IPL vs BBL Explained: Photo Rejuvenation Treatments, Skin Concerns, and What to Expect

[Intro] Hey, everyone. Welcome back to Facially Conscious with myself, Trina Renea, esthetician, Dr. Vicki Rapaport, dermatologist, Rebecca Gadberry, the cosmetic ingredient guru, and our fabulous, overly-educated consumer, Julie Falls. 

We are gathered here together with you to talk about this crazy world of esthetics. It's confusing out there in this big, wide world. That's why we are here to help explain it to you all, subject by subject. We will be your go-to girls. And from our perspective, without giving medical advice, we will keep things facially conscious. 

Let's get started!

00:58 Trina Renea: Hello, ladies, welcome back. It's nice to see you again. 

01:01 Julie Falls: Nice to be back. 

01:02 Trina Renea: How’s it going?

01:03 Julie Falls: Good. Welcome to Facially Conscious. 

01:04 Dr. Vicki Rapaport: Trina…

01:05 Trina Renea: What? 

01:06 Dr. Vicki Rapaport: Hi. Your skin looks amazing today.

01:09 Trina Renea: Really? 

01:09 Dr. Vicki Rapaport: Yeah.

01:10 Trina Renea: It's my barrier repair I've been using since the last episode.

01:12 Dr. Vicki Rapaport: Oh, it looks glowing. 

01:13 Trina Renea: Ceramides, and glycerin. Thank you. 

01:17 Dr. Vicki Rapaport: It's good. Yeah.

01:18 Trina Renea: It's also makeup, kind of. Well, not really. 

Anyways, today's episode number 18 is on IPL and BBL. These are two kind of lasers that we're going to talk about that, well, IPLs have been around for a really long time. So we're going to tell you what it is and what the results are, who it's good for, who it's not good for, and if it hurts, what it costs, and if you should do it or not. 

I know a lot of doctors have IPLs in their offices. It's pretty standard now, I think. IPL stands for, Dr. Vicki? Dun, dun, dun…

02:03 Dr. Vicki Rapaport: Intense pulsed light. 

02:06 Trina Renea: Intense pulsed light. And it does what? 

02:09 Dr. Vicki Rapaport: IPL relies on the principle of selective photothermolysis, which means you selectively photodamage something, a target. And there are many different targets in the skin. Typically, it's either melanin, brown, hemoglobin, red, or water. And basically every cell has water. So for an IPL, the energy ranges from 500 nanometers to 1,200 nanometers. It's a wide range of heat. Versus a true, true, true laser is one nanometer of light. An IPL is a broad range of light that will still individually target one thing based on the technology of the laser. 

So with this selective photothermolysis, it will target one thing and it will spare all the tissue around it. And by sparing all the tissue around it, you get less scarring, less hyperpigmentation, less irritation, all that. 

So it is, to me, a workhorse in dermatology and plastic surgery and cosmetic surgery and cosmetic doctors. IPLs are a mainstay.

Basic purposes in just general terms, brown spots, red, like red blood vessels, hair, and a little bit of resurfacing. Not resurfacing like a CO2 resurfacing but baby resurfacing. So mostly hair, brown spots, red blood vessels. 

03:40 Trina Renea: Right. And once you target those and the brown spots and redness goes away, and stuff like that, then your face looks resurfaced. I think that's how sometimes they say resurfacing. It's not really resurfacing the texture of the skin, but it is making it more even toned, so it looks like a resurfaced skin. 

04:00 Dr. Vicki Rapaport: Yeah, I think that's right. That's correct. It does a little pore refining, and it does a little bit of resurfacing in that it will photothermolyze water if it's on a certain setting. So, yes, you are right that it's more of a color corrector, is how I like to describe it to patients. Like if they have any color that isn't what they want in terms of having that porcelain, beautiful skin, an IPL can most likely treat it. 

04:29 Trina Renea: Right. So when somebody comes in for an IPL, do you normally numb them? 

04:35 Dr. Vicki Rapaport: It's an interesting question. An old machine, an old device that I used to have, absolutely never. It was a little hot, but it didn't really hurt that much. It's just kind of messy and goopy to put numbing on sometimes, and it also takes up a lot of time. So in my old machine, I didn't have to. 

