Nathalie Fournier, M.D.

I have been using Novoxel’s Tixel system for skin resurfacing of moderate to severe wrinkles on the face, upper lips, crow’s feet, cheeks, glabella, forehead, perioral region, and the full-face. I have also tried it on the neck and the results are impressive. Healing is quick making the Tixel a great device for the face and neck. Currently, we are evaluating the efficacy of the Tixel for the décolleté and hands using milder parameters. Some more conservative doctors are using much lower settings for the treatment of mild photodamage, also resulting in little or no downtime, when performed in combination with topical products.

Monica Elman, M.D.

So far, I have used the Tixel in several full-face treatments (skin rejuvenation / resurfacing) for smoothing fine wrinkles and improving skin texture, and also for the cosmetic improvement of the aging hands. I have used fractional CO₂ lasers over more than ten years with great success. However, I am now discovering that Tixel is identical to CO₂ with few substantial advantages.

Nathalie Fournier, M.D.

The Tixel is a compact device enabling it to be portable. Contrary to lasers, no eye protection is required, and it’s quiet and easy to use. The Tixel is also extremely fast, enabling a rapid treatment, which results in an outstanding ROI. In addition, there are no expensive consumables, and the maintenance is quite simple compared to laser or radiofrequency (RF) devices currently on the market. The economic advantages combined with the versatility of the Tixel make it an outstanding value, both for experienced physicians who want the “next big thing” in the aesthetic device market, or for younger physicians just entering the field of aesthetics who cannot afford an expensive system out of the gate.
Discomfort with the Tixel is significantly less than most in-office, ablative or non-ablative fractionated lasers currently on the market. Topical anesthetic or nerve blocks are not required. Patients most commonly experience a warm sensation in the target area similar to a sunburn, which dissipates after about an hour following treatment.

Compared to most ablative laser treatments, there is much less downtime associated with Tixel treatment. