Reading Time: <1 minuteToday, we gathered our staff together to explain the absorption curve, which is the most basic of laser principles. If you do not fully understand the absorption curve, you will not understand the meaning of laser treatment. In the body, there are three substances that must be considered when irradiating with a laser: water, red blood cells, and melanin. The principle of laser treatment for dark spots is how to destroy melanin efficiently without damaging other targets. Not only the wavelength but also the absorption rate of other targets must be considered. In addition to this, we consider various laser wavelengths, the depth of penetration, and the target that absorbs it when performing treatment. The longer the wavelength, the deeper the light penetrates, and the shorter the wavelength, the shallower the light penetrates. This is supplemented by doubts about pulse width and energy. ・Wavelength ・Pulse width ・Energy This is an important point for laser treatment. The 10nm Q-switched YAG laser targets melanin in the epidermis. The 6nm Q-switched YAG laser targets pigmented disorders in the dermis (ADM, nevus of Ota, tattoos, nevus spilus, etc.). The Q-switched ruby ​​laser has good absorption properties for melanin. It is sharp when treating age spots, so dermatologists prefer to use it. Recently, pico lasers with extremely short pulse widths have been actively used for tattoo removal and age spot treatment. 20-XNUMX is pico, XNUMX-XNUMX is nano. The Q-switched YAG laser also has a fairly short pulse width of XNUMX-XNUMX billionths of a second, but... Cutting-edge laser equipment is constantly evolving.

Reading Time: <1 minute The other day, I gave a lecture at the aesthetic medicine community. Clinical experience and applications of the latest Q-switched YAG laser. The content was educational. Currently, our clinic has introduced the world's most advanced Q YAG laser device to perform skin beautification treatment and stain treatment. Laser toning and laser peeling are also possible at the same time. Pico lasers have been a hot topic recently, but there is no special sense of effectiveness in treatments other than tattoos. Our clinic aims to achieve total skin beauty. We have introduced the re-examination Q YAG laser device Pastelle Pro for skin beautification treatment. Stains, open pores, dullness, fine wrinkles, melasma, tattoos... Recently, many cosmetic surgery clinics seem to have nurses performing laser treatments, but this is a gray area. At our clinic, I, the director, will always be responsible for everything from counseling to examinations and treatments. Please feel free to consult us.

Reading Time: <1 minuteMany patients who wish to have moles removed visit our clinic. In addition to the scars left after mole removal, everyone is concerned about the pain during treatment and the pain of anesthesia. Local anesthesia is performed with a local anesthetic to remove moles. Since men are particularly sensitive to pain compared to women, our hospital manufactures local anesthetics in-house to reduce pain during anesthesia as much as possible. Generally, local anesthetics are administered by injecting a drug called lidocaine hydrochloride, also known as xylocaine, into the mole removal site with a syringe. The concentrations of xylocaine used in cosmetic surgery are mostly 0.5%, 1.0%, and 2.0%, but since the drug is acidic, the higher the concentration, the greater the difference in pH with the body, and the stronger the pain of the local anesthetic being felt when injected. At our hospital, we adjust the concentration of xylocaine containing a vasoconstrictor called epinephrine to about 0.2%. We mix it with a drug called Meylon, which has an alkaline pH of bicarbonate, to adjust the local anesthetic to be neutral so that it approaches the pH of the body. This significantly reduces the pain during local anesthesia. Unfortunately, the knowledge of how to adjust local anesthetics is not yet widespread among many cosmetic surgeons. The cosmetic surgeons and cosmetic dermatologists I have taught always use Meiron to adjust the pH and dilute the concentration of local anesthetics, rather than using them as is. Also, the thicker the needle used for injection, the stronger the pain when it is inserted into the skin. Depending on the area, anesthesia is administered using extremely thin needles of 30G to 34G, so the pain is significantly reduced compared to when local anesthesia is administered with a normal needle. It is also important in medical terms to take into consideration the method of anesthesia and the drugs used when performing treatment. Private medical treatment requires advanced knowledge, skills, and delicate care. When removing moles for cosmetic purposes, we believe that it is essential for patients to receive the best cosmetic medical services, and we provide treatment accordingly. If you are still afraid of injecting anesthesia into your face, we can perform a special anesthesia method using a small medical vibrator or vibration oscillator that vibrates at an even higher speed, which vibrates the skin near the injection site to cause vibrations and lower the pain threshold.