My new machine is a little stronger, and actually we do numb people. If they're not numbed, they can get through it, but it's nicer if they're numbed. Usually, it takes about 20 to 40 minutes to numb them. 

05:00 Trina Renea: And it feels kind of like a rubber band that’s slapping your skin, right? 

05:03 Dr. Vicki Rapaport: Yes, ma'am. In fact, I just did Julie's hands a couple weeks ago. How did it feel, Julie? 

05:08 Julie Falls: Like a little burning. I think the skin on the hands is so thin. It was definitely more painful than doing your face. 

05:19 Trina Renea: Do you numb your face when you do? 

05:21 Julie Falls: I mean, I have, but... 

05:23 Trina Renea: It's not super necessary. I mean, if you don't want any pain, sure, numb. 

05:27 Julie Falls: Yeah, I think I have a high pain tolerance because I've done things. 

05:31 Dr. Vicki Rapaport: And I think patients shouldn't judge whether they got numbed in this place and didn't get numbed in that place. Certain things 100% across the board, we numb. You know, for microneedling or other more invasive treatments. But this is noninvasive, non-ablative. Non-ablative means not cutting. So it doesn't really have to be numb. 

05:49 Julie Falls: Right. 

05:50 Trina Renea: Right. It's just more for the patient's comfort level. And because some patients are like, “Ooh, does it hurt?” You want to make them feel like it's okay. You don't have to feel pain. More like that.

06:01 Dr. Vicki Rapaport: Yeah, we don't want patients to suffer. We don't want to scare anybody away. And we do read the patients in terms of who we think needs it and who we think doesn't need it. Julie is a veteran. She's a stud. She didn't need it at all. 

06:14 Trina Renea: Because once you know what something feels like, it's like when I give somebody a peel or a microderm, the first time they've ever had it, they're scared of that feeling of what it's going to be. But then they're like, “Eh, it's fine.”

06:23 Dr. Vicki Rapaport: Yep. Exactly. 

06:24 Trina Renea: It's kind of like that, right?

06:25 Julie Falls: I don't even get it offered to me anymore. My question about IPL is I've heard that, over time and if you do enough of them, that your skin doesn't really react to it any longer and that maybe there are areas that might be resistant.

06:25 Trina Renea: Through an IPL?

06:45 Julie Falls: Um-hmm. 

06:47 Dr. Vicki Rapaport: So remember, it's targeting mostly brown and red, mostly. And hair, of course. So I guess the perfect analogy would be if you treat all your hair, you don't have any more hair to treat, so it's not going to “be effective”. But it has been effective. It's done its job. 

And if people, say, come in for brown spots, with my device, I can usually get it done in one time. Sometimes people need a second one. Sometimes they need a third one, based on many, many factors, whether they're brown spots or red spots or really, really, really stubborn. Or whether if we did too low of a setting. These are like the secrets that we all as providers know. It's like, “Ooh, God, we should have just gone up in the setting, that’s why it “didn’t work”.”

But once you color corrected them, the efficacy doesn't go down. You just don't need that treatment anymore. Some people aren't good about sunscreen and protecting after they have an IPL, so they do need to come back every year. It'll just be as effective because they'll get new brown spots that we need to zap. But if they've really kept their brown spots at bay or their red vessels at bay, they don't really need it. So that's the “non-effective” maybe complaint that they're having. What are they treating? There's nothing there to target. The laser needs a target.

07:56 Trina Renea: But are you saying if there are brown spots there to treat, then it's not working on the brown spots?

08:03 Julie Falls: Another dermatologist had said to me that, eventually, he's just saying there are things that are better. I don't know if he meant stronger. Maybe.

08:15 Trina Renea: New lasers target brown?

08:20 Julie Falls: I don't know. Brown, red. I'm curious. We need his opinion.

08:24 Dr. Vicki Rapaport: I think IPLs are not the gold standard for red. That’s true. The Vbeam, there are other better gold standards for red. But for brown, IPL is incredible. 

08:34 Julie Falls: It's still the… okay. 

08:35 Dr. Vicki Rapaport: Yeah. And I think, truthfully, really, if there's a brown spot that’s stubborn, again, it's either the settings are way too low or nothing is going to zap that brown spot.

