treated with Lumecca. There is this whole grading system in dermatology called the Fitzpatrick scale, where it grades individuals from a grade one to grade six in terms of how fair they are to how dark complected they are. One being the fairest, six being the darkest. So essentially, anyone who’s like a five or six cannot get Lumecca treatment because of the amount of pigment that they have in their skin and introducing heat and light into those types of patients is going to trigger hyperpigmentation or dark spots. So, it’s going to create problems as opposed to help problems. Anyone who’s like a 1,2,3,4, , those are good candidate patients and three, four, you know, you still have to be careful because those individuals can still hyper pigment but, they’re in a safer spot than someone who’s a five, six. And just to kind of give you some examples of what each number kind of represents, someone who’s a one would probably be like a fair complected individual with light colored eyes, light colored hair, reddish hair, things like that. Someone who freckles very easily when they’re out in the sun. Someone who’s like a three or four might be someone who is like Hispanic or Middle Eastern descent, maybe even some Asian descent, you know, and then five, six, you’re kind of getting into more of like, darker complected individuals. Either like really, really dark, Middle Eastern, dark Hispanics, African Americans things and along those lines. So, it kind of gives you an idea of you know, who might be a good candidate who isn’t?

 

Dr. Johnny Franco: What about… Because one of the things that we see a lot is melasma. Does IPL, is the laser treatment for melasma? Or is there a better treatment for that? The people want to know. Anybody want to answer that one? Because I feel like this is one that people get confused on.

 

Sara Mack: Yeah! I think that’s a great point that I get asked all the time.

 

Christine Bell: So going back to the consultation, I tried to identify what those spots are when I see my patients, so I ask a couple questions. There’s usually some characteristics with melasma that can be seen cheeks, upper lip, forehead, usually, and then hormonal changes, stuff like that. If they’re just kind of like freckle looking sunspots, the shape of them where they are, how long they’ve been there and also still getting my patients history. Were you in the military? Have you spent all your life in the sun? Where you a farmer? You know, stuff like that. 

 

Dr. Johnny Franco: Does this come after pregnancy?

 

Christine Bell: Right. Maybe somebody never, you know, I’ve worn sunscreen all my life, but this showed up after my baby, then I’m like, boom! you know, it’s probably melasma. And if I’m unsure, then I’ll grab Gilbert. I love having him in the office just to kind of, you know, second set of eyes, make sure that I’m selecting the right treatment for the patient. 

 

Dr. Johnny Franco: But why is it important to… because the point that I’m getting to is why is it important to know whether it’s melasma or sunspots?

 

Christine Bell: So, lays, so, heat can make melasma worse. It can force those melanocytes to over stimulate and cause the pigment to get darker. So chemical peels are usually the route to go for melasma with compound creams, retinal brighteners, stuff like that, so much safer to do that.

 

Dr. Johnny Franco: And that was the point I was trying to get to is that like you did this, this treatment’s great. It’s not for everything. And then this is the point of seeing some providers that are going to help like spend a little bit of time actually talking to you going over through this because we’re going to help guide you to the right treatment because I think a Lumecca, IPLs are great, and they really help a lot of people, but they’re not the treatment for everything. You know, we talked about one of our previous episodes, you know hammer works great for a lot of things, but not for everything. 

 

Travis Osborne: Yeah.

 

Dr. Johnny Franco: Is that true for anesthesia?

 

Travis Osborne: A hundred percent, Yeah we…

 

Dr. Johnny Franco: You love the hamme?

 

Travis Osborne:  In our business, we have the expression, there’s 1000 ways to skin a cat, you know, a lot of them get us to that endpoint that we’re looking for, you know, general anesthesia, pain relief, blah, blah, blah, whatever we’re doing, but there’s a million ways to get there and I think skincare is very similar right? You want to get to that patient’s end result. How you’re getting there? Totally different with those different tools in your tool belt.

 

Dr. Johnny Franco: And just for the people listening to, No cats were actually injured. 

 

(Chuckles)

 

Travis Osborne:  Sorry. I apologize.

 

(Chuckles)

 

Dr. Johnny Franco: What other…

 

Travis Osborne: It’s a figure of speech.