Reading Time: <1 minuteTreatment methods for mole removal vary depending on the location, size, type, and shape of the mole. Of course, if malignancy is suspected, the mole is excised and a pathological examination of the tissue is performed to determine whether it is malignant or not. In general, if no malignant findings are found with a dermascope and even benign moles are removed by excision, the scars left after excision are often more noticeable than the mole itself. Moles are classified by shape as follows: 1. Raised moles 2. Slightly raised moles 3. Flat moles. Of these, raised moles are easier to remove and are less likely to leave scars. For about 30 years, mole removal has been performed using the vaporization method with carbon dioxide laser irradiation. When you hear the word laser, you may think of something cutting-edge, but the principles of the carbon dioxide laser device itself have hardly evolved since 30 years ago. The theory is also the same. Just because it is a carbon dioxide laser does not mean it will remove the mole cleanly. We offer unlimited carbon dioxide laser irradiation for mole removal at low cost. We receive many consultations about cases where moles were not removed by simply irradiating them at a medical institution and only burn scars remained. It is not true that carbon dioxide laser can be used to remove moles cleanly. In particular, for raised moles, we recommend a method of carefully and precisely evaporating the mole tissue with high-frequency heat to avoid post-burn scarring and remove the scars in an inconspicuous manner. We do not dare to irradiate carbon dioxide laser. Of course, advanced techniques are required technically, but in most cases, it can be removed very cleanly and the postoperative scars are not noticeable. For flat moles, the pigment reaches the deep dermis and subcutaneous tissue, so if you try to remove it completely in one go, it is necessary to evaporate the deep parts as if it is being gouged out, and it is prone to scarring, so it is often difficult to remove it completely in one session. In that respect, if you first evaporate the raised mole tissue to a flat surface, the wound will heal cleanly and scars will be less likely to remain. A specialist can diagnose moles preoperatively to determine what treatment is best and what care is required.

Reading Time: <1 minuteOf course, armpit surgery is performed by a doctor. However, recently, there have been many problems with nurses treating armpits. Non-surgical armpit treatments include Miradry and Viewhot. Recently, ultrasound treatments such as HIFU have also become available. The common feature of these treatments is that they all use equipment to press a dedicated probe against the affected area and irradiate it. For this reason, the technique is simple and even nurses can perform the treatment. However, nurses have not studied medicine. Even if they study nursing, they are not experts in dermatology, wound healing, or cosmetic medicine. It is not the same whether they are nurses or doctors, as they only press a probe against the skin and irradiate it. First of all, there are individual differences, so detailed parameter settings such as output, irradiation time, and range are required depending on the condition of the skin, the treatment area, etc. of each individual patient, and following the manual given by the company not only does not produce sufficient results, but extremely serious skin damage, burns, and nerve damage have actually occurred as medical accidents. So why do nurses treat armpits? The reasons are assumed to be as follows. 1: The treatment time is long and it is not worth it considering the doctor's fee. 2: The surgery is performed by a doctor, but only nurses are available due to the reservation situation. 3: The company sold the equipment to me, saying that it is a simple treatment that even a nurse can do. 4: Considering how to reduce the cost of treatment in the price war, the business will not be viable unless a nurse performs the treatment. 5: Doctors do not know anything about body odor. For this reason, not only are there risks involved in nurse treatment, but there are also legal issues that are gray. Since it is a medical procedure, even if it is under the supervision of a doctor, it cannot be said that there is definitely no problem under the Medical Practitioners Act for a nurse to perform body odor treatment. Ethically, it is absolutely not OK for a nurse to perform body odor treatment. I have been advising manufacturers about this issue for many years, but they have completely ignored me, and the thing I feared happened. Although it was not a treatment for underarm odor, a nurse was performing high-frequency treatment for wrinkles and sagging skin (reported as laser treatment) without the supervision of a doctor, which caused severe burns to the neck and resulted in a six-month recovery, causing a cosmetic medical incident in which a certain clinic was raided for professional negligence resulting in injury.The report included real names and even the name of the cosmetic medical device used. https://news.yahoo.co.jp/articles/98c0df8670df62a988c3d9b40ea6cdbff7afabcc It is unusual for police to investigate a medical institution for reasons other than fatal accidents. This case is just the tip of the iceberg, and the reality is that many problems occur as a result of nurse treatments. Our hospital has also received many consultations after problems with nurse treatments. It is unfortunate, but the cosmetic medical industry is building a business system that lowers the unit price for nurse treatments, promotes them, and attracts customers. In order to avoid lowering the quality of cosmetic medical care, perhaps it is time to reconsider the gray area cosmetic medical procedures performed by nurses.  