08:43 Julie Falls: What makes you determine if you're going to freeze something or use the IPL to get rid of it?

08:50 Dr. Vicki Rapaport: They're almost interchangeable, is the answer to that question. Some people are laser happy. Some doctors are like they're not even going to freeze anything. They want you to come in and get laser. So they'll just tell you that's what you have to do. 

But most things, I say that with a grain of salt, that most things can be frozen. 

08:50 Trina Renea: Are you talking about freezing a brown spot?

09:09 Dr. Vicki Rapaport: Um-hmm. You can liquid nitrogen brown spots. The problem with freezing is it's not as sophisticated as an IPL in that you are not selectively photothermolyzing. You're just freezing all the air, so the skin can get damaged and it will result either in a hypopigmentation, like a white spot, or a hyperpigmentation, like a brown area. Once the brown spots are removed, you have like hyperpigmentation. So, liquid nitrogen isn't as sophisticated as the IPL.

09:37 Trina Renea: Meaning it's a…

09:39 Dr. Vicki Rapaport: Risky. 

09:39 Trina Renea: It's risky. Right. 

09:40 Dr. Vicki Rapaport: Yeah. It can be injurious. Although everybody has a different love for liquid nitrogen, I feel like I'm pretty good with it. But once in a blue moon, I'll spray something and it's like, “Ooh, that didn't come out the way it has 10,000 other times before you, Mrs. Jones.” So if that happens, you can eventually just IPL it. 

09:56 Julie Falls: Interesting. Okay.

09:58 Trina Renea: So for more targeted bigger spots, would you use an IPL?

10:05 Dr. Vicki Rapaport: Yes, so that's a good question. One basic difference would be if the spot is big, I would not liquid nitrogen. It's too much injury to too much area of the skin. But a photofacial or an IPL would be much, much, much safer. 

10:17 Trina Renea: Right, because you can target the whole area. 

10:20 Dr. Vicki Rapaport: Well, you can target that one problem, which is brown. And if the skin around it isn't brown, the laser won't heat up in that area, so it won't irritate or damage that surrounding skin. It'll only damage, literally, only the brown in the skin. It just lifts up the brown. 

It basically is a controlled burn. It burns the color that the target is, based on the setting, based on the laser. If the target is brown, it kind of burns the brown. The brown turns into a very thin scab. I explain it to patients, it's kind of like coffee ground stains, like little tiny, tiny black grits. And then about a week to 10 days later, it sloughs off and it's almost perfect. If it's not perfect, you can laser it again about six weeks later. 

11:04 Trina Renea: Right. Okay. So then how often do people usually do an IPL, or they shouldn't do an IPL? Because I know that sometimes doctors will tell people to get an IPL too often. I know that it's usually like once a year if you have a lot of pigmentation, maybe twice a year if you live in sunny California where you're out in the sun and the pigment comes back, because the pigment does come back a lot of the times. I mean, it's damaged melanin cells. They go up and down in the skin. So, what's too much? 

11:43 Dr. Vicki Rapaport: In general, getting the problem taken care of. One to three treatments as the start. And then once you're happy, once you've reached your goal, then once a year is my recommendation. Too much would be, gosh, coming back every month. There's nothing to do. They're not improving you anymore. They're just feeding off you. I think it's not necessary, unless really truly that you weren't improved after one to three. Then, yeah, you can do it monthly or every six to eight weeks to get to that final goal, if somebody is using really low settings. But usually after three treatments, you can reach your end point pretty quickly.

12:22 Trina Renea: Because I think there's a lot of places, like laser centers and things like that, that will be like, “Buy a series of six.” And they make them inexpensive. The machine is too low. You don't see a lot of improvement till the sixth one, but this is kind of what they do. 

12:37 Dr. Vicki Rapaport: Yes, that’s exactly right. 

12:38 Trina Renea: But if you go to someone that's doing a good job, I say, at it and turning it up the way they should, you can do it in one to three treatments. 

12:50 Dr. Vicki Rapaport: Well, I think that there's a lot of alternative providers out there. And I love PAs, I love RNs, but a lot of them are new to the cosmetics game. And that's who a lot of the med spas hire, are these brand new, barely experienced PAs. 

