Dr. Darm Revlite Technical Overview This multi-purpose laser provides industry-leading treatments for skin resurfacing (including wrinkle reduction and acne scar treatment), multi-color tattoo removal, vascular, dermal and epidermal pigmented lesion removal, and hair removal — for all skin types. RevLite® features a proprietary variation of the PhotoAcoustic engineering pioneered by HOYA ConBio nearly two decades ago with the original MedLite Q-Switched Nd:YAG lasers. The hallmark of PhotoAcoustic technology is high peak power and short pulse duration. This generates a PhotoAcoustic action against the target molecule, whether it's collagen, tattoo ink or pigment. Forcing energy at such a high rate, the molecules vibrate and shatter, without any harm to the surrounding skin. This PhotoAcoustic action is different from the traditional photothermal effect that many lasers use to target chromophores with bulk heat. A flat-top beam profile delivers high energy evenly over the skin's surface, which significantly minimizes epidermal injury. RevLite takes this PhotoAcoustic action one step further with PhotoAcoustic Technology Pulse (PTP) — a unique dispersion of maximum energy that delivers very narrow pulse widths at up to 60 percent more power. The unique nanosecond pulse configuration cause a dual collagen stimulation action -- delivering both a PhotoAcoustic effect and a subtle photothermal effect from the pulse delivery. Aesthetic treatments with RevLite are safe, patient-friendly and require no downtime, epidermal cooling or messy gels. Anti-Aging Maintenance™ RevLite is a safe, fast, effective method for skin rejuvenation, whether used as a one-time treatment or as part of an ongoing Anti-Aging Maintenance regimen. The PhotoAcoustic "shockwaves" reorganize the skin's collagen into parallel arrays of compact fibers, giving skin an overall tightening and inducing ongoing dermal remodeling, without any downtime or messy cooling gels. In a recent clinical study of patients treated with the RevLite over 6 bi-weekly sessions, the PTP mode showed superior results in improving wrinkle amount and depth, appearance of pores, number of whiteheads and skin laxity-- with significantly lower patient discomfort than standard Q-switched technology. After an initial treatment series of 6 to 8 sessions, doctors report that patients frequently opt to come in for monthly or quarterly "touch up" sessions to maintain smooth, radiant, younger-looking skin — while continuing to build collagen long-term. Tattoo Removal RevLite is built on the same foundation as the MedLite, known as the goldstandard device for multi-color tattoo removal. RevLite harnesses high peak power to gently shatter the tattoo ink particles, which are gradually removed by the body's natural processes. Optional MultiLite handpieces allow physicians to convert RevLite's 532 nm wavelength to either 585 nm or 650 nm. Including the core 1064 nm setting, that's a total of four wavelengths to tackle multi-color tattoos. Award-winning, proven technology treats even stubborn tattoos with virtually no risk of scarring or pigment changes. Epidermal & Dermal Pigmented Lesions RevLite's multiple wavelengths make it ideal for treating a wide variety of pigmented lesions on all skin types, including brown "age" spots, solar lentigines, café-au-lait lesions, melasma, Nevus of Ota and aberrant Mongolian Spot. Most lesions can be removed quickly with little to no risk of hypopigmentation. Acne Scar Reduction The nonablative skin resurfacing benefits of the RevLite are ideal for treatment of acne scars, providing immediate and long-term benefits. Clinical studies† show that Q-Switched Nd:YAG treatment of mild to moderate atrophic acne scars showed a significant improvement in skin smoothness of 23% after one treatment, increasing to 39.2% six months later. Patients see visible improvement in less than five sessions. Hair Reduction Safe for all skin colors and even tanned skin, RevLite

1. Aesthetic Medicine Dr. Darm’s OfficeRevLite Technical Overview

2. Tattoo Reduction Treatments require the Ability to treat the target effectively while minimizing the thermal impact to the surrounding tissue Ability to treat all color tattoos Ability to safely treat all skin type patients Achieve 80% reduction at a minimum without adverse effects on the adjacent tissue