 

Dr. Johnny Franco: We’ve talked about face, but can you use IPL in the neck, chest or other areas of the body? 

 

Christine Bell: Yeah

 

Sara Mack:Yeah

 

Dr. Johnny Franco: I feel like bikinis are getting smaller and smaller and we got to be looking good all over.

 

(Chuckles)

 

Sara Mack: Neck, chest and hands. I feel like hands are another great spot for Lumecca. Everyone gets the age spots. We’ve actually done quite a few in the office that I believe are posted on our Instagram, Austin plastic surgeon. You can check out some great before and afters mixed with filler, and you know things like that we can really rejuvenate the hands. 

 

Christine Bell: Yeah, I did some shoulders. I had a girl that had freckling all over her shoulders and arms and that one turned out really well. And she’s like Gilbert said you know, the lighter the skin type, the lower the risk so we’re able to kind of turn it up a little bit and get aggressive. So, two treatments, the spots are almost gone. You know, it’s pretty impressive.

 

Dr. Johnny Franco: And what about timing? Because I know sometimes with appeal, sometimes laser stuff tends to be something that I’ve always heard that they’re better in the, in the winter than the summer. Is true? Not true?. Is that factor fiction?

 

Christine Bell: I mean, I guess it would be a fact that it…

 

Dr. Johnny Franco: Oh, Okay.

 

Christine Bell: it’s safer to do them in the fall, but…

 

Dr. Johnny Franco: Is that mostly because it’s just the weather’s not great and we’re not out on the sun?

 

Christine Bell: Right! Exactly. Because people aren’t, yeah, people are usually busy and doing things during the summer. But if you’re that person that’s gonna, you know, plan to be home for a week or two, and you have time to do that, I think we can still do these treatments during the summer. But again, it’s having that conversation. It’s super important that you don’t get some exposure, and kind of listening to your patient to if they’re talking about a trip, because sometimes you have that conversation, and then you get ready to do the treatment. They’re like, “Oh, yeah, I can’t wait to go to Cabo” and all and I’m like, “Wait, what?” You know. So that’s important. You really have to have the conversation.

 

Dr. Johnny Franco: So maybe doing somebody’s treatment, right before you’re getting your mom a makeover. Can you get me home anyway? 

 

Christine Bell: Yeah! 

 

Dr. Johnny Franco: So, then you can get have a little downtime.

 

Christine Bell: I’ve totally done that. Seeing one of your patients two weeks prior, Because she’s like, “I want to be home. I have time to appeal” Yeah, let’s do it!

 

Dr. Johnny Franco: Okay, Cool!

 

Dr. Johnny Franco: What other nuggets would you guys like people to know about IPL and these treatments? I feel like we’ve talked about pre, post-care, being careful about that, and some of those nuggets.

 

Sara Mack: I think another great point to make about Lumecca is it also treats red tones. We’ve mentioned that earlier. But one of the things that I feel like a lot of our patients are super excited about is the little broken capillaries and little vascular lesions on the face. I don’t think we realize how many we have until we get them in the room. We shine the light, and we actually show them. They make such a significant difference on the cheeks, around the nose. And that’s pretty instant if we have the energy just right, we can get rid of them with one or two treatments. 

 

Gilberto “G-Berto” Saenz III: It’s awesome. I think it’s also helpful for scars, especially…

 

(all agree)

 

Gilberto “G-Berto” Saenz III: Talking about talking about the reds in red tones in the skin. As a scar heal, when a scar first forms, it’s typically in that reddish hue, before it eventually kind of fades away to white. And that’s kind of just like the progression of a scar in terms of color. And so when it’s in that reddish hue and that reddish tone, where it’s like reddish, purplish, pinkish color, you can actually draw out some of that redness in those incision lines and improve the appearance of the scar fairly quickly.

 

Dr. Johnny Franco: And it’s funny because I get a lot of people who…the redness does get better on its own with some time, but sometimes time is like a year, year and a half. And so, you know people want some of that color out a lot faster. I do think this works great to get some of those things out. How about bruises? Does it help getting bruises out a little bit faster at all, or not really when you talk about it? 

