Treatment of vascular lesions with the Vbeam 2 Perfecta™ pulsed dye laser

The Vbeam 2 Perfecta is the fifth  generation of vascular lasers made by Candela, the acknowledged world-wide leader in pulsed dye lasers.  Since 1993 Dr. Barkey has used each succeeding version of this laser     beginning with the original SPTL-1b at McLaren Regional Medical Center. 

The Vbeam 2 Perfecta allows office treatment of various vascular lesions including small facial veins, capillary hemangiomas, and port wine stains (vascular birthmarks).  No anesthesia is needed.  Because the Vbeam 2 Perfecta passes through the skin without any disruption of the surface, no wound is created.  There is very minimal risk of infection or scarring.

How does the Vbeam 2 Perfecta™ work?

The Vbeam 2 Perfecta uses one specific wavelength of light designed to be absorbed by the color red.  It passes through the top layer of skin without injuring it and delivers a small unit of energy (as heat) in a fraction of a second to the inside of the desired target blood vessel.  This heat injures the blood vessel which is then absorbed over the next 2-4 weeks.  The Vbeam 2 Perfecta is also equipped with a patented cooling device call the DCD (dynamic cooling device).  The DCD sprays an inert cold spray onto the skin surface just before each pulse of the laser.  The DCD provides anesthesia and because the skin surface is cooled, allows higher and more effective energies to be delivered.

Unlike previous versions of this laser, the Vbeam 2 perfecta has the ability to vary the duration of the pulse of the laser to minimize bruising that occurs when the blood vessel is injured.

What can I expect during and after treatment?

During treatment protective eye shields are worn.  Each pulse of the laser feels like a small rubber band being snapped on the surface of the skin.  Test pulses are given to determine just the right energy to apply to produce the best result.  Afterwards the treated area feels very warm and a cool pack is applied to the area intermittently for the next several hours.  The treated area is flushed red and there is some swelling of the skin.  These changes resolve in 1-2 days.  Depending on the fragility of the blood vessels and the aggressiveness of the laser surgeon, there may be some bruising produced.  This bruising is completely under the skin and lasts 7-14 days.  Moisturizers, sunscreen, and make up may be applied at any time after the procedure. 


Are there any restrictions before or after treatment?

As always it is best to treat areas that are not tan and also to protect areas from sun (or tanning spa light) for about 4 weeks after treatment.

Since the laser works by clotting the tiny blood vessels that are being treated, blood thinners (e.g., Plavix, Coumadin, and aspirin) may not be taken for a week before treatment.  These may be resumed the day after treatment.   


Cost and Insurance Coverage

Vbeam 2 Perfecta treatment of port wine stains is covered by major insurance carriers.  Treatment of small facial veins and capillary hemangiomas is not usually covered although some people have had coverage through their health savings plans.  The cost of treatment of multiple facial veins covering the nose, cheeks, and chin is approximately $200—250 per treatment.  Over 90% of the time only one treatment is needed to produce an 80% reduction in these unwanted blood vessels. 

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