Dr Feng Yang on PicoSure Pro by Cynosure

Would you recommend Cynosure’s PicoSure® Pro to clients and to clinic owners?
“Yes, without hesitation. Look at me, I had my first PicoSure® five years ago and three years ago, I got another. Now I have PicoSure® Pro. It makes sense, both professionally, academically, and obviously, economically, because PicoSure® laser, PicoSure® Pro especially, is our champion device. In our clinics, it’s our cornerstone of the business as well as a device our team uses every day. So yeah, it’s the sensible choice.”
In this insightful podcast, Dr Feng Yang shares how PicoSure Pro by Cynosure is for tattoo removal and helps multiple skin concerns – including Melasma! Listen to find out why he recommends this to clients and clinic owners.
Dr. Yang has more than 30 years of experience in medical surgery and cosmetic medicine with a total of four clinics in Melbourne.
@melbourneclinicallaser @melbourneclinicallaserboxhill @cynosureaustralia

Transcript – Dr Feng Yang on PicoSure Pro by CynosureTrish 

Hello listeners. It’s Trish Hammond here from the Aesthetics Uncensored Podcast and today I’m joined by Dr. Feng Yang. Now Dr. Yang has more than 30 years experience in medical surgery and cosmetic medicine. He trained in Beijing. He was offered a surgical fellowship at Alfred Hospital in 1994 and he then continued his medical career in Melbourne. Now, Dr. Yang actually has four clinics and today we’re going to talk in particular about the PicoSure® Pro, because he would definitely have to have done the most PicoSure® treatments in Australia. So welcome, Dr. Yang. 

Dr Yang

Thank you. 

Trish 

Thank you so much for taking the time to join us today. So tell us so before we start, can you tell us a little bit about what landed you in the aesthetics industry? And like, why is aesthetics for you?

Dr Yang 

As a doctor with 35 years experience in medicine, and about 15 years ago, I started doing injectables, and as a GP with a very strong surgical background, and I thought, it’s fun for me and making people beautiful, and it really gave me satisfaction in my practice as a GP. About five years ago, these people showed a laser that had been on the market and became very popular and the Cynosure team has convinced me to start with PicoSure® and SculpSure®. And I started from then, and we got an amazing result and our patients are very happy. So about two and a half years or three years ago, we started to expand our practice. Now, I’m the owner of four skin laser clinics and we go for PicoSure® and one cutting age PicoSure® Pro, we just have this new device arrived in our box in our clinic. 

Trish  

Fantastic. So I can imagine 13 years ago when you first started, there would have been very few cosmetic doctors around so you probably had lineups of people wanting to get their injectables done.

Dr Yang  

Yeah. Well, cosmetic medicine has evolved very fast, like a lot of areas in medicine, and with the level of technology improving all the time and the patient expectation is improved, as well. So obviously we have to like other areas of medicine, we have to keep learning and adapting and improving in the meantime.

Trish  

Yeah, and so with the Cynosure PicoSure® Pro, could you tell us like that tell us a little bit about like, what can you treat with the PicoSure® Pro?

Dr Yang 

Well, the common indications for this device are pigmented skin lesions like melasma like birthmarks, like sunspots that all can be treated with PicoSure® Pro and also it can treat birthmarks with failed laser treatment in the past because it’s very powerful and safe to use. And on top of that, we treat acne scars, we use it for skin rejuvenations and also tattoo removal so that’s a big part of our practice.

Trish  

Okay, so does it treat the whole gamut?

Dr Yang  

Yeah, I want to say so. Another advantage of this device is it treats almost all skin types and because in the past and like a used  to which are other laser skin devices can only treat skin type one to four. Put simply, it only treats people with skin melanin less than East Asian levels. So people from generally say, from African background, or people from South Asian background, and some have even the Mediterranean background, they couldn’t use any sensible laser device and it’s a big frustration for them because they can’t treat the conditions and with Picosecond laser, especially this PicoSure® Pro, we can treat almost all patients skin type, which is a huge elevation for our for treatment choice.

Trish   

Yeah, well, we hear a lot about the Picosecond. What is a Picosecond laser?