So when you are an experienced PA, NP, dermatologist, plastic surgeon, and you are experienced with your device, you feel very comfortable at the higher settings. And God forbid there's a problem, you can take care of that problem for the patient. You know, God forbid they get a burn or they get a this or they get a that. 

IPLs don't usually permanently damage. I shouldn't say ‘don't usually’, because if it's done at the wrong setting on the wrong skin type, yes, there are people with scars from IPL. So you just have to be very careful. 

13:32 Trina Renea: Well, I always tell people like, “Be careful who you go to.” Make sure that it's someone that is referred to you that knows that that person who's doing the IPL is really good at what they do. They're not afraid to turn up the machine. They know how far to turn it up. They can numb you if you want, but tell them to go for it, and like, “I want to see some change in my skin.” You should see those spots that it is actually hitting darken on the very first time. 

14:02 Dr. Vicki Rapaport: Yes. Yeah. And I would also say the Fitzpatrick type, which is a skin type, people who are very fair are usually incredible candidates. People who are even a little bit olivey skinned should be very careful where they go, what procedure they have, because they can absolutely hyperpigment. So it's unfortunate, right? The blonde hair, blue-eyed, redhead, freckly person does really, really, really well. The person with a little more brown in their skin or black in their skin or just darker, they just have to be careful.

Now, it can be done on them, but sometimes we'll just do test spots to be sure we have the right settings because we do not want to burn you. Absolutely not. 

14:36 Trina Renea: No. I would say even do the lower settings on those patients, maybe, the darker patients. 

14:40 Dr. Vicki Rapaport: Totally different settings. They have totally different settings. They can do IPLs, but it's actually complete. It's done for you so that if you want to get more nitty-gritty, there's a xenon, there's like a chamber with xenon gas, which is basically when it gets heated up, it's like a flash of light. So there's energy that goes through the xenon flash lamp and then there are filters in the actual head of the laser. And it's all done for you in a sense. I mean, we know the settings to push on the machine, but the machine changes the filters and the settings based on the skin type that we know the patient is. And it gives us different settings for those skin types. 

15:19 Trina Renea: That's cool. It makes it easier for the practitioner to do it. 

15:24 Julie Falls: I was just looking at the last laser I did, Vicki, and I'm wondering what you think of it. Lutera? It starts with an L.

15:36 Trina Renea: Oh, there's so many different lasers that are now targeting brown that aren't IPLs, that are other lasers. Also remember, lasers are like cars. They have different names. 

15:46 Julie Falls: It's Lutronic. 

15:50 Trina Renea: Lutronic is a brand.

15:51 Dr. Vicki Rapaport: The Spectra? 

15:53 Julie Falls: I don't know. It's something I did at another doctor's office.

15:59 Trina Renea: Also, what was I going to say? Oh, the pigment that if somebody does a really good IPL on you, turned it up and it's really good, and you see the brown spots that show up and you're like, “Okay, I can see that's where it hit,” if there's other brown areas, it could be dermal pigmentation that is not going to be hit by the laser. And so you know that that pigment is dermal and, therefore, it's not going to ever get treated probably by an IPL. 

Like melasma, it can actually make it worse. So bigger, patchier pigment is not a good candidate for IPL either. 

16:40 Dr. Vicki Rapaport: Right. That's why if people think they have pigment that an IPL can hit, hopefully that practitioner will be very clear what is appropriate to tell the patient that will be treated with an IPL and what is contraindicated. 

For instance, melasma, the rule of threes. 30% get better with IPL, 30% it doesn't change at all, and 30% actually gets worse with IPL. Unfortunately, sometimes IPL will unroof melasma that, honestly, we didn't even see. It's happened to me before. It's devastating. But we can treat melasma in other ways. But yes, it can happen. It can find the melanin in melasma that we weren't even seeing that was deep down in there, and it can actually hyperpigment it and make it come to the surface. 

17:22 Trina Renea: I would love to do an episode on pigmentation and melasma and treatments that you can do to help both sides, because melasma is different than hyperpigmentation.

17:36 Dr. Vicki Rapaport: Melasma is just a form of hyperpigmentation, but it's very specific and it's very testy. It's very stubborn. And yeah, there are different ways to treat it, not with an IPL. The IPL is not the gold standard to treat melasma. 

17:48 Trina Renea: Right. So you said one to three usually can get you to a place where you like. How often are you doing those one to three? 

17:58 Dr. Vicki Rapaport: So one, and then the next one would be six to eight weeks later. The same thing with the third one, if they really need it. Six to eight weeks later. Because you just want the skin to fully heal and really see if there's anything more to treat. It takes a while, even though the initial, like, black little coffee ground stain stuff comes off on the face in seven, maybe ten days if you're not as fast of a healer. But you still want to give that skin time to really, really extra heal before you zap them again. But six to eight weeks in between the treatments. 

18:25 Trina Renea: Okay. And then how much do those cost usually?

18:25 Dr. Vicki Rapaport: They can range. I’ve seen them as low as $200. I’ve seen them as high as $1,000. 

18:35 Trina Renea: For a full face?

18:36 Dr. Vicki Rapaport: Yes, for a full face.

18:37 Trina Renea: And why would you pay $200 compared to $1,000?

18:40 Dr. Vicki Rapaport: I think it's just the location, the branding, the pricing. It just depends on the place, what kind of laser they have, who's doing it. Plastic surgeons can charge a lot more because they just do and they can. Dermatologists can sometimes charge a lot more than like a med spa.

It's a great question. I don't know why certain places charge so much and why they charge so little. But you're right. Saying, for instance, like, you need to buy a package of six, but they're going to charge, say, only $200 per. It's still $1,200 for six. Whereas just one really good one might cost five to six and then you're done. 

19:15 Julie Falls: No, they're going to try and have you come back several times, because they're not like you. They're trying to make money.

19:20 Trina Renea: What did you say, Julie? 

19:21 Julie Falls: No, they're going to have you come. “Oh, you have to do three.” Not everybody is like Dr. Vicki, who's like, “You're fine with one.”

19:28 Trina Renea: I think I prefer when doctors say, “Let's do one, see how it goes. Come back in eight weeks, six weeks. We'll see if you need another one.”

19:31 Julie Falls: Yeah. That's why you have to do your homework. 

19:36 Trina Renea: And you just go one by one, because you don't know that you need six or you need three until you see how it reacted on the person’s skin. 

19:44 Julie Falls: But people are going to sell you things. 

19:45 Trina Renea: Also how they treated themselves at home later. Like, did they then go out and sunbathe and go the beach? That’s going to bring it back, right? You also have to care for it at home. 

But after you get an IPL, you tend to be red, a little bit swollen in some people, right? And then what’s their aftercare?

20:07 Dr. Vicki Rapaport: The worst immediate post would be a little red, a little puffy. The best would be a little hot and just a little bit the brown spots get browner. And if you’re targeting red with the certain settings, sometimes the red blood vessels will actually even be purple. 

So it can range from like a little red to very purple, a little brown to really, really brown, a little swollen to really swollen, and that lasts about half a day to maybe a day. That usually is gone by the next day. But all the brown spots will be really, really, really brown, like you painted each brown spot with brown paint. That lasts for about a week. And all the red spots…

20:46 Trina Renea: And stay out of the sun.

20:48 Dr. Vicki Rapaport: Oh, yeah. I mean, zero sun. Hats and sunscreen. 

20:51 Julie Falls: Any way, you should stay out of the sun.

20:52 Dr. Vicki Rapaport: And then the red spots, if they did get redder or purple, they just fade kind of like a bruise in about a week. 

20:59 Trina Renea: So I was at a doctor's office observing Vbeam when it first came out, and I was observing somebody getting it done. So she asked me, “Would you like to try it?” I was like, “I'm kind of scared.” But I was like, “I guess, like maybe just right around the nose.”

So she zapped me. It hurt so bad, but I was not numbed. And then when I woke up in the morning, I looked like I had an explosion of purple veins all around the area.

21:28 Julie Falls: Those are the super strong Vbeams. I had the same thing. 

21:30 Trina Renea: Oh, my God, I freaked out. I was like, “Is this permanent? Like, what happened?” And I wasn't told that that was going to happen. I didn't know. I ended up calling Vbeam, the company because I was too embarrassed to call the doctor's office and complain, because she did it for free. 

