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Aurora DSR ELOS TM Technology and key features. AMA. ELOS TM Technology for Aesthetic medicine. Utilize optical energy and electrical (radio frequency) simultaneously Two different selectivity mechanism for optimal treatment Epidermal cooling Active dermal monitoring TM.
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Aurora DSR ELOSTM Technology and key features AMA Proprietary Information of AMA
ELOSTM Technology for Aesthetic medicine • Utilize optical energy and electrical (radio frequency) simultaneously • Two different selectivity mechanism for optimal treatment • Epidermal cooling • Active dermal monitoring TM Proprietary Information of AMA
Aurora applications • Aurora DS indicated for non invasive hair removal • Light hair • Dark skin types • Aurora SR indicated for Skin Renewal • Pigmented lesion • Vascular lesion • Skin texture improvement Proprietary Information of AMA
Existing technology for selective photothermolysis • Optical energy: penetrating into the skin and selectively absorbed by the target • Lasers - monochromatic light • IPL produces broad spectrum of light • Electrolysis basing on delivery of RF energy to the hair root by insertion of needle to each follicle (Thermolysis) • ThermaCool By Thermage (RF) –unipolar system for wrinkle treatment Proprietary Information of AMA
Hair chromophore melanin - the same as of epidermis Dark epidermis has higher risk of damage Treatment of light hair is not effective Does not effect hair follicle and buldge directly Indeterminacy of light effect because of its scattering and reflection Strong absorption by dark hair shaft Penetration depth of a few millimeters High selectivity between hair shaft and dermis High efficiency for dark hair and light skin _ Light-based Hair removal + Proprietary Information of AMA
What is the main Light problem? Energy Light Skin Dark Hair Dark Skin Dark Hair Light Skin Light Hair Dark Skin Light Hair Dermis damage Epidermis damage Hair damage Proprietary Information of AMA
Treatment window for light based systems Proprietary Information of AMA
Syneron ELOS Technology • Two types of energies sources with different selectivity mechanism • Optical energy: absorbed in the target by the right choice of wavelength and pulse duration • Electrical RF energy: Chromophore independent not sensitive to skin or target color! Proprietary Information of AMA
Syneron ELOS Technology • Reduce the optical energy to a safe level for all skin types • Compensate for the lack of optical energy with electrical RF energy that is not sensitive to skin or target color Proprietary Information of AMA
Technology Cooling Light RF Proprietary Information of AMA
Temperature distribution created by light • Light heats selectively hair shaft • Bulge and follicle are damaged due to heat transfer from hair shaft Shaft Follicle Proprietary Information of AMA
RF energy properties • Well known in medicine • Does not effect the melanin • All RF parameters (Voltage, Current, Impedance) can be measured and controlled with high time resolution • Skin impedance depends on temperature and can be used for skin heating monitoring where impedance drop is about 2% per C Proprietary Information of AMA
Mechanism of RF selectivity I – Geometry Effect Electrodes • Current density is twice higher in the follicle than in surrounding tissue • Heat generation is proportional to square of current density Proprietary Information of AMA
Heat created by RF • RF creates heat in the 30microns layer around the hair shaft • Heated layer includes hair follicle and buldge Proprietary Information of AMA
Mechanism of RF selectivity II – Impedance Decreases with Temperature • Impedance linearly decreases with Temperature Increase • RF current will flow at lower impedance part of the tissue and selectively heats it • Light acts as a trigger – preheat the target for the RF current Proprietary Information of AMA
Skin and follicle heating by RF • Heat generation H=j2, where -conductivity, j-current density • Ratio between skin and follicle heating Hfollicle=4 Hskin • Skin temperature increase Tskin=ERF /(S d Cskin) S-spot size, d-penetration depth, C-specific heat Tskin=16 /(2x0.4x4)=5°C • Follicle temperature increase Tfollicle=4 Tskin=4x5=20°C Proprietary Information of AMA
Heat created by combination of Light and RF • Combination of two types of energy create uniform heating the shaft and follicle Proprietary Information of AMA
Contribution of Light and RF in Heat generation Light RF • Light provides high selectivity between hair shaft and dermis • RF energy heats mostly hair follicle and does not react to melanin of epidermis Proprietary Information of AMA