 

Gilberto “G-Berto” Saenz III: So, in my experience, I think that there are other treatment modalities that are better for bruises than IPL. I can’t say that I have a lot of experience treating bruises with IPL, but I have treated bruises with other devices, something called pulsed dye laser or PDL laser, which targets more of the like hemoglobin and the hemosiderin in the skin. So, I think those work a little bit better for bruises. So that’s been my experience.

 

Dr. Johnny Franco: And sometimes people ask but, just so everything was clear, IPL is not a skin tightening device and so this is a little bit different and this is why we have multiple things in the office per se.

 

Christine Bell: So that would not be the device that I would go to for skin tightening but you do get a little bit of collagen stimulation just with the light…(Chuckles)

 

Christine Bell: I mean that’s why people call it the photo rejuvenation, you know, Photo facial. So, I think there’s a little bit, but if somebody came in just for skin tightening that’s not the route I would go yeah

 

Dr. Johnny Franco: And this is where the consultation is super helpful is to help make sure that you get the right treatment and we see it with our injectables all the time somebody comes in and says I want Botox but they really you know, need some filler, they need some other things and sometimes it’s a combination of these treatments and there’s only so much we can do at one time. You know it can’t really do a peal laser you know, Botox everything in like 130-minute session stuff, you know, we have this with some of our surgery patients like, let’s figure out what bothers you the most let’s come up with a game plan and sometimes that game plan takes time.

 

Christine Bell: So, with the Lumecca and Morpheus, you can actually do them together in the same appointment. I would do the Lumecca first because we’re working with the surface of the skin and then I would apply numbing cream for about 30 minutes, rolling the Pronox if they need it and then do the Morpheus that takes about another 30 minutes if we’re just doing face. So, I mean if you can get them all done in one shot, you know

 

Dr. Johnny Franco: New question I think the more you can get done or things, because it’s hard for people to get time off. They’re gonna have a little downtime that’s grea. And I think this is where the provider kind of helping, guide you a little bit of what we can and what we can’t do in one setting and sometimes there’s things you can do, we just got to adjust the order a little bit.

 

Christine Bell: Yeah, we got to be careful with injectables and spa stuff and our , you know, the scheduling team I think is really good about making sure that they’re, you know, because you can’t lay back after Botox and you don’t want to get filler and then come get a facial or you know, because we’ll be Pressing around in areas that are tender and we don’t want to move products. So, I think that’s, the order of operation is super important. 

 

Sara Mack: Yeah, they see you first and then us.

 

Dr. Johnny Franco: Awesome. Any last kind of IPL laser tip stuff that you guys want to leave our listeners with?

 

Gilberto “G-Berto” Saenz III: Just a couple other things that we didn’t mention in terms of what it might be helpful for acne scars, stretch marks the appearance of stretch marks to, you know, those are some other areas where I think it can it can help minimize the appearance of, I mean, not gonna make them go away entirel, but I think it’s, you know, important to note that there’s some improvement in the appearance of those with the Luma treatment.

 

Dr. Johnny Franco: And the stretch marks, isn’t that another one where sometimes people can really benefit from combo treatment? Because they treat different stuff as we’ve talked about here right? So doesn’t Lumecca help get some of the redness and color out of the stretch marks where the other Morpheus, ERF might help just tighten up that skin a little bit and maybe …

 

Gilberto “G-Berto” Saenz III: Exactly!

 

Sara Mack: Texture.

 

Dr. Johnny Franco: Smooth them down just a little bit. I think that’s another great example to what Christina said earlier, if where sometimes a combo treatment is great, and this is where we can help them a little bit. And I definitely feel like we get people come in they want one. And we’re like, that’s, you know, and I think Travis, maybe said on the last podcast where it’s figuring out what their actual concern is. And we spent a lot of times and I know some of them as soon as you’re done and asking you a thousand questions, but we’re really trying to figure out what bothers you and so that we can help you get to a spot that’s going to fix that or improve it at least 

 

Gilberto “G-Berto” Saenz III: Yeah, I agree. 

 

Christine Bell: I learned early on in my career not to point out somebody’s flaws before they speak because I had a woman that I thought she was there for spots because she was covered in them. And I just assumed, and she said the spots didn’t bother her and she was super offended. So, I like to let them speak and tell me what bothers them. Because it may just be, you know, something really simple and we don’t need to spend thousands of dollars on you know.

 

Dr. Johnny Franco: It’s such a good point because even when I know somebody’s here for breast talk, although it’s just ask them like, What can I help you with? What can I do for you? Because even the way they present it always tends to lead you a little bit of what their mindset is in terms of what their overall goal and I feel like if you over direct them, then it doesn’t let their true kind of concern come out sometimes.

 

Sara Mack: Yeah, another great tip that I have. I’ve loved real self and we’ve done some events with them, and I know you’re really, you know incorporated with them as well. I tell a lot of my patients what’s great about the website is you can go type in 40-year-old female sun damage Morpheus and you can get all of these before and aftes. And so, sometimes I’ll send them there if they’re not quite all the way sold on it and they just want to see what to expect, go on there and scroll through, you know, hundreds of photos so that you have a realistic expectation of what to expect and there’s tons of good stuff on there.

 

Dr. Johnny Franco: Gilbert, any other nuggets? That was a good one, The scars.

 

Gilberto “G-Berto” Saenz III: No, that I think that pretty much covers it. 

 

Dr. Johnny Franco: Awesome! Well, any behind the bovie nuggets you guys would like to leave us wit?

 

Christine Bell: I am still working on this booty facial. It’s a kind of facial to help brighten dark spots on the butt cheeks. And, what was the other one? Ingrowns, like acne, a lot of, you know, ingrown hairs, little bumps, stuff like that. So, coming up with like a light peel or an exfoliation process. Little HydraFacial on the buttocks. Yeah, so something in the works on that.

 

Dr. Johnny Franco: Some stuff to come. 

 

Gilberto “G-Berto” Saenz III: Yeah I got a behind the bovie nuggets…

 

Dr. Johnny Franco: Oh, yeah, give it to us.

 

Gilberto “G-Berto” Saenz III: About Lumecca So what kind of sets Lumecca apart from other IPL devices is the fact that it’s able to treat these pigmented lesions at energy that is three times stronger than most other IPL treatments safely, and with less discomfort. Meaning that it will get you to the endpoint that you’re looking for in fewer treatments. So that’s one of the… 

 

Dr. Johnny Franco: We liked that.

 

Gilberto “G-Berto” Saenz III: Yeah, it’s cool. So, it’s three times stronger and gets you where you want to be sooner.

 

Christine Bell: The lasers are like cell phones. They come out with new ones all the time. They’re better. They’re faster. They’re in this one. Just again, using my mom as an example. I’ve treated her with several different IPOs in the past and this one she said was the most comfortable out of all of them. So… 

 

Dr. Johnny Franco: Oh, great.

 

Sara Mack: I’m super impressed with it. I mean for how amazing the results are. The downtime is minimal compared to a lot of stuff you see on the market. So…

 

Dr. Johnny Franco: Hopefully we don’t have to replace this one every six months… (Chuckles)

 

Sara Mack: We plan to keep this one. (Chuckles)

 

Dr. Johnny Franco: Could we do a quote of the day? 

 

Travis Osborne: I think G’s got this one.

 

Gilberto “G-Berto” Saenz III: Yeah, I got a quote. So, I found this one to be kind of interesting. It doesn’t necessarily apply to our podcast today, but I thought it was pretty cool. Max Lucado said, “A man who wants to lead the orchestra must turn his back on the crowd.” So, like essentially what that means is you know, if you want to be a leader, you can’t let, you know the crowd be an influence on you in any way. So, you got to just , you know, do like, just do what you’re gonna do, and don’t allow anyone to be a naysayer or hold you back or do anything, but in order to make beautiful music, you got to turn your back on the crowd.

 

Dr. Johnny Franco: Damn! That’s a good one. I like that.

 

(Everybody agrees)

 

Dr. Johnny Franco: Well, on that note, see what I did there?… (Chuckles)

 

Dr. Johnny Franco: On that note, thank all of you for listening to plastic surgery until greatest podcast in the world as voted by us. You can download us anywhere you get your favorite podcast, iTunes, iheart, Pandora, Spotify, and tons more. So, we’ll see you guys soon. All right bye.