4. Hoya Con-Bio RevLite Tattoo reduction Q-switched Nd:YAG 1064/532 nm Black, brown, yellow, blue ink with 1064 nm Red ink with 532 nm 585 nm dye handpack for sky blue ink 650 nm dye handpack for green ink Photo rejuvenation/wrinkle reduction Dermal and Epidermal pigmentation Hair reduction 532 nm Laser Peel

7. True Q-switched Laser with Nanosecond Pulse Widths s – second (101) ds – decisecond (10-1) cs – centisecond (10-2) ms – millisecond (10-3) ms – microsecond (10-6) 1 millionth ns – nanosecond (10-9) 1 billionth ps – picosecond (10-12) 1 trillionth

8. Nanosecond Technology The RevLite Laser is uniquely set apart by the fact that it offers the user the power of nanosecond technology. Our Q-switch allows the RevLite laser to produce an extremely high energy, short pulse (5 ns) of light. This short pulse duration limits the tissue’s exposure to heat build-up, offering extremely safe and fast treatments with repeatable results 10-9 One billionth of a second

9. Absorption and other factors involved to effectively treat Light will reflect, refract, absorb and scatter upon impact with the target tissue Fluence Spot size Wavelength Pulse width Thermal relaxation time of the target tissue (t) Beam profile Gaussian curve vs Flat-top beam

10. ABSORPTION CURVE 1064 nm is weakly absorbed by melanin, and can penetrate deeply to destroy dermal lesions and hair structures without causing epidermal hypopigmentation. 532 nm is well absorbed by melanin and oxyhemoglobin. This permits treatments of epidermal pigmented lesions.

11. Power and Fluence Power is an energy/time term (J/s) Fluence is an energy/density term (J/cm2) The RevLite has a maximum pulse energy of 1.6 Joules with MDP The high pulse power allows for a higher fluence setting with larger spot sizes Higher pulse power allows higher fluence setting with dye handpacks

12. Fluence With a 1064 nm high pulse energy of 1.6 Joules allows 5 J/cm2 with a 6 mm spot size to be treated at 10 Hz 3.5 J/cm2 will effectively reduce the appearance of any darker color tattoo Increase fluence by 0.5 J/cm2 with each treatment to a maximum fluence level of 7 J/cm2 4.5 J/cm2 will effectively treat dermal pigmentation 3.9 – 9.8 J/cm2 with 585 nm dye handpack 2.6 – 6.6 J/cm2 with 650 nm dye handpack Shorter treatment times Petechiae will be observed with multiple passes or high fluence levels over sensitive tissue

13. Selective Photothermolysis Tattoo Ink Example - The specific color of the ink is targeted by the correct wavelength. The high energy, short pulse of light hits only the targeted chromophore, breaking it up into minute particles without harming the surrounding skin. The body’s own natural cleansing system is then able to remove the fine particles.

14. Other factors involved with tattoo reduction Monochromacity of the ink Quality of the ink Depth of insertion Patients ability to recognize the effected pigment as a foreign body and reabsorb Inability to predict the number of treatments to effectively reduce the appearance of the tattoo

15. Beam profile Gaussian curve – bell shaped curve with highest concentration of energy in the center of the beam. Energy will dissipate to zero as you approach the edges of the beam. Causes an explosion of the tissue in the center of the beam. Increased potential for scarring Flat-top beam – energy at any point in the spot is the same as any other point Even treatment over entire surface

18. Advanced Tattoo Removal by RevLite The “Gold-Standard” for Tattoo Removal Minimal risk of scarring and pigmentary changes Ability to treat all skin types Less discomfort than with other systems 1064 nm for dark inks 650 nm for green inks 585 nm for light blue inks 532 nm for red inks

19. Tattoo Results Tattoo after multiple treatments. Images Courtesy of Bruce Saal, M.D., Los Gatos, CA

20. Tattoo Results Professional Tattoo - No previous treatment. Very good results with several 1064 nm treatments. Photos Courtesy of Dr. Suzanne Kilmer, M.D., Sacramento, CA

21. Tattoo Results Traumatic Tattoo - No previous treatment. Very good results with treatments at 1064 nm. Photos Courtesy of Dr. Suzanne Kilmer, M.D., Sacramento, CA

22. Tattoo Results Professional Tattoo - Red & black ink. 90% of clearing was obtained with one treatment at 532 nm, 5 J/cm2. One additional treatment cleared the red. The black was cleared with 3 treatments at 1064 nm.

23. Tattoo Results Images Courtesy of Larry Weinstein, MD, Chester, NJ

24. Tattoo Results Professional Tattoo - Multicolored. This tattoo received 11 treatments of a combination of 532 nm and 1064 nm.

25. Cosmetic Tattoo Removal

26. Cosmetic Tattoo Removal

27. Cosmetic Tattoo Removal

28. Cosmetic Tattoo Removal

29. Cosmetic Tattoo Removal

30. Cosmetic Tattoo Removal

31. Photorejuvenation/Wrinkle reduction treatment The flat-top beam profile will allow for an even treatment over the target tissue. Photoacoustic Therapy (PAT) Nanosecond (ns) pulse width Heat not involved in treatment Treat once a week for 6 weeks Return monthly for maintenance treatments

34. Laser Toning by RevLite Peri-Orbital Area After 6 Treatments Images Courtesy of Paul J. Frank, MD, New York, NY

35. Laser Toning by RevLite Peri-Oral Area After 5 Treatments Images Courtesy of Paul J. Frank, MD, New York, NY

36. Laser Toning-Active Acne 1064nm, 6.0mm spot size, 3.5 J/cm2, 8 treatments 1 week intervals Images Courtesy of Skin Laser Clinic, Taipei, Taiwan

37. Dermal and Epidermal pigmentation 1064 nm wavelength used for dermal pigment treatment Able to fade the appearance of melasma Treat once a week for 8 weeks Treat once a month for a maintenance prn 532 nm wavelength used for epidermal pigment treatment One treatment

40. Pigmented Lesion Treatment Successful Pigmented Lesion Treatment Images Courtesy of Bruce Saal, M.D., Los Gatos, CA

41. Dermal Pigmented Lesion 5 treatments, 3 months Post Op,1064nm, 3mm-4mm，10Hz, 6.1-8.3J/cm2

42. RevLitePigmented Lesion Treatment Pigmented Lesion – Treated once at 532 nm.

43. Pigmented Lesion Treatment Solar Lentigines - Treated once at 532 nm.

44. Pigmented Lesion Treatment Pigmented Lesion - Treated once with 532 nm. Post treatment photo taken 5 weeks post-op.

45. Pigmented Lesion Treatment Pigmented Lesion - Treated once with 532 nm.

46. Medlite 532nm Treatment Images Courtesy of Clarence Wiley, MD, Shawnee, OK

47. Epidermal Pigmented Lesions 1 treatment, 4 months Post Op, 532nm, 3mm, 1Hz,1.3J/cm2

48. Dermal Pigmented Lesion 4 treatments, 6 months Post Op,1064nm, 4mm, 10Hz,6.6-7.6J/cm2

49. Dermal Pigmented Lesion 4 treatments, 3 months Post Op,1064nm, 4mm, 10Hz,6.4-7.4J/cm2

50. Dermal Pigmented Lesions Nevus of Ota, five 1064 nm treatments

51. Dermal Melasma 1064nm, 2 treatments, 4 mm spot 5 j/cm^2

52. Dermal Melasma 1064nm, 8 treatments, 6 mm spot 3.5 j/cm^2

53. Hair reduction The nanosecond pulse width will better match the thermal relaxation time of the finer vellous hair. You will achieve short term reduction similar to a laser waxing procedure. Patient will be required to maintain prn

56. Touch screen No more charts to refer to for fluence levels and correct treatment settings. User friendly

57. Call Today for a free Consultation 503.697.9777