1. 2007

2. No absorption into melanin and hemoglobin No absorption into melanin and hemoglobin Secondary heating from water and protein Secondary heating from water and protein Highest water content in papillary dermis Relative sparing of epidermis Highest water content in papillary dermis Relative sparing of epidermis Surface cooling provides epidermal protection Surface cooling provides epidermal protection Heating of deep dermis to 60C: Heating of deep dermis to 60C: Reduces sebaceous gland oil production Reduces sebaceous gland oil production Depending on cooling temperature and fluence Depending on cooling temperature and fluence The degree of dermal heating can be tuned accurately The degree of dermal heating can be tuned accurately upper mid lower ThermaScan: 1319 Nd:Yag

3. Temperature in the Region Near the D/E Junction Versus Cooling Time papillary dermis Scattering and conduction pre-heats the tissue under an adjacent pulse. It can take several seconds for subsurface tissue to cool 12C Cooling Devise Brief 60C Heating

4. ThermaScan Features Non-sequential scanning Non-sequential scanning Fast treatment of large surface areas Fast treatment of large surface areas Precise placement Precise placement –No pulse stacking –Eliminates heat buildup Flat-top beam profile Flat-top beam profile –No central hot spot –Uniform heating Controlled contact cooling Controlled contact cooling

5. Collagen Remodeling Thermally injure a dermal region in the skin Thermally injure a dermal region in the skin Initiate the body’s wound healing response Initiate the body’s wound healing response Stimulate fibroblast activity Stimulate fibroblast activity Exercise the skin’s wound healing ability to remodel or replace collagen Exercise the skin’s wound healing ability to remodel or replace collagen

6. Fibroblast Stimulation Following Dermal Heating James Newman, M.D. 3 weeks post 1319 tx before treatment

7. Collagen Remodeling Initiated 4 months after 1319 Tx Photodamaged, aged skin Photos courtesy of David Goldberg, M.D. New collagen

8. Low Fluence + High Plate Temp = Superficial Heating High Fluence + Low Plate Temp = Deep Heating High Fluence + Low Plate Temp = Deep Heating ThermaScan Skin Rejuvenation

9. ThermaScan Treatment Perioral ThermaScan Treatment Perioral Before After

10. ThermaScan Treatment Cheek ThermaScan Treatment Cheek Before After