And so I called Vbeam and I was like, “Is this a permanent situation? Was this supposed to happen?” I was terrified. 

And they said it was like because it went strong and it burst the vessel. That's like the blood that comes out and then your body absorbs it or whatever. It'll go away.

I was like, “Oh, my God.” I mean, it was horrible. It so scared me. 

22:09 Dr. Vicki Rapaport: Two things, Trina. One thing is, (a) you didn’t have a bruise right then and there. It came the next day. 

22:13 Trina Renea: Yeah.

22:14 Dr. Vicki Rapaport: Okay, that’s interesting. Because it usually happens right then and there. But the second lesson to you and all our listeners, you have to call the doctor’s office because (a) they should know, (b) they want to help you. You should never be embarrassed even if it's for free. Who cares? Let your practitioners help you through it.

And most of the time, most of that is more for them to learn and for the staff to learn, because if you're having a “bad outcome”, it's not a bad outcome. It's a regular outcome. But wouldn't that have been great they could have reassured you right away? “Oh, yeah, Trina, that's totally expected. This is what you should put on.”

I would have recommended Biafine, I would have recommended Vaseline, I would have recommended some things that Vbeam really can't recommend because they're not going to take care of you, but they could have helped you get better faster. So please don't ever be embarrassed to call your doctor's office. That's so silly. 

23:02 Trina Renea: Well, the same doctor's office did Botox on my masseter, is that what this is called, muscles as an experiment, because I have a square jaw line and they said it would make it more oval if they put some…

23:15 Dr. Vicki Rapaport: Botox in there?

23:15 Trina Renea: Botox in there, so I let them. But the doctor did an experiment where she had me bite down to make the muscle stick out and she injected it while it was out. Is that normal? I don't know. It was like an experiment.

23:30 Dr. Vicki Rapaport: It just hurts more when they bite down. I have them bite down to feel the muscle and then I have them relax, because it just hurts more when you have the muscle contracting and you get injections. 

23:39 Trina Renea: Well, she was doing some experiment on me. I didn't know. Then when I went home, in the morning, I was eating breakfast and I felt this weird feeling in my cheek. I was like, “What is that?” And I looked and, as I'm chewing, there's one, it looks like a finger, is coming and sticking out of my cheek because that part of the muscle didn't get done. 

24:01 Dr. Vicki Rapaport: Yes. No, it didn't get Botoxed. 

24:04 Trina Renea: Right. It didn't get Botoxed. Right. And so it was like a finger was coming out of my face. Every bite I took, I almost died. That I did call the doctor for.

24:14 Dr. Vicki Rapaport: Thank you.

24:15 Trina Renea: Because I was like, “Oh, my God, I look like an alien.” 

24:19 Dr. Vicki Rapaport: And what did that doctor say?

24:20 Trina Renea: She laughed, and then she called me into the room where they take pictures and she had her photographer take pictures of it. And she's like, “I've never seen that before. That's so interesting.”

24:32 Dr. Vicki Rapaport: No, it's actually not. It's not uncommon. 

24:35 Trina Renea: And she was laughing and then she fixed it. 

24:36 Dr. Vicki Rapaport: She just put more Botox in. Yeah. 

24:37 Trina Renea: Yeah.

24:38 Dr. Vicki Rapaport: Because she just missed part of the masseter. The masseter has two parts. If you miss part of it, it can do exactly that.

24:42 Trina Renea: That happens?

24:44 Dr. Vicki Rapaport: Yeah. But you don't tell patients you've never- well, unless you want to be that honest, but it's not that uncommon. 

24:47 Trina Renea: But then also what happened was, because I guess I have a really big masseter and because it was so numb, I couldn't chew. I would take like three or four bites and it would be sore and I'd be rubbing my jaw because what muscle is chewing now. That's the chewing muscle. It was completely numb and it hurt chewing for like three months. 

25:10 Julie Falls: Caroline just had it done. She didn't go through any of that.

25:15 Trina Renea: I know. I'm telling you she put way too much in. Way, way, way. 

25:20 Julie Falls: And it really helps with her migraines and it helped with her clenching.

25:25 Dr. Vicki Rapaport: Botox is incredible in that way, yeah.

