2. A review in the science and experience of using an Optical and Conductive Radiofrequency System Your Speaker: Epilation And Photo-rejuvenation With The Aurora DS 

4. Hair Growth Cycle

5. Current Techniques to remove unwanted Hair Lasers Electrolysis Intense Pulsed Light Waxing Tweezing Shaving Depilatory Creams 9.8 million women spend a total of over $3.2 billion each year for hair removal services. The number of women seeking hair removal exceeds the number of men, 3:1. People are looking for a faster and less painful solution than electrology and more permanent alternative to waxing Must treat all hair colors and all skin types What Does The Market Look Like?

6. Follicle Depth And Hair Cycle

7. x-rays cosmic rays Microwaves TV and radio waves Excimer Argon KTP Dye Ruby Alexandrite Nd:YAG Er:YAG CO 2 190 - 390 488 - 514 532 577-630 755694 10642940 10600 UV VISIBLE INFRARED 400 700 Electromagnetic Spectrum (in nanometers)

8. Goals For All Contemporary Technology Efficacy is unimportant without Safety Safety is unimportant without efficacy Multiple application platforms suggest greater ROI and flexibility System should perform regardless of skin type or hair color

9. ELOS TM Technology Efficacy, Safety, Predictability ELOS TM Technology Efficacy, Safety, Predictability The combination of electrical (Radio- Frequency) and optical energy providing a synergistic, therapeutic treatment Active epidermal cooling Automatic safety and monitoring to protect the patient

10. How Does It Work? Pre-Pulse test First 10 ms + + Contact Test Cooling Test

11. How Does It Work? Light Pulse + + Target is Pre-heated Impedance of target is decreased

12. How Does It Work? RF Pulse Continues while monitoring impedance + + Higher RF Current in Zone with Low Impedance Target is heated more efficiently than dermis or skin

13. Review: How Do They Work Together? Light RF Cooling + +

14. Properties Of ELOS  Well known in medicine Is not absorbed by melanin All RF parameters (Voltage, Current, Impedance) are measured and controlled during the treatment. Examples: – Contact must be maintained with the skin or the Aurora will not fire. – Skin impedance depends on temperature and can be used for skin heating monitoring RF Energy

15. Temperature Distribution “RF Heating” RF creates heat in the 30 micron layer of the follicle that surrounds the hair shaft Heated layer includes hair follicle and bulge Follicle Shaft

16. Properties Of ELOS  Light pulse pre-heats the tissue and the target* (*vein, pigmented lesion or hair shaft) A Higher Temperature in the target area will lower the impedance of the target area. – Lower impedance provides an easier path for electrical energy to flow Light energy

17. Temperature Distribution “Optical Heating” Light heats hair shaft through selective photothermolysis Bulge and follicle are damaged due to heat transfer from hair shaft Surrounding tissue temperature is passively increased Shaft Follicle

18. Temperature Distribution - Combination Of “Optical Heating” And “RF Heating” Combination of two types of energy create uniform heating in the shaft and follicle

19. Properties of ELOS  The Active Cooling in the Aurora DS  handpiece, increases the impedance of the epidermis making it resistant to RF heating. The Cooling also provides additional comfort to the patient Cooling

20. Profile Of Short And Long Pulses RF energy Light ~25ms 50ms Short Long 200ms One pulse of light for 25 ms. TRT Thermal Relaxation Time Time necessary for target tissue to cool down by 50% through transfer of heat to surrounding tissue via thermal diffusion

21. Pre-Pulse Test o System is disabled if the following conditions exist: o If cooling temperature is not at the preset setting → “COOLING UP” appears in the display o If skin contact is not established → “BAD COUPLING” message appears in the display → “BAD COUPLING” message appears in the display

22. RF Pulse Distribution 1. RF energy distribution is dictated by the impedance distribution within the tissue. – Tissue with low impedance (warm temperature) conducts higher RF current – Tissue with high impedance (cold temperature) conducts lower RF current.

23. RF Pulse Distribution 1. Cooling the epidermis raises the impedance on the surface forcing the RF under the epidermis. The result: – Less heating in the epidermis – Greater efficacy and energy efficiency – Greater safety

24. RF Energy Distribution Cold epidermal layer Dermis Pre-heated target

25. Mechanism Of RF Selectivity Electrodes  Current density is 2 times higher in the follicle than in surrounding tissue  Heat generation is 4 times higher in follicle

26. RF Effect At A RF Effect At A Depth Of 3.5mm Human hair follicles at the edge of a treated area. Damaged Normal

27. Aurora DS  Treatment (Light Brown Hair) Optical pulse at 20J/cm 2 with no additional RF energy. Optical pulse at 20J/cm 2 and RF energy of 20J/cm 3.

28. After Before White Hair ( Aurora DS  Treatment )

29. Cross Section Of Hair From Scalp: Healthy Hair Follicles

30. Cross Section Of Hair From Scalp: Damaged Hair Follicles After Aurora DS  Treatment

31. BeforeAfter

32. Light Energy Treatment of hair is a broad band wavelength of 680nm to 980nm Light Excimer Argon KTP Dye Ruby Alexandrite Nd:YAG Er:YAG CO 2 190 - 390 488 - 514 532 577-630 755694 10642940 10600 980

33. 30 20 10 0 % Te m p Baseline temperature ISL Change Impedance Safety Limit (ISL) If the ISL is set for 10% the pulse would cut off here ISL - measures the change in skin temperature every millisecond (comparing baseline to present temperatures) throughout the pulse. If the temperature increases too rapidly (reaching ISL setting) then the pulse is stopped.

34. Fine, Upper Lip Hairs Three Months After 1 treatment

35. Two Months After 1 Treatment

36. ELOS  Technology ELOS  Technology Pigmented Lesions Vascular Skin Rejuvenation

37. Rejuvenation, Telangectasia, and Pigmented Lesions Study Syneron Aurora DSR  System

38. Phase 3 Of Study Investigation of exact therapeutic benefits and advantages of the Aurora DSR  device for Photo- rejuvenation Photo- rejuvenation and collagen repair or shrinkage have precise spatial and temperature relationships The nature and spatial configuration of RF energy and the way it radiates through the skin make it especially suited to PR by modifying collagen shrinkage and fibroblast proliferation The optical energy is especially suited for its effects on epidermal pigmentation and micro- vasculature

39. Treatment Sites Rejuvenation22 sites Telangectasia8 sites Pigmented lesions 17 sites

40. Aurora SR  Treatment Lentigines Before After 4 Treatments Photo courtesy Dr. S. Laughlin

41. Before After 2 Treatments Photo courtesy: Dr. S. Laughlin Aurora SR  Pigmented Lesions

42. Aurora Photo-rejuvenation Treatment Before After 3 Treatments Photo courtesy Dr. S. Laughlin

43. Aurora Photo-rejuvenation Treatment Before After 4 Treatments Photo courtesy Dr. S. Laughlin

44. Aurora Photo-rejuvenation Treatment Before After 4 Treatments Photo courtesy Dr. S. Laughlin

45. Aurora Photo-rejuvenation Treatment Before After 4 Treatments Photo courtesy Dr. S. Laughlin

46. Before After 4 Treatments Photo courtesy Dr. S. Laughlin Aurora SR  Photo-rejuvenation

47. Aurora Photo-rejuvenation Treatment Before After 4 Treatments Photo courtesy Dr. S. Laughlin

48. Aurora SR  Telangectasia Before After 2 Treatments Photo courtesy Dr. S. Laughlin

49. Before After 5 Treatments Photo courtesy Dr. S. Laughlin Aurora SR  Telangectasia

50. Rosacea And Skin Texture BeforeAfter

51. Immediatelyafter 2 weeks after Telangectasia Before

52. Before 2 week Lentigos 1 month

53. Before 2 weeks after LentigosAnd Fine Lines

54. Before 3 weeks after Rosacea

55. Before Immediately Aurora SR  Treatment Age Spots 1 month

56. Before Immediately Lentigos

57. Syneron Medical Thank You Questions?