Dr Yang  

Okay, I love that question. I can tell you. What is Picosecond? So a lot of people, even some professionals, call it actually wrong. Picosecond is a very short time unit, how short it is, it’s equivalent to one second divided by 1000s of billions so that’s how short it is. All right. So the Picosecond laser is using technology to make the pulse, the duration of the laser energy delivery to that second, like Picosecond duration of time. The point of this breakthrough technology is it delivers the required energy to destroy the pigmentation we want to destroy, but at the minute at the same time, minimise any damage to the skin or reduce the chance of any side effect. So this is what the huge breakthrough Picosecond laser is about. And in the old days, a lot of people know that if you have a laser treatment, you will stay in those for up to two weeks and you can’t see anyone because you may scare them so the recovery is painful. And with PicoSure® treatment and PicoSure® Pro treatment, you’re generally able to keep your normal schedule so this is revolutionary, especially in this day and age.

Trish  

Yeah, I can’t disagree with this because some people want the best treatment and they want the latest treatment and they want to know that someone that the person doing the treatment is going to get the maximum out of it as well as sorry is going to give them the maximum that they can get out of it as well.

Dr Yang 

Yeah, yeah, of course.

Trish  

I have a question like if you can, I don’t know if this is kind of covered but if you can tell us about the world’s first Picosecond laser and the PicoSure® Pro.

Dr Yang  

The first Picosecond laser is called PicoSure® which I had four devices, and as I just mentioned before PicoSure®  was born well, the first first one is nearly 10 years now in America made in Boston and the previous technology cannot minimise the damage or side effect of the laser machine created on the skin. And from a technology point of view, it delivers too much heat. To put it simply, it delivers too much heat which the skin cannot tolerate so basically at the same time or treatment and you basically burn the skin to a certain extent that’s the old technology. Picosecond lasers almost resolved that problem totally so it can destroy the pigmentation that gives skin the benign stimulation, what do we want for skin rejuvenation, to achieve the fantastic result at the meantime, and it keeps the skin’s structure intact so that’s the biggest advantage for this machine and the PicoSure® Pro give us more method, if you like to manoeuvre the energy level and the delivery method so we can achieve much better result with even less sad effect so it’s very safe to use its powerful and effective device.

Trish  

Okay, so with the different concerns that the PicoSure® can treat, so if we say, choose the most common like removal of pigmentation or acne, scar treatment, skin rejuvenation, fine line reduction and tattoo removal? What do you see the most of these days? What do you see people coming to you the most these days?

Dr Yang  

I would say the top two conditions were pigmentation removal and also skin rejuvenation. And obviously, a lot of people come in for removal, and there are some clinics more concentrated on tattoo removal because that machine was made 10 years ago, and was the first generation and I will say it will be more useful these days with the PicoSure®Pro for tattoo removal. But in our clinic, we mainly sign pigmentation and also for skin rejuvenation.

Trish  

Okay, so see if we went through them one by one. So with the laser tattoo removal, how long would it take to remove? Like, how many sessions would it take? And I know that kind of varies person to person.

Dr Yang 

Obviously, it varies and with PicoSure®Pro people will need up to five sessions, sometimes even 10 sessions, obviously, it can vary quite greatly and it’s effective and we always give people a realistic estimate to give them information about what going to be anticipated and to prepare for the treatment course.

Trish 

Okay, so it depends on the tattoo, but roughly between five and 10 sessions.

Dr Yang   

I want to say between five or 10 sessions, they will reach a satisfactory level for for most people they will reach a satisfactory level of treatment.

Trish

Okay. And I’m really interested in what you said about the different skin types because I am one of those people with dark skin and I’ve always stayed away from getting my skin rejuvenated with laser because I’ve always been scared that I’m going to block champs or something like that. How do you like when you’re consulting with a client? How do you determine what treatment that clients are going to get the best benefit from?

Dr Yang 

Well, patients will come in normally with one concern or a few concerns. Let everything in medicine, you first have to address that and to offer them after the assessment, you offer them the best treatment of choice and then we move on to address the issues, I can say. And then the patient may be constant, maybe not but from a professional point of view we can offer them the best available choice with a minimum set of facts, and they achieve the best result, we try to benefit the patient the most with the devices we have.

Trish  

And one of the things that I get asked all the time is like, does it hurt?

Dr Yang 

These days we use a medical formula, topical anaesthetic cream, which is called 21 Seven. It actually was originally used in America and is widely used by a lot of Cosmetic Dermatologists and Physicians and we find that it’s very effective and minimally uncomfortable because I see that out of my personal personal experience because I am self had quite a few PicoSure® including PicoSure®Pro treatment myself, so I can say it’s very minimum uncomfortable, I wouldn’t say it’s rich, painful level, I would say. It’s a little bit scary,  irritating after half an hour of topical cream. Yeah.

