Cosmetic Surgery

Zerona Laser Report And Critique For Cosmetic Surgeons

This will be a synopsis and critique of Zerona lasers, a aesthetic procedure that’s turning out to be a lot more widespread in laser centers, nonsurgical cosmetic medical spas and  physician clinics. This assessment relates to an important study entitled Low Level Laser Therapy Effectiveness For Reducing Pain After Breast  Augmentation, American Journal Of Cosmetic Surgery Volume 26, November 3rd, 2009. This comprehensive study was first published on  Medspa MD.

1. The first thing they educate you on in medical school on how to assess research is exactly who obtained the investigation. In this case the particular patron for this study and article was Erchonia the organization that makes Zerona lasers.

2. So , who wrote the article? In this case the article happens to happen to have been crafted by Ryan Maloney. Who is Ryan Maloney? He’s not just the medical director of Erchonia he ultimately is one of the owners of the patent on the Zerona laser. Aside from that you don’t know his experience. We discover he is not necessarily a PhD or MD. Usually it would be right behind his name underneath the authorship of this article. He  possesses a straightforward fiscal gain to post this content in a beneficial light.

3. Eight individuals didn’t have finalized measurements. The first dilemma is why? 4 had been from the treated group and 4 were from the  placebo group. Initially that seems OK, but after you examine deeper within it, they kept all of these test subjects within the study.  They took the last measurements for those subjects and took them forward. Again, it appears Ok to begin with but when you  begin to look at the pattern of circumferential reduction in the 14 days post treatment the measurements are trending back towards  baseline. So if you ever incorporate these individual’s last measurement (which by the way is the best overall average circumferential reduction  during the treatments for the treated group) and take them forward they are going to artificially decrease the true values fourteen days post  treatment. All eight of those individuals should’ve already been eliminated from the study.

4. There’s no evaluation of cosmetic benefit. To have this be worth anything you’d probably have to have before and after pictures which  are examined by a group of people who are blinded to what treatment the individual participant received. So, put simply,  is a three inch reduction aesthetically noticeable.

5. They do not express if individuals are male or female. Therefore the question is left, should it work as well on men as it will on females? This might be very important because men normally have thicker skin. So, does the laser penetrate as deep in men?

6. the study was limited to patients with a BMI of 25 to 30. Now I think it is fine to have this limitation as you have to  start your research somewhere. But the limitation is that the article is implying that it will work for all BMI’s. What about the  thinner female patient with a BMI of 20 but has a small lower abdominal pooch? Or what about the patient that has a BMI of 35?  This should be stated in the conclusion but Mr. Maloney seems to forget this.

7. They also do not state if the patients received their Zerona laser treatments for free or if they were compensated for their time. This  is only important for the portion of the study that talked about the patient satisfaction. We need to understand that patients  will put a value on the treatment because if something is free their expectations are much lower. their expectations are much  higher if they paid $2500 for the procedure. So if this was free to the patient and you could have 30% of the treated group that are  dissatisfied or neutral what would that mean to a clinic if the patients are paying for it. I would guess you will have a much  higher dissatisfied group that either wants their money back or free treatments. I do not want something in my clinic that has a  30% failure rate.

8. They do not discuss if either group was asked to change their diets. This should be stated up front in the methods portion  of the article. They also do not mention if there were any dietary supplements required such as niacin. Many clinics using Zerona  are having the patients take niacin even Erchonia recommends it.

9. They set the standard for success to be an inch loss of 3 inches or greater. Only 62.86% of the treated group achieved  success. So this translates in to a 37.14% failure rate. Again, not something that I would want to stake my reputation on.

10. Now what do the numbers mean? In the event you look at the numbers the patients baseline combined measurement average was 120.31  inches. At week 2 of procedure (the best measurements achieved) the average was 116.79 inches or an inch loss of 3.52 inches on  average. This sounds pretty good until you look at the true numbers. Using the numbers from the study this equates to a 2.9% inch  loss as measured over 4 areas. Is this clinically (visually) significant? I do not think that most individuals will be able to view  a 2.9% change or if they can it will be meaningful.

11. Lets take a look at the 2 weeks post treatment measurements. Remember, these are not true numbers as 4 patients had their  best numbers included in these measurements pulled forward and included here. (I think all of their measurements should have been  puled out). At 2 weeks post procedure, you view a .31 inch increase from the circumferential measurements at the 2 week  procedures. What this equates to is an 8.8% increase in inches in only 2 weeks. So what ends up at 4 weeks? 6 Weeks? So if it were  a perfectly linear increase it would only take about 20 weeks or so to be 100% back at baseline. That is if it were linear and I  highly doubt it can be a linear response and if i had to guess nearly all patients will be back at baseline measurements within 6 to 10  weeks and this is why there are no long term medical studies. The organization has had ample time to generate longer term casestudies they  apparently do not want to.

So as you can view, there are a few issues with this article and how it was analyzed and written. The first and foremost problem is  that the article was authored by an individual with direct financial interest in the product. The ASLMS journal never should have  published this article as a result of the authors conflict of interest or it should have a disclaimer prior to the abstract. I have no  vested interest in any of these non-invasive technologies and would love to view something like this work and have long term  benefits for the patients. I think this technology may have better long term benefits on cholesterol etc. I have heard that there  are some interesting scientific studies coming. I just hope they are not written by Mr. Maloney. And for others reading this I assume that  Chad works for Erchonia or the advertising company that is selling this thing to anyone they can including chiropractors.

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Soft tissue augmentation in skin of color: market growth, available fillers, and successful techniques.: An article from: Journal of Drugs in Dermatology $9.95 This digital document is an article from Journal of Drugs in Dermatology, published by Thomson Gale on January 1, 2007. The length of the article is 3268 words. The page length shown above is based on a typical 300-word page. The article is delivered in HTML format and is available in your Amazon.com Digital Locker immediately after purchase. You can view it with any web browser.Citation DetailsTi…