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AcuPulse TM – MultiMode TM SuperPulse TM CO 2 Laser Powerful. Versatile. Simple.

PB-1004125 Rev B. AcuPulse TM – MultiMode TM SuperPulse TM CO 2 Laser Powerful. Versatile. Simple. PB-1004125 Rev B. A g enda. 01. Background & Laser Physics in a Nutshell. 02. Product Overview. 03. AcuPulse Treatment Modes. 04. Clinical Evidence. 2. PB-1004125 Rev B.

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AcuPulse TM – MultiMode TM SuperPulse TM CO 2 Laser Powerful. Versatile. Simple.

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  1. PB-1004125 RevB AcuPulseTM – MultiModeTM SuperPulseTM CO2Laser Powerful. Versatile.Simple.

  2. PB-1004125 RevB Agenda 01 Background & Laser Physics in aNutshell 02 ProductOverview 03 AcuPulse TreatmentModes 04 ClinicalEvidence 2

  3. PB-1004125 RevB Agenda 01 Background & Laser Physics in aNutshell 02 03 04 3

  4. PB-1004125 RevB Skin resurfacing is the 2nd most popular skin treatmentand there is room for bothablative and non-ablative There are two available options for skin resurfacing: ablative andnon- ablative, and physicians are tailoring treatments according to patient needs andpreferences: • Non-ablative procedure volume is growing. However, we see consistent demand for ablative fractional procedures and CO2 systems, which are also used for a variety of otherdermatological indications • There is also more research on the combination of ablative andnon- ablative procedures, as well as CO2-assisted drugdelivery 4

  5. PB-1004125 RevB Consistent demand for fractionalablative Inthenext12monthsweareconsideringapurchaseofnewsystemsfor the following type of treatments [select all thatapply] Source: Lumenis market survey US dermatologists,2013 5

  6. PB-1004125 RevB EMR Absorption byWavelength 6

  7. PB-1004125 RevB 3 Main Parameters –WTF According to Dr. Rox Anderson (in Cutaneous Laser Surgery): “The thermal relaxation time of pulse CO2 laser heated tissue is about0.8msec. In effect, for the CO2 laser wavelength, we must deliver the necessary 5 J/cm2 inat most a 0.8 msec pulse, preferably less, if we expect to minimize injury tothe underlying tissue.” 7

  8. PB-1004125 RevB 3 Main Parameters –WTF • The CO2 wavelength (W) provides the best controlover • T andF 𝐸𝑛𝑒𝑟𝑔𝑦 𝑃𝑜𝑤𝑒𝑟 ×𝑇𝑖𝑚𝑒 𝐹𝑙𝑢𝑒𝑛𝑐𝑒= = 𝐴𝑟𝑒𝑎𝐴𝑟𝑒𝑎 • Time is limited to 0.8 msec (tissueTRT) • Area (spot size) is determined by theapplication • Deep small spots for deep fractional skinresurfacing • Superficial medium spots for smalllesions • Superficial large spots for large area ablation, like fullskin • resurfacing or superficial fractionalresurfacing 8

  9. PB-1004125 RevB Controlling CO2 LaserPower • Power is thekey! • Once time and area are determined, the key is tocontrol the power and where itgoes • AcuPulse provides different power modes for avariety ofapplications • CW: Long pulse at a power of40W • Low power = superficial, morecontrolled • SuperPulse: Short pulse at a peak power of 170W High power = deeper, faster, less collateraldamage 9

  10. PB-1004125 RevB Agenda 01 02 ProductOverview 03 04

  11. PB-1004125 RevB AcuPulse: Full and Fractional Ablative CO2Laser Powerful. Versatile.Simple. AcuPulseisapowerfulandversatileCO2skin resurfacingsystemaddressing treatments in the a multitude of dermatology and plastic surgerypractice. AcuPulse delivers unparalleled efficacy, asthe only SuperPulse-enabled CO2 skin resurfacing system. Its 10 built-in treatment modes and intuitive user interface offer a complete ablative skin resurfacing solution with over 30 FDA cleared indications.