RF Current Distribution Cold epidermis Dermis Pre-heated vessel Proprietary Information of AMA
Aurora pulse sequence Light RF energy RF energy Testing pre-pulse to ensure coupling and skin calibration for RF monitoring Intense pulse Fine heat adjustment Proprietary Information of AMA
Light ~25ms Short and Long Pulses Short RF energy Long 50ms 50ms Proprietary Information of AMA
ISL safety feature Impedance Temperature Light Energy RF energy Testing pre-pulse Intense pulse Fine heat adjustment Proprietary Information of AMA
Impedance safety limit (ISL) 0 10 20 30 40 ISL= 10%, energy is cut off Light Light ISL= 30%, all energy is delivered Light Light RF energy Proprietary Information of AMA
Clinical results with the Aurora DSR Proprietary Information of AMA
Treatment technique • Incomplete contact cooling • All RF current is concentrated in one point, potential for increased tissue temperature at contact points. • Complete contact cooling • RF current is distributed over entire electrode surface Proprietary Information of AMA
Hair removal results withELOS Technology Proprietary Information of AMA
Cross Section of Hair from scalp: Not-treated Hair Follicles Proprietary Information of AMA
Cross Section of Hair from scalp: Hair Follicles after Aurora DS treatment Proprietary Information of AMA
How Deep Does RF penetrate? Treated Normal Human hair follicles at the edge of a treated area. Depth is 3.5mm Proprietary Information of AMA
White hair (Aurora DS Treatment) Before After Proprietary Information of AMA
Light brown hair Optical pulse at 20J/cm2 and RF energy of 20J/cm3. Optical pulse at 20J/cm2 with no additional RF energy. Proprietary Information of AMA
Treatment Case Dr. J. Shaoul Hair removal RF: 18 J/cm3 Light: 25 J/cm2 Pulse: Short Number of Sessions: 2 Follow-up: 6 months Proprietary Information of AMA Pre-treatment Post-treatment
Treatment Case Dr. J. Shaoul Hair removal RF: 20 J/cm3 Light: 22 J/cm2 Pulse: Short Number of Sessions: 2 Follow-up: 10 months Proprietary Information of AMA Pre-treatment Post-treatment
Treatment Case Dr. J. Shaoul Hair removal Pre-treatment RF: 18 J/cm3 Light: 26 J/cm2 Pulse: Short Number of Sessions: 2 Post-treatment Follow-up: 4 months Proprietary Information of AMA
Hair Removal Study6 Month Follow-upA. DelGiglio, J. Shaoul Proprietary Information of AMA
Conclusion • The Aurora DS device has a definite biological effect on hair including reddish blonde and gray hair • Further studies in skin types 5 and 6, and on white hair, are on going • With an observation period of ten months it is possible to say that this is the same degree of permanent hair loss that one sees with any other laser technology Proprietary Information of AMA
Photo-rejuvenation Treatment Using ELOS Technology Pigmented Lesion Vascular Lesion Wrinkle and skin texture treatment Proprietary Information of AMA
Treatment Case Dr. J. Shaoul Lentigo Pre-treatment RF: 20 J/cm3 Light: 15 J/cm2 Pulse: Short Number of Sessions: 2 Follow-up: 1month Post-treatment Immediately Proprietary Information of AMA
Treatment Case Dr. C. Chess Age spots Pre-treatment RF: 15 J/cm3 Light: 22 J/cm2 Pulse: Short Number of Sessions: 1 Post-treatment Follow-up: 1 month Proprietary Information of AMA
Treatment Case Dr. S. Laughlin Rosacea Pre-treatment RF: 18 J/cm3 Light: 24 J/cm2 Pulse: Short Post-treatment Number of Sessions: 3 Follow-up: 1 month Proprietary Information of AMA
Treatment Case Dr. J. Shaoul Rosacea skin texture RF: 20 J/cm3 Light: 15 J/cm2 Pulse: Short Number of Sessions: 2 Follow-up: 1 month Pre-treatment Post-treatment Proprietary Information of AMA
Treatment Case Dr. S. Laughlin Skin renewal Pre-treatment RF: 20 J/cm3 Light: 26 J/cm2 Pulse: Short Post-treatment Number of Sessions: 3 Follow-up: 1 month Proprietary Information of AMA
Aurora Photo-rejuvenation Treatment Before After Proprietary Information of AMA
Treatment Case Dr. S. Laughlin Telangiectasia Pre-treatment RF: 20 J/cm3 Light: 23 J/cm2 Pulse: Short Number of Sessions: 4 Follow-up: 1 month Post-treatment Proprietary Information of AMA
Treatment Case Dr. C. Chess Telangiectasia RF: 15 J/cm3 Light: 22 J/cm2 Pulse: Short Number of Sessions: 1 Follow-up: 1 month Pre-treatment Post-treatment Proprietary Information of AMA
Treated sites by clearance FDA Multi-Center Study Proprietary Information of AMA
Aurora Competitive Advantages Proprietary Information of AMA
Aurora major advantages Safety: use less optical energy – less epidermal damage Deliver more selective energy to the treated target Treat dark skin without compromising efficacy or safety Treat light hairs Additional safety features Portable, multi-applications platform Proprietary Information of AMA