The Power of Two: Why MOXI and BBL HERO are Better Together
How Sciton's MOXI and BBL HERO devices are revolutionizing aesthetic treatments
In just a short time, Sciton's power couple—MOXI™, a 1927nm non-ablative fractionated laser, and BroadBand Light (BBL®) HERO™ (High Energy Rapid Output)—has become the go-to combination procedure for skin rejuvenation. Together, the two devices can address most skin concerns, including discoloration and pigmentation, vascularity, fine lines and wrinkles, and textural issues.
Both power players are available on the new smaller mJOULE™ platform from Sciton®, which is more portable than the Joule platform. The devices are available together or alone on the mJoule platform, and the HERO technology can be added to JOULE™, enabling users to customize their platform to their individual needs.
"BBL HERO plus MOXI is a home run for pigment as well as restoring luminosity, radiance, glow and improvements in superficial skin texture," says Sherrif F. Ibrahim, MD, PhD, founder of Rochester Dermatologic Surgery, PC and assistant professor of dermatology at the University of Rochester Medical Center in Rochester, NY.
Understanding MOXI: Light Yet Powerful
The latest modality to join the Sciton family of offerings, MOXI can treat uneven pigmentation, tone, and texture abnormalities, light photodamage and skin aging, rejuvenation, and provide long-term maintenance of more aggressive laser procedures such as Halo™ or Resurfacing Perfected™. It offers a range of delivery options from light at 5mJ and five percent density up to 20mJ and 20 percent density.
MOXI can be used on all body areas, including the face, neck, chest, arms, and hands. The average treatment time is just 12-15 minutes for a full face, with improvements noticeable after a single treatment and tending to be long-lasting.
Three Customizable Treatment Levels
Level 1: Prevent and Refresh
5-10mJ, five to 10 percent density, four to five passes
Level 2: Revitalize and Maintain
10-15mJ, 10-15 percent density, four to five passes
Level 3: Transform and Renew
15-20mJ, 15-20 percent density, six to eight passes
"You can set MOXI at level one for a light treatment and ideal for dark skin types or increase up to level three for greater correction," notes Dr. Ibrahim. "It is a simple, but elegant laser that is easily programmable with little to no learning curve."
MOXI offers an intuitive user interface with three modes for simple operation: Quick-Start, Measure, and Manual. In Measure mode, practitioners can program how many passes over each treatment zone by manually entering the surface area and dialing in a very specific amount of energy and density of coverage. Alternatively, users can jump right in with Quick-Start levels or select Manual mode for complete control.
BBL HERO: The Fastest IPL on the Market
Sciton's BBL is already an industry darling, having quickly gained worldwide popularity after its introduction in 2004. BBL HERO improves on the original, allowing practitioners to quickly treat the entire body. "It has four times the speed, three times the peak power, and two times the cooling capacity of the original BBL," says Dr. Ibrahim. "These features establish it as being leaps and bounds beyond any other IPL that exists."
BBL HERO can address a variety of conditions, including acne breakouts, rosacea, pigmented lesions, photoaging, photodamage, sunspots, vascular lesions, and skin laxity. "This is the Lamborghini or Ferrari of IPL devices," Dr. Ibrahim remarks. "We are seeing corrective changes in browns and reds, an unprecedented smoothing of the skin, and an improvement in texture."
Speed and Efficiency Redefined
With BBL HERO, providers can treat the full face and large body areas such as the back, arms, and legs in just two to five minutes thanks to its large spot size (15x45mm), high repetition rate, easily exchangeable snap-on Finesse Adapters for hard-to-reach areas, and change-on-the-fly Smart Filters that enable treatment of various skin conditions with a single handpiece.
These new attributes have opened the door for non-facial treatments. "Traditional IPL relies on the stamping method which results in uneven or over- or under-treated areas once you start treating off of the face," Dr. Ibrahim explains. "With BBL HERO, the handpiece is constantly in motion," notes dermatologist Joel L. Cohen, MD, Director of AboutSkin Research. "You have complete control over settings, joules, pulse width, and cooling, but also most importantly, how quickly the system pulses as you move the handpiece."
"Instead of trying to line up squares or rectangles, you are actually gliding quickly along the skin, which avoids lining things up and allows you to treat larger areas in less time," Dr. Cohen explains. "For treatments where efficiency and time are important, especially with multiple large areas, BBL HERO makes a huge impact. Instead of doing neck and chest one day and then the face and hands the next, we can now do it all together in a single 30-minute session."
Understanding Treatment Responses
Patients with more significant sun damage may temporarily have their pigment darken as part of the normal response. "Those with some milder pigment, and often, redness, may see an increase of redness along with the darkening of any pigment appearing like cayenne pepper as the clinical endpoint," Dr. Cohen says. "These manifestations of chromophore absorption will resolve over the next few days as the skin responds and recovers from the treatment to reveal newly revitalized, healthy skin."
BBL HERO Plus MOXI: Perfect Together
When BBL HERO and MOXI are used together, the results far exceed either one alone. "One plus one equals 10 in this case," Dr. Ibrahim says.
When treating patients with BBL HERO plus MOXI, practitioners start with 400 to 600 pulses of BBL HERO to cover the face, followed by an immediate transition to MOXI. MOXI safely addresses deeper pigments than BBL, including for melasma. "We can do one treatment at a higher setting, which will cause a little more swelling and peeling with about two days of downtime, or we can do multiple treatments on the lower end with less swelling and peeling," Dr. Ibrahim notes.
The flexibility of this combination is remarkable. Some patients request multiple treatments with no downtime, while others prefer a more corrective intervention followed by lighter treatments down the road. And because 1927nm is highly absorbed by water, these treatments are safe on all skin types.
"This is not a combination for advanced photodamage including etched-in lines or acne scars, but it's a match made in heaven for pigment and luminosity, radiance, and glow. It has become our go-to combination overnight," Dr. Ibrahim concludes.
Clinical Results Speak for Themselves
The award-winning results speak for themselves. Dr. Ibrahim took home the Maverick award at the 2021 Vegas Cosmetic Surgery & Aesthetic Dermatology (VCS) meeting for his talk on MOXI plus BBL HERO. He shared data on 12 female patients aged 18 or older with Fitzpatrick skin types ranging from I-IV who had moderate sun damage, aging skin with visible areas of fine lines, dyspigmentation, and/or erythema of the face. Of these, 11 patients received a single combination treatment of BBL HERO and MOXI and one patient underwent two treatments. "Improvements in pigment and texture were seen in all patients," he concluded. "These treatments with BBL HERO in combination with MOXI are safe and effective in the treatment of mild to moderate dyspigmentation and photoaging."