25:26 Trina Renea: Right, but I think she was experimenting on me and she put, way, way, way, way, way, way too much. 

25:32 Dr. Vicki Rapaport: I'm glad that you called her because now she learned. You know, honestly, again, like the same thing. She learned something that she probably went to go and read about it, that it's actually not that uncommon. You have to know where to hit the masseter. But she doesn't know that you had pain and difficulty eating, and you should tell her that too, because she probably did put too much in there. 

25:48 Trina Renea: This was like 10 years ago. It's too late. 

25:53 Dr. Vicki Rapaport: Too late. 

25:55 Trina Renea: Okay. So we talked about how IPL is good for lighter-skinned people rather than darker skin. What do you do with darker skin pigmentation? 

26:04 Dr. Vicki Rapaport: It's hard. Depends on what the pigmentation is. Is it the little tiny DPNs, those little tiny dark growths? Is it melasma? What is it? It depends.

If it's the DPNs, we just cauterize them. We just burn each one. They just wipe right off. It's kind of amazing. If it's melasma, you've got to put topicals on them. You cannot laser anything like that on dark, dark, dark skin.

26:29 Trina Renea: Okay. So then there's a new machine out there that is called a BBL, which is like an IPL but it's broadband light. So it's different, but does the same thing basically. It targets the exact same thing. It's just done in a different technology, right? Pretty much?

26:55 Dr. Vicki Rapaport: Right. I don't have a BBL, and what I know from my reading about BBL, so broadband light is literally the same description of an IPL. Remember, an IPL is 500 nanometers to 1,200 nanometers, which is also broadband light. Remember, laser is one nanometer. True, true, true laser is one nanometer. But BBL and IPL are broadband light devices.

I guess the difference between BBL and the old school IPL is that it's a little stronger because it has two of those xenon flash lamps, whereas most IPLs have one. So there's a little more energy that can be zapped into the skin.

And there is a theory that it helps reverse aging. I don't know how that works. I don't know if that's correct. 

27:38 Trina Renea: Something about working on the genes or something.

27:41 Dr. Vicki Rapaport: Something about working on the genes or something, yeah. And I know that you have your favorite doctor who has that laser. I think that maybe we can ask him a little bit more details. But they basically do the same, the same target. 

But the problem with more, I guess, like newer lasers, fancier lasers, stronger lasers, is sometimes that means more expensive. To me, an IPL works beautifully, so I'm sticking with my IPL. 

28:09 Trina Renea: Yeah, I think BBL, if an office has a BBL or an IPL, they're both targeting red and browns. It's just a new technology. It's a newer technology, maybe less treatments you have to do. I don't even know that for sure, but maybe because it has the two lights that are hitting it. 

But also probably, again, you'd want to be careful what doctor you go to because you don't want them to hit you too hard where it could also damage or have that. So make sure the doctors have the BBL for a little while, or really uses it a lot and knows what they're doing. 

28:44 Dr. Vicki Rapaport: And I would just, one quick comment about how IPLs work for hair. They're great for hair and there's so much hair removal. Because there are so many populations of people who get hair removal, whether it's just for fun for our underarms or our bikini, or the transgender population. 

I was at this meeting the other day and this one nurse literally started her own laser hair clinic because she has so many transgender patients. I thought, “Oh, that's interesting. Yeah, they do need all their hair.” You know, if you're transitioning from male to female, the laser hair removal is the mainstay for them. And so maybe, if that's the case, maybe you want to go with something stronger, if the BBL truly is stronger for hair. Truly, I think the diode is still the best, but I thought that was a really interesting new population of patients that we can help. 

29:35 Trina Renea: Wow. Did you know that BBL has another term? If you look up BBL on the internet, a BBL, it means a Brazilian Butt Lift. 

29:44 Dr. Vicki Rapaport: Well, that was the original name. 

29:46 Trina Renea: Did you know that? 

29:48 Dr. Vicki Rapaport: I mean, BBL, to me, is a Brazilian butt lift. 

29:51 Trina Renea: I didn't even know that. 

29:53 Julie Falls: This says that…

29:53 Trina Renea: Do you give Brazilian butt lifts? 

29:55 Julie Falls: This says that IPL uses a single focus beam while BBL uses multiple light wavelengths. Is that, do you think? 