  12. PB-1004125 RevB AcuPulse: Full and Fractional Ablative CO2Laser • Powerful. Versatile.Simple. • The only true SuperPulse for the best ablation/ • coagulation ratio in itsclass • Ultimateversatility • AcuPulse is also used for superficialtreatments • With 2 advanced scanners, a variety of handpieces and 10 treatment modes, AcuPulse adds great flexibility and versatility to theclinic

  13. PPBB--11000044112255RReevvAB AcuPulseVersatility AcuPulse addresses a significant portion of themost common dermatology and aestheticprocedures Wrinkles Acne scars Dyschromia Surgicalscars Syringomas Striae (skinfurrows) Blepharoplasty Moles (excisionof soft tissue) Benign tumors Rhinophyma Surgicalscars Actinickeratosis/ cheilitis Surgicalscars Warts Medical Aesthetic

  14. PPBB--11000044112255RReevvAB AcuPulse PulseModes • SuperPulse vs.CW • 3 dayspost-op • Spot size =0.12mm • Energy =30mJ • CW acts more superficially, with a wider zone of thermalnecrosis. • SuperPulse penetrates deeper, leaving less residual thermaldamage. • Each mode is beneficial for differentneeds. SPCW Courtesy of Girish Munavalli,MD Director of Dermatology, Laser and Vein Specialists of the Carolinas, Charlotte,NC 14

  15. PB-1004125 RevB AcuPulse Power andSafety SuperPulse – Optimal Ablation / CoagulationRatio Laser energy = ablation + heat E(total) = E(Ablation) +E(thermal) If ablation depth is equal,excess energy must go toheat. The goal is to get deeper withless excessheat. AcuPulse needs less energy to get deep, meaning less energy goes to heat, thereby reducing risk ofside effects, reducing downtime and reducing patientdiscomfort. Moreover, AcuPulse provides the shortest pulse durations pergiven energy, further enhancing patient safety andcomfort.

  16. PB-1004125 RevB Agenda 01 02 03 AcuPulse TreatmentModes 04

  17. PB-1004125 RevB AcuScan120TMMicroscanner • The AcuScan120 microscanner is designed for fractional delivery and enables 4 treatment modes to address many different indications, such as wrinkles, dyschromia, acne scars,etc. • It delivers deep 120µm diameter spots,superficial • 1.3mm diameter spots, or both in thesame scan • Scans are performed in a variety of shapes,sizes, densities and energylevels

  18. PPBB--11000044112255RReevvAB AcuScan120TMMicroscanner Focused sequentialscanner Articulated arm of theAcuPulse Purge aircompressor connection Communicationcable connection Disposabletip

  19. PB-1004125 RevB AcuScan120TMMicroscanner AcuScan120 modes

  20. PPBB--11000044112255RReevvAB HistologicalEvidence DeepMode SuperficialMode Spotdiameter: Energy: Density: Penetrationdepth: 120µm 20mJ 15% 700µm Spotdiameter: Energy: Density: Penetrationdepth: 1.3mm 170mJ 60% 150-200µm

  21. PB-1004125 RevB Testimonials Francesca De Angelis, MD; Plastic Surgery Specialist, DE.A. Center and Head of Plastic Surgery, Clinica Mediterranea,Italy AcuPulse Combo mode is a MultiMode CO2 laser with both SuperPulseandcontinuouswaveCO2technologiesfora concomitantdeepandsuperficialimpact.It enables disorders treatmentofcommonandchallengingskin characterised by texturaland pigmented lesions. In the author’s experience, for patients having mild to moderate acne scarring, one single, combined, Deep and Superficial treatment using the Combo mode enables a high rate of improvement in scarring, as well as in skin tone, with no complications and with a shortdowntime.

  22. PB-1004125 RevB SurgiTouchTM Scanner and HandpieceSet • The SurgiTouch scanner enables 5 treatment modes to address many different indications, such as syringomas, small skin tumors, soft tissue excision, etc., as well as full skinresurfacing • Itis usedwith3handpiecesforpreciseablationina variety of shapes, sizes and powerlevels • But how does itablate uniform large spots when the • beam diameter is only120µm?

