5th abls aec symposium 13dec20

• Combination Treatments
คนยุคนีอยากไดอ้ ะไร ไดท้ นั ที ไมอ่ ยากเจบ็ ตวั มาก ดงั นนั ในบางกรณี คลินิกความงามควรสร้าง
นวตั กรรมใหม่ เช่นการทาํ Combined Face Lift Surgery มีการผา่ ตดั เสริมความงามร่วมกบั การทาํ
หตั ถการทีไม่ใช่การผา่ ตดั เชน Filler ,Botox, PRP, Thread Lift ร่วมดว้ ย ทาํ ใหก้ ารผา่ ตดั เท่าทีจาํ เป็น
ทีเหลือ เป็น non-surgical procedures.
• Minimally Invasive Facelifts
ปัจจุบนั การทาํ invasive facelift หรือ full face lift ไมค่ ่อยทาํ กนั แลว้ เพราะใชเ้ วลานาน อยู่
โรงพยาบาลนาน ค่าใชจ้ า่ ยมาก และ ผลขา้ งเคียงมากดว้ ย การทาํ SMAS Lift อยา่ งเดียว หรือร่วมกบั
non-surgical procedures จึงเป็ นทีนิยมมากขึน ค่าใชจ้ ่ายนอ้ ยลง downtime ลดลง complications
ลดลง

ทีมาของการเขียนเรืองนีเพอื ใหข้ อ้ คิดกบั ชาว ABLS ในการประกอบธุรกิจ คลินิกความงาม
ขอใหป้ ระสบความสาํ เร็จในการงานตลอดปี 2021 ดว้ ยนะครับ

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GROUND BREAKING COSMETIC LASER SURGERY CONCEPT

In 1900’s the two rivals but both were twice noble prize warded , Max Planck and Albert
Einstein initiated the quantum theory and stimulated emission . Their theories took another 50 years
to realize the first laser machine (Maser) .

In 1963, Leon Goldman, also known as the “father of lasers in medicine”, was the first to use
the laser in dermatology. In his first studies, Goldman reported the effects of Maiman’s laser (ruby
laser ) in the selective destruction of cutaneous pigmented structures, like black hairs.

In 1966, Mester, having discovered the positive effects of low-energy red laser on hair growth
in rats, and the its healing on ulcers.

Only a year later, Dougherty experimented with the use of laser in activating photosensitive
substances which were able to bind and destroy cancer cells selectively. This was the origin of
photodynamic therapy.

1980 Rox Anderson and John Parrish initiated the ” Selective Phototherapy ” laser treatment
theory. His theory is based on the experiment with Port Wine Stain (PWS) , the capillary size 120-
150 micron.

The eighties are also characterized by the first use of a photo-acoustic laser in the treatment of
penis plastic calcifications .

SPT could not explain many episodes in laser surgery . 2001 GB Altshuler and RR Anderson
made the ” Extended Theory of Selective Photothermolysis to explain laser hair removal.

Both the above theories have the sample principle in ” removing target tissue in toto” ,
irradiating the whole target at once.

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WHAT ARE PROBLEMS OF THIS CONCEPT ?
1. This conventional concept consider enough irradiation energy to remove the whole
target without injuring adjacent tissue. But this is only a theory . In real world practice
, we cannot apply accurately the exact laser dose to irradiate the target tissue through
its whole depth ( because we are not certain how deep it is .) So, most of the time for
novices in cosmetic laser surgery run into either ineffective treatment or
complications.
2. The concept does not give value to biological response of living tissue to irradiation
. Living tissue absorbs laser energy and converts it into heat energy. Heat causes
biochemical changes as well as physical changes in the tissue. The temperature of
the histological water in the tissue is raised up from 37°C to 100 °C. During
temperature rise, there is a cascade of change in the tissue in various temperature ,
like we fry raw park in a hot oil . The color of the tissue changes. Degeneration
occurs. The conventional concept does not define any of these changes . Practitioners
only use laser equipment by protocols they have been advised by suppliers or their
peers.
3. Skin tissue is not a homogeneous one. It is heterogeneous. Physical properties varies
from person to person and place to place of the same person. There is different
absorption, scattering . Using the same protocol for every person or the same
parameters and techniques everywhere on a client’s face is not a good algorithm.
4. The conventional method describes vague “End Point” & ” Complications”. We
have seen many episodes of “person’s end-point is another person’s complication “.

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LAYER BY LAYER CONCEPT(SLT)
The principle of Soft Lasing Technique (SLT )

We have seen a lot of laser complication in aesthetic procedures done by novices in laser.

The main problem is that they found it hard to grasp the Conventional Concept of ” Removing
Target Tissue In Toto”. They do not know how to design parameter for each laser machine
appropriately with the skin lesion confronting them. They just open “the protocol ” sheet and doing
laser blindly. The other big problem is that they do not know how to sweep laser beam across the
client’s face ( using sweep beam delivery effectively).

1. SLT first concept : Depth of Target : ” Removing Target Tissue Layer by Layer ” like in surgical
operation ” removing tissue layer by layer “. They need not know the depth of the target.

2. Define each target by its Physical Property : solid / liquid / fractional volume of chromophore,
in order to choose laser photothermal, photo-biochemical or photoacoustic effect.

3. Define Clinical Effective Signs & Early Complication Signs :
For each target there are signs of clinical effectiveness which may not an “all-or-one” logic, there

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are spectrum of effectiveness which time and experience will teach attentive surgeons. Also for
early complication signs for each type of targets , there are spectrum of variation. These signs are
warning or stop signs, beyond these there are impending dangers.
4. Parameter setting .
SLT tells all its novices to assign parameters ( fluence, pulse duration ,spot size and frequency)
according to clinical effective signs and early complication sings. Then test effect sweep beam
speed and effective distance ( distance between handpiece and the skin surface) against clinical
effective signs with himself/herself and then with the client .
Experienced SLT specialists know scenarios of skin changes immediately after , one or more days
after. They can foresee their client’s prognosis.

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RENOVIA-ABLS 2020 AND THE DAYS AFTER

2020 has been a tough time for all people of the world , including us, ABLS alumni. Yet what
should be done with physical presentation has been done via Zoom video meeting. We had

- Zoom Video ABLS Training for ABLS 10 group nearly every month since May 2020
- Zoom Video Conference by topics to ABLS in Thailand and abroad for couple times.
- Zoom hands-on studio is set up for the 5th ABLS in AEC Symposium Live Hands-on

Demonstration on Sunday 13th 2020. And it will be the main studio for Renovia-ABLS
Academy training and Laser Doctor Thailand YouTube Channel, Facebook, Instagram etc.
- Most of our effort will be dedicated to make a Video Textbook on Cosmetic Laser Surgery
. In this creation, there will be text contents, animation videos and video tutorials and
hands-on .

2021 : Renovia-ABLS Academy together with ABLS(USA) are going to provide Fellowship
Training in Advanced Cosmetic Laser Surgery & Aesthetic Procedures. Attendants will have to
spend at least 2 days working with the academy clinic for 1-2 years. There will be lectures, clinical
hands-on, clinical practice and researches. We accept maximum number of 4 candidates a year. The
fellow will get doctor’s fee and per diem as appropriate.

Our fellows will have exposure to the latest aesthetic medical devices such as the Plasma
Pen,HIFU, Coolsculpting , Lasers : Pro Yellow, Pulse Dyed, Long Pulse Nd:YAG, Picosecond
Laser, Fractional CO2 with Vaginal Rejuvenation, PDT, Fractional Micro Needle RF & etc., in
addition to our very own proprietary skin-care line and advanced skin care treatments. Additionally,
Renovia-ABLS Academy offers hair restoration procedures including FUE techniques, Fat
Banking , Liposuction & Body Sculpture, Regenerative Medicine, Stem Cell and Stem Cell
Banking.

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Our fellows will also be exposed to matters that affect aesthetic surgeons today such as
business management, including data analysis with data mining specific to plastic surgery practices,
metrics-led decision making, negotiating contracts, dealing with top tier injectable accounts with
MERZ, Allergan and Galderma, marketing in a competitive environment, and social media for
plastic surgeons. We are also involved in community activities and charity fundraising.

Renovia-ABLS Academy is going to have partnership with TACS to train their Fellows in
Cosmetic Laser Surgery.

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VOTES OF THANKS

A profound sincere heart-felt thanks to the president of ABLS(USA) , Dr. Edward
Zimmermann ,MD., ABLS Administrator , Steve Fisher and all ABLS (USA) for their generous
unending support to us and to this event. We will remain one with them in the global ABLS spirit.

To all ABLS members and 5th ABLS in AEC Live Hands-on Symposium faculty members
who put their time and effort to make this symposium come true. We owe you all our humble
thanks.

To all suppliers who are so kind to lent us your precious machines for our live hands-on
demonstration.

May the Almighty God bless you all and your families , the magic of Christmas and Happy
New year 2021.

Dr. Staporn Jinaratana,MD.
Director of Renovia-ABLS Academy
LIST OF SUPPLIERS

1 Astraco Group Company : Picolo Laser / Fractional Micro Needle RF
2 Laser Engineer : 585 nm Laser / Long Pulse Nd:YAG Laser
3 All other equipment are from Renovia Clinic

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