30:02 Trina Renea: It's just two light. 

30:02 Dr. Vicki Rapaport: They're both broad light nanometer. 

30:03 Julie Falls: Okay. It says BBL often better for treating a broader skin range.

30:12 Trina Renea: Because it has two of the light prisms. 

30:15 Dr. Vicki Rapaport: But just back quickly to the Brazilian butt lifts, I know we're not going to talk about that because I'm not a plastic surgeon and I don't offer that. But I know it is a very, very dangerous procedure. 

30:24 Trina Renea: Oh, really?

30:26 Dr. Vicki Rapaport: That is even more important to go to somebody really well trained. People die. People die from Brazilian butt lifts. It's not a lot. It's one out of 3,000, but, still, they can die because what happens is there's so many blood vessels in the glute area, big blood vessels. And if you dislodge fat and it goes into a blood vessel, you're throwing off a clot, which you can get a heart attack, you can get a pulmonary embolism, and you are dead because you want a big butt. 

30:52 Julie Falls: So they're injections and implants and they're both dangerous, right? 

30:56 Dr. Vicki Rapaport: Yes. Well, they're injecting fat. They're harvesting fat from somewhere else, they lipo somewhere else and then they put it in the buttock. 

31:05 Trina Renea: Instead of fillers, Sculptra, or whatever they do?

31:09 Dr. Vicki Rapaport: Sculptra is not as soft and supple. 

31:10 Julie Falls: Yeah, they put fat, but there are also implants too they’d be doing. 

31:14 Dr. Vicki Rapaport: I don't know about— yeah, the butt implants are, I think they're a little safer because you're not dislodging fat inside of a vessel. But, yeah, you know, I'm certainly not a plastic surgeon. I don't know a lot about that. But just people beware. BBLs are not perfectly safe. 

31:27 Trina Renea: BBL meaning butt lift, not broadband light. That kind of BBL. 

31:34 Dr. Vicki Rapaport: Right. 

31:35 Trina Renea: All right. Well, is there anything else anyone have questions about on IPL? I think we pretty much explained it, right? 

31:43 Julie Falls: I think so. 

31:44 Trina Renea: To finish up our episode on IPL, do we have any takeaways from today, Julie? 

31:50 Julie Falls: I learned that the difference between an IPL and having liquid nitrogen and pros and cons of that. 

32:01 Trina Renea: Okay.

32:03 Dr. Vicki Rapaport: My takeaway and plug would be if you're going to invest and do an IPL, invest in sunscreen and protecting your skin. Because why go through all that and then just go in the sun again? You can be in the sun but you have to protect and wear clothing to protect your investment, protect all the zapping you just did.

32:19 Trina Renea: Right. And that being said, a lot of people think that if they get an IPL or a series of IPLs, their pigment is gone forever. That is 100% not the case. 

32:31 Dr. Vicki Rapaport: And the other takeaway on top of that would be you age again. So even though I think people don't really need them, but maybe once a year, if, if, if, they age again. So in five to 10 years, all the sun that they've had will again produce more new brown spots, new issues. So, yes, you will need IPLs eventually more and more over time. You're right. One or a series of three isn't going to protect you forever. 

32:55 Trina Renea: Right. And some people do get more hyperpigmentation than others. Some people are more prone to it. Some nationalities are more prone to it. Some people don't get it barely at all. But also a lot of products, different products, which we can talk about, can help with hyperpigmentation or for pigmentation in general, for protecting your skin from getting sun damage, which we will talk about in future episodes. 

All right. Anyone else have a takeaway? No? Okay. I think we're done for today. We're all hungry and need to go and drink our water.

33:34 Dr. Vicki Rapaport: Goodbye everybody.

33:35 Julie Falls: Safe sunning, no sunning.

33:38 Dr. Vicki Rapaport: Do your protective measures. 

33:38 Trina Renea: Yes. Wear sunscreen.

33:43 Rebecca Gadberry: I always thought BBL was “bodacious” butt lift, not Brazilian butt lift.

33:49 Trina Renea: Bodacious. 

33:50 Rebecca Gadberry: Yes, bodacious. A bodacious butt. A very round butt. 

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