Reading Time: <1 minutehttps://www.mbs.jp/news/kansainews/20211115/GE00041054.shtml

Burns for XNUMX months after laser treatment ... Victims file criminal accusation with doctors Medical equipment is not approved in Japan

There were reports like this, but I was concerned about some mistakes and a shift in focus, so I have explained it in more accurate terms. It is unusual for a case to be reported as a criminal offence and a search warrant at a beauty clinic other than a fatal accident. In terms of cosmetic medical risk management, there were problems with follow-up and treatment of patients when cosmetic medical troubles occurred, which is thought to have led to the problem expanding beyond medical troubles. First of all, this cosmetic medical trouble was,Laser treatmentso···scaldThere is a title, but in the document it is not due to high frequency and laserhigh frequencyIt turns out that it is a medical accident of beauty treatment by. Lasers and high frequencies are completely different. Lasers are light with a single wavelength, and high frequency is electrical energy, meaning that light and electricity are completely different types of energy. Lasers are primarily used in cosmetic treatments that approach the epidermis or the superficial dermis, such as removing age spots and tattoos. However, high frequency is mainly used to treat wrinkles and sagging skin, not the epidermis, and is a treatment that targets the subdermis. Lasers and high frequency are confused. Next, the name of a medical manufacturer called Jis●● Co., Ltd. was shown in the news video as an unapproved device, and a photo that appears to be a brochure for the device that was supposed to have been used, ULTRACell?, was also shown. This could make it seem as if the company itself is in trouble. If this company had promoted this device by advertising it as a nurse treatment, the company's responsibility could be questioned, but common sense would make it impossible to make such a recommendation. It is unthinkable that a medical device that can be used by a nurse to perform medical procedures that should always be performed by a doctor would be sold. Of course, no company can sell unapproved devices in Japan. In reality, the flow of purchasing unapproved cosmetic medical equipment is that the doctor imports the equipment at his/her own personal responsibility, and the company acts as the agent for the personal import. In this case, of course, leasing is not possible, so all payments must be made in cash. We are concerned that this report will give the impression to viewers that there is a problem because unapproved equipment was used. In the current world of cosmetic medicine, unapproved equipment is often used when performing cosmetic treatments, and if unapproved equipment is considered to be illegal, many cosmetic medical services must be stopped. There is no problem with using unapproved medical equipment as part of a doctor's responsibility. The doctor at this medical institution should have had no problem introducing this equipment. Now, the problem with this incident is that the nurse performed the treatment. This is a medical procedure that is often described as black and gray. The doctor seems to have given instructions such as printing at the beginning, but the nurse was just doing it like an assembly line? Or she must have been following some kind of manual. I saw the scars from this patient's surgery on the Internet, and they were second- and third-degree burns. There were some areas of severe burns that seemed to have caused skin necrosis. Unlike abrasions and cuts, burns take longer to heal, are more likely to scar, and scar contraction is more likely to occur. It is assumed that the pain after surgery was also quite severe. Rather than the skill of the nurse, the doctor should have checked the patient's condition during the procedure. Of course, after surgery too. When the skin damage caused by the burn was discovered after the procedure, early intensive treatment for the burn (if it were me, I would thoroughly perform PRP therapy, cytokine skin regeneration therapy, moisturizing therapy, cooling, inflammation suppression, etc., and consider daily wound care) should have been necessary. To the patient: If the medical diagnosis and treatment at that time were explained in detail and an apology was given, and as much cosmetic and regenerative medicine as possible was performed, it is assumed that not only could the scar heal more easily, but also the patient's mental burden could have been reduced. According to the reports, the medical institution was criminally charged, so it is clear that the patient was angry and distrustful of the medical institution's response, not just as a result of the medical trouble. Nurse treatment: I think that this treatment is not gray, but black, that is, it is also a legal problem. Ethically, it is absolutely not allowed. It seems that patients chose nurses for treatment because it was cheaper, but I question the idea of ​​having nurses perform treatments that should be performed by doctors just to reduce treatment costs. I am not a legal expert, but as a cosmetic surgeon I have been practicing cosmetic medicine in clinical practice for over 30 years, and I have always feared that the more nurses perform treatments in place of doctors, the more problems there are and the more dire the results. I have repeatedly told cosmetic medicine manufacturers with whom I have a connection that problems occur when nurses perform treatments, that ethically and legally, nurses should never perform treatments, and that as a manufacturer of cosmetic medicine equipment, they should never use this term in their sales pitches. In reality, there are cosmetologists who are willing to convince and do not recommend nurse treatment, and there are cosmetologists who are repulsed and let the nurse do what is wrong. This incident does not seem to me to mean that this medical institution is extremely unscrupulous or illegal, or that it has caused any major problems. Cosmetic medical troubles like this one are just a small part of the problem. I have received many consultations about more tragic problems caused by nurse treatments. I think it's just the tip of the iceberg. I hope that this incident will encourage cosmetic medical businesses to straighten up in the future and provide support and business in which doctors, not nurses, are responsible for operating cosmetic medical equipment and directly carrying out cosmetic medical treatments. I am not trying to defend the doctors and nurses at this clinic, but I think it is important that this incident be a lesson to encourage people to be careful when receiving cosmetic medical treatments, rather than criticizing the doctors and nurses in charge, and that it will be an opportunity for doctors to be responsible in providing cosmetic medical treatments. The purpose of cosmetic medical treatments is to make women happy.

Reading Time: <1 minuteIn principle, the anesthetic used for mole removal is lidocaine hydrochloride, or xylocaine.　https://www.kegg.jp/medicus-bin/japic_med_product?id=00000332-003is used. We use xylocaine containing epinephrine, a vasoconstrictor. Epirenamine has the effect of constricting blood vessels during treatment to suppress bleeding and extending the effective time of xylocaine. Although medical school textbooks state that use on the tip of the nose and fingertips is contraindicated, there are currently no clinical problems. (It was thought that vasoconstriction could cause skin necrosis.) A 0.5% to 2.0% concentration is often used, but for mole removal, 0.5% is a sufficient concentration and there is no problem with use. We use xylocaine in our clinic, and as the name xylocaine hydrochloride lidocaine suggests, its pH is acidic 3.3 to 5.0. When injected into the body, especially into the dermis, the drug causes pain due to the difference in pH when it diffuses. For this reason, we mix an alkaline drug called Meylon to further lower the concentration and adjust the pH to about 7.3, which is as close to the body's pH as possible, and we make our own by adjusting the pH. In actual use, the pain during injection is much less than that of conventional xylocaine injections, reducing the burden on the patient. In addition, the needle used to inject is extremely thin, from 30G to 34G, which significantly reduces the pain. When removing multiple moles, an injection is required for each mole, so pain relief care for the patient during anesthesia is always necessary. Although the amount of anesthesia required for mole removal is small and easy, careful injection can relieve pain. At our clinic, we use extremely thin needles and a homemade xylocaine anesthetic with an adjusted pH level to remove moles.

Reading Time: <1 minutehttps://news.yahoo.co.jp/pickup/6409686 Recently, there have been reports of problems with treatment at beauty clinics. There are some errors in this content, so I would like to give my personal opinion. The news article states that it is a problem with a laser, but in reality, wrinkles and sagging are rarely treated with lasers, so it is expected to be a treatment with high-frequency electrical energy. The article also mentions the word high-frequency, and I think that if it was high-frequency, a system like Thermacool would have been used to generate heat energy from a single terminal and promote collagen production in the dermis to treat sagging and wrinkles. However, the main system for treating wrinkles and sagging on the neck today is called HIFU, which is a treatment method that focuses ultrasound at a high density, generates heat, induces protein denaturation in the dermis and fascia, and lifts the skin. There are many articles on the Internet asking whether the problem was caused by HIFU, and the truth is still unknown. It says that unapproved equipment was used, but using unapproved equipment in beauty treatment is not illegal. Rather, in Japan, most beauty treatments in beauty medicine are performed with unapproved equipment, and if unapproved beauty medical devices were illegal, it would be impossible to run beauty clinics or provide beauty treatments. The current situation in cosmetic medicine in Japan is that doctors import unapproved cosmetic medical devices from overseas at their own risk and perform treatments using them. We are concerned about the reports that give the impression that it is bad to use unapproved devices, or that the police conducted a search of the hospital because of the use of unapproved devices. The problems with this case are: 1. The nurse performed the treatment. 2. The nurse was not given proper instructions or post-operative checks, and even if the treatment was performed under the supervision of a doctor, it was insufficient. It is unusual for the police to conduct a search of a medical institution for a medical accident other than a fatal accident, and it is assumed that the patient's report of the damage and criminal complaint were submitted to the police with concrete evidence, such as a medical certificate. Alternatively, it is assumed that there are other similar victims and there are multiple similar cases, or that the medical institution's response to the current patient was extremely inappropriate. In any case, I do not think that this problem is only a problem for the medical institution that was searched. We also receive a considerable number of consultations from patients who have received laser irradiation or HIFU irradiation at other clinics, which should have been performed by a doctor, and suffered burns. If there is even the slightest risk in any treatment, it should always be performed by a doctor, and I believe that import agents and manufacturers should not sell cosmetic medical devices on the assumption that a nurse will perform the treatment. We will be closely monitoring the facts of this incident so that more people can receive cosmetic medical treatment, which has many gray areas, with greater peace of mind. Since opening, I, as the director, have been responsible for all treatments at our clinic, from start to finish.

Reading Time: <1 minuteAs the COVID-19 infection spreads, people now have to cover their faces with masks, leaving only their eyes exposed. Many companies now require employees to wear masks indoors. Currently, the number of patients undergoing mole removal is increasing rapidly. Carbon dioxide laser treatment is well known for mole removal, but our clinic recommends thermal evaporation treatment using electronic energy, which leaves less scars than carbon dioxide lasers and can be removed reliably in a short time, or evaporation treatment of mole tissue using a thulium laser (Lavieen). >>About mole removal Unlimited mole removal Treatment is performed on a flat-rate basis. In medical institutions, removal using a carbon dioxide laser is common, but there is a high possibility that a very noticeable hypertrophic scar will remain, so careful consideration is required. Many patients come to our clinic to consult about hypertrophic scars after mole removal using a carbon dioxide laser. CO₂ or carbon dioxide laser mole removal has a cutting-edge image with the name laser, but it has been used clinically for over 25 years. In a sense, it is an old-fashioned treatment and is not necessarily recommended as the first choice for carefully removing moles. In fact, I also removed moles more than XNUMX years ago using a domestic carbon dioxide laser system developed by Japan Infrared Industries Co., Ltd. (Neek), which was sold at a list price of about XNUMX million yen at the time. When I started working as a cosmetic surgeon, the treatment for mole removal was basically excision, so the carbon dioxide laser system, which can evaporate and disappear by simply irradiating it with laser light, was revolutionary and seemed like a magical device. Scars are less noticeable than with incision surgery, and scar healing was not a big issue more than XNUMX years ago. Laser treatment In those days, patients were satisfied if the swelling and color of the mole improved. However, nowadays, there are systems that can remove moles more cleanly, so the issue of scars such as hypertrophic scars caused by carbon dioxide laser removal has come into focus. I am still reluctant to use the same treatment method as XNUMX years ago. Currently, raised moles are mainly removed using a treatment method that evaporates the mole tissue with heat from electronic energy of radio waves. For flat moles, a laser is irradiated with a medium called thulium to evaporate the tissue and remove it. Moles are diagnosed with a device called dermoscopy. If malignancy is suspected, the affected area must be removed by excision or hollowing out, and a pathological examination is performed to confirm the diagnosis. For tumors and moles that have been diagnosed as benign, we do not perform excision, but choose to treat them with electronic energy evaporation or thulium laser. For aftercare, a medical sticker is applied for a few days and moist wound healing is performed, but the affected area is not disinfected. Disinfecting the wound will delay wound healing due to the tissue damage caused by the disinfectant, and the risk of infection will increase. The main reason for removing moles is for aesthetic purposes, but there are also cases where a fortune teller recommends removal, or there are symptoms such as itching or pain. Mole removal does not mean that all scars will heal and become inconspicuous in the same way. Depending on the part of the body, the scar may become raised and become a state of hypertrophic scarring, so careful consideration is required before surgery. On the face, scars are likely to be noticeable around the mouth, lower jaw, and above the cheekbones. On the body, scars are likely to be noticeable on the shoulders, above the deltoid muscle, and above the sternum, because the skin is highly taut and the scar is always pulled by the surrounding area. In particular, in these areas, there are many cases where the scar heals as a white raised hypertrophic scar. Depending on the part, excision surgery can also be performed without leaving any scars, so if the mole is too large, surgery may be necessary. Because there is cartilage just below the tip of the nose, it is difficult to remove the mole, and you will need to choose a treatment other than excision. Mole removal is not a difficult cosmetic surgery procedure, but there are many things to be aware of, such as postoperative care and the selection of the surgical site, so we recommend that you receive a thorough explanation of the risks and benefits from your doctor before undergoing treatment. contact@sakae-clinic.com phone:0120566680