Trish   

And because you’ve got really good skin. 

Dr Yang  

In the last 12 month, I had three PicoSure® treatments, including the last one. I had PicoSure®Pro in January, about four weeks ago. So I’m 57 So how do I say my skin condition compared with this same age group is is one of the top you know conditions. 

Trish 

I was gonna say like, so when because you said you had three, three in the last year. When you go to heavy treatment, do you have it just for rejuvenation?

Dr Yang

For myself, I actually have some pigmented lesions on my face, most of the skin keratosis or solid keratosis is a sunspot and so we can treat that less than the colour but sometimes it’ll get rid of it. And obviously, it’ll improve the skin texture and make your skin look useful and brighter and make people look fresher. So a lot of people tell me they got a comment, and their friends will say Oh, you look really fresh and then you went on the holidays recently or something. So while at the best college they will get all their friends.

Trish  

Well it’s really funny because like every so often I look at myself in the mirror I’m like, Oh, I just need a little bit of juja. I just want something and the most important thing when you are looking to make yourself look better. It comes back to skin number one, hey. Like youthful looks, having youthful looking skin isn’t great.

Dr Yang  

Yeah, well skin texture is very, very important and also I think these days, people are more aware and the benefit it can bring to people. And I went to a conference last year with one of the leading Dermatologists who were presenting some of the fundings from the College of Dermatology. They said the study shows that if people’s skin and acne scar can be improved with treatment and the confidence level, and even their income level can have a dramatic improvement and they followed up the patient for up to 15 years so it’s a very strong evidence to show that to have a skin rejuvenation or some acne scar treatment is benefited is a big benefit for patients.

Trish  

So it makes you younger, and it makes you richer.

Dr Yang  

Yeah, I sometimes use that figure in a discussion and consultation with my patients, I said, how many degrees you got to do to improve your lifelong income of 15 to 20%, you’ll probably need three degrees, or at least two but with a cause of treatment, you can achieve that. And I often find that message is quite powerful and people realise, and how important it is to have treatment and even enhancement of the skin condition is and they absorb that message and understand the treatment more.

Trish 

Yeah, I agree with you 100% because when you look better, even if it’s just when you look better to yourself, you just feel better, and it makes you do better things in life and you want to kind of I don’t know, I agree with you 1,000,000% there.

Dr Yang  

Yeah, thank you.

Trish 

I was going to ask you, so back on the facial rejuvenation. So when you have your sessions, how long does that take?

Dr Yang 

The numbing cream will take half an hour, as I mentioned, the treatment will take 25 minutes to 35 minutes so generally say you will be in the clinic for about one hour, which includes the preparation.

Trish   

And what about the downtime? Like can you walk away? And go back to it? Or do you have to hide for a couple of days? and when does it start to wind up and start to look red? Or do you pee or what happens to your skin?

Dr Yang  

Your face or redness is equivalent to people who may be spinning it, spin an hour on the beach, or they have two glasses of wine. It’s not a rendus that you walk on the street, people will look at you in amusement, it wouldn’t be like that so your friends or family may comment to say, Hey, your face looks red, and it hardly ever bleeds, almost none and it doesn’t scabs and other than tiny spawned. So the downtime we normally advise our patient to take is between 12 to 36 hours and most of the people carry on their normal schedule like me I have a treatment, I will go back to consultation straightaway. Yeah, that was before we even used a mask. So most of my patients wouldn’t feel uncomfortable or they’d find much different. So basically, it’s almost a lunchtime treatment, but it doesn’t hurt. You organise it and the day that you go home and normally, for the next day, you should be able to go back to work and for most of the people, so I I just tell my patient, the downtime is between 12 to 36 hours.

Trish   

Okay and it’s nothing and with that, with that downtime, how long before you start to look amazing, like after 36 hours, can you see a difference straightaway? Or is there time for the skin needs to heal?

Dr Yang  

Generally they say it all takes people a week to two weeks to see the result, probably adding three or four weeks, they say the best result. 

Trish  

Okay. And if someone was coming to, if I’m coming to your clinic, like what’s your preferred option for fine lines? like would you do injectables or would you use the PicoSure®?