  23. PB-1004125 RevB SurgiTouchTM Scanner and HandpieceSet • ModusOperandi • The SurgiTouchTM scanner delivers a focused laser beam with constant velocity in a spiral pattern over a designated scanarea • The scanning velocity is such thatthe energy per spot during the scan is delivered in a time shorter than the thermal relaxation time of tissue, resulting in char-free ablation and predictable, repeatablevaporization Spot size forthe scanner handpieces to be selected perprocedure

  24. PPBB--11000044112255RReevvAB SurgiTouchTM Scanner and HandpieceSet

  25. PB-1004125 RevB SurgiTouchTM Scanner and HandpieceSet SurgiTouchmodes 25

  26. PB-1004125 RevB Testimonials Nariaki Miyata, MD; Director of Miyata Plastic Surgery andDermatology Clinic,Japan I have found that FineTouch mode on AcuPulse has the precision that I need to treat fine pigmented lesions. I have also found that FineTouch has the capability to ablatelayers evenly into deep nevus cells with visual contact. The FineTouch mode is very easy to control and easy to operate with minimum damage to normal tissue that is unrivalled by any otherproducts.

  27. PB-1004125 RevB IncisionalHandpiece • An incisional 125mm handpiece, producing a 0.26mm diameter micro-beam, can be used on its own,requiring neither one of the scanners, for accurate surgical incisions • Bleeding is minimal, due to the coagulative,hemostatic natureoftheCO2laser’sinteractionwiththetissue • This also allows for better visibility of the treated area and less labor cleaning and sterilizing equipment, dueto eliminating the need in ascalpel

  28. PB-1004125 RevB IncisionalHandpiece Incisionalmode

  29. PB-1004125 RevB ConfigurationSummary

  30. PB-1004125 RevB Testimonials E. Victor Ross, MD; Director, Laser and Cosmetic Unit, Scripps Clinic, La Jolla,CA I have used the AcuPulse to perform over 500 CO2 laser procedures. The most impressive features are its small footprint, mobility, and wide range of applications. The two scanners can be interchanged easily.One can perform conventional resurfacing and deeper fractional procedures. The scanner technology allows for a wide range of injury patterns onthe skin, so one can customize the treatment type for a particular pathology. We have used it for skin conditions as varied as warts to syringomas to photo-damage. The Combo mode is especially helpful as the unique injury patterns allow for deeper fractional treatments (e.g. for acne scarring), while still allowing for lighter conventional superficial resurfacing for pigment and fine lines (all in one pass). Its SuperPulse technology allows me to be more aggressive when I need to, while maintaining a wide patient safety margin, which ensures my patients aresatisfiedwiththeresultsoftheirtreatmentsafterasinglesession.

  31. PB-1004125 RevB Agenda 01 02 03 04 ClinicalEvidence

  32. PB-1004125 RevB Compendium of ClinicalPublications

  33. PB-1004125 RevB Skin Resurfacing (combined with M22IPL) Courtesy of E. Victor Ross,MD Baseline 3 monthspost

  34. PB-1004125 RevB SkinResurfacing Courtesy of Rafael Nunes,MD Baseline 3 monthspost

  35. PB-1004125 RevB ScarRevision Courtesy of Gilly (Girish) Munavalli,MD Baseline 6 monthspost

  36. PB-1004125 RevB AcneScars Courtesy of Francesca de Angelis,MD Baseline 6 monthspost

  37. PB-1004125 RevB Blepharoplasty, Lower EyelidResurfacing Courtesy of Gilly (Girish) Munavalli,MD Baseline 4 monthspost

  38. PB-1004125 RevB Soft Tissue (Mole)Removal Courtesy of Nariaki Miyata,MD Baseline 3 monthspost

  39. PB-1004125 RevB ThankYou www.lumenis.com

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