Dr Yang 

Obviously PicoSure® is one of the major choices for us to treat fine lines in skin and basically it’s a medical treatment in a sense, although it’s in a cosmetic area so you got to assess a situation. Look at what’s the best choice in some areas of the skin, obviously use injectables. But if you look at the fine line multiple areas, and like your mid phase or below the eyes and you would choose the PicoSure® Pro or PicoSure® to treat your patient and injectables normally reserved for the stronger or thicker or deeper, wrinkles lines and for fine lines, I think the injectables are not as good as light as a device if we if the patient really concerned about the fine lines.

Trish   

Okay, and if we go back to the tattoo removal ambit, you said it can take between 5 and 10 sessions, would a patient notice a difference after the first session? And in how long does that take to heal? Is it the same as face or is it like a more intense treatment?

Dr Yang  

Tattoo treatment is actually treated with higher energy and you can also call it intense treatment with a tattoo treatment so we use smaller size and high energy levels. Generally, people will say the difference after a couple of weeks, and the result will be continually improving up to six to 12 weeks. But the interval between the treatment was normally scheduled at six weeks, and to have the second treatment and so most of the people understand because they have done some research they heard from their friends, what to expect so we will normally schedule their treatment beforehand, and then recall the patient to the clinic to have the tattoo treatment here.

Trish   

Because I get amazed as to the way that tattoo removal works because you do it your budget, and you go away and slowly, slowly it kind of gets better and clearer. It’s just, it’s surprising, like it’s just the way it works is really quite fascinating to me.

Dr Yang 

Yeah. Well, there is some data about how many of us now have tattoos. It’s a very high percentage and so you know, all life changing, what we believe it’s fantastic, fantastic idea, and suits me lifestyle wise, artistic wise. It may not be there after 10 – 15 years, so scenarios change. I’m looking for a new tattoo or I don’t want this tattoo anymore so the requirement for tattoo removal is increasing. So PicoSure® Pro is, in that aspect, a huge help for people who have that requirement. So I’m happy to offer that to all the patients who have that requirement, and to have that indication so it’s also a big part of our practice, obviously. 

Trish  

Yeah, I’ve even heard that. Well, actually, I even know people that go and get a tattoo removed. So get a new tattoo put in the same spot, because they just don’t want to do it anymore. I am one of those people that has tattoos that I wish I’d never gotten. But then I also think I’d like to get a different one, you know, hits the head because I still like them. I just don’t like that tattoo because like you said, it’s from years ago, and you know, things change for you.

Dr Yang 

Yeah, well, it’s become popular so we do tattoo movements, a lot of the time, the tattoo artist will talk to us to say, you lighten it so we can put the second layer on, we can do a new tattoo in the same spot. So it’s become much more popular, so we would normally give them a few treatments, and then they move on to have the new artwork done. 

Trish  

Yeah. And just very briefly, so when you’re doing your facial rejuvenation, it can take 25 minutes but with a tattoo removal, it must be a whole lot quicker. Hey, I mean, I know it depends on the size of the tattoo, but you’re not going to be there for hours getting a tattoo removed. Are you?

Dr Yang 

It depends on the size of the tattoo, most tattoos are not very large and so it’s quite quick. So we do the numbing cream as well and then if the tattoo is small, then obviously we only do one to two passes so it’s very quick. But sometimes you have very large tattoos so people can be there for up to one and a half hours, including the numbing time. We have to do it very slowly and accurately because some of the tattoos come in with a very delicate graph. Yeah, you know, so you have to treat it, like, very very carefully, you don’t want to treat the normal skin in between so it can take up to I wouldn’t say they will be there more than two hours but one and one half hours altogether. It’s possible.

Trish

Okay. And is there any like is there anything with the colours is like is there certain colours that don’t that you can’t remove or …?

Dr Yang 

Before PicoSure® was born, people had almost no way to remove the colour tattoo, especially the red and the green. And with the PicoSure® and PicoSure® Pro, we got wavelengths of 532 and then that revolutionised this treatment of colour tattoos to red, and green because those coloured ink is widely used recently, and in the last decades, it’s a really big help. For those people who want to remove the colour tattoo, the 755 nanometer wavelengths, which we use for skin rejuvenation, and scar treatment, are useful for the dark and blue ink and that we use the most but the colour tattoo have to use other wavelengths to use, merely the 532.

Trish  

So you just change your settings and just keep going.

Dr Yang   

Yeah, you can, they are two choices, you can do the treatment in the same session. Sometimes you have to reschedule them into different sessions depending on where the tattoo is, how the title looks, and the area of it. So you basically want to minimise the side effect and you can’t do overlapping because it’s still a powerful treatment and so you sometimes reschedule them a few weeks apart to treat the coloured area.

Trish  

Okay, okay. Until we do you have a patient story like a mad a really terrible tattoo that you’ve removed like that, that can actually honestly be life changing for that client.

Dr Yang 

I want to say one of my nurses, and she actually had a kill switch treatment for a tattoo she had when she was very young and now she’s at a different stage of life. And that tattoo became an irritation. You know, sometimes we understand that and become irritated and so she’s frustrated, frustrated about the previous experience, and I treated her with emotional problems and the result, the result is very promising and I’m looking forward and to treat them all and she’s very happy and and tell me she’s excited then this is life changing treatment finally come in. So I would say we’ll hear a lot of happy stories in the coming years here.

Trish 

That’s so good. That’s so it’s some you know, we’re not always the same as what we want you know, this year is different to what we want in five years time and I know exactly what that feels like.

Dr Yang 

That’s right.

Trish 

After years, a lot of tattoos, if they’ve got words on them, their words, the letters all mumble jumble together. So you might want to get it removed and get it done again, like, I know so many people that do that.

Dr Yang 

That’s right. That’s right. So when your lifestyle changes, as I just said, you’re at different stages of your life so you probably sometimes want to change this out with the artwork you have.

Trish 

Yeah, yeah. And because I have a friend whose daughter wanted a tattoo, and I said, just let it be like, she wants it, just let her get it because in five years time, she’s not gonna want it, she wants to, she’s gonna want to get it removed. And honestly, it would be five years today where the daughter was sorry that she had the tattoo. So mum agreed to get it removed, or she went with her and she was like, we can do that. I wanted to ask you. So would you recommend Cynosure’s PicoSure® Pro to clients and to clinic owners?

Dr Yang 

Oh, yeah. Um, no hesitation. Look at me, I had my first PicoSure® five years ago and three years ago, I got another. Now I have PicoSure® Pro. And it makes sense, both professionally, academically, and obviously, economically, because PicoSure® laser,  PicoSure® Pro especially, is our champion device. In our clinics, it’s our cornerstone of the business as well and is a device we use our team use every day, along the years. So yeah, it’s the sensible choice.

Trish  

Yeah. And it’s good having that. Not, I guess, like a workhorse, the one that does nearly everything that you do in the clinic, you know, because it sounds like your PicoSure® Pros are on all the time. 

Dr Yang  

Yeah, yeah. And, and every day we show our sharpies or treatment, you know, on a busy day, and our record was like, I think was eight a day and in one single day, we do a treatment and I originally do three or four treatments, easy. Yeah. And so it’s you know, with a break and the numbing cream and our girls are busy all the time with a machine. 

Trish  

Yeah. And that’s what you want as a clinic and as a patient, that’s what you want. You want to go somewhere where they’re using that device all the time and exactly how to use it properly and get the best results.

Dr Yang  

Oh, yeah, obviously, we have a lot of experience behind this machine and feedback, and great results follow. And so that’s what gives us the confidence to, I’m pretty sure we’ll have a great time in the future to utilise this machine more.

Trish 

Yeah, fantastic. Well, look, thank you so much for joining us today. That’s been really insightful. I’m like, I don’t want to get a tattoo removed, or do I just want skin rejuvenation? So I’m going to get in the lineup now.

Dr Yang 

Okay, welcome.

Trish 

Thank you so much for joining us today. 

Dr Yang

Okay, thank you. 

Trish 

Thank you and listeners, look, if you do want to visit Dr. Feng Yang, you can actually find him at melbourneclinicallaser.com.au which is based in Box Hill in Melbourne and as it says there’s a few clinics there. There’s Chadstone, South Yarra so he’s got quite a few clinics. So there’s bound to be one in Victoria that’s going to be close to you and just reach out if you want to send us a DM or a message and we’ll put you in touch as well. So thank you, so much for joining us today, Dr. Yang.

Dr Yang  

Yeah, no problem. Thank you for having me.

Trish

Thank you so much. Bye bye.

Dr Yang

Thank you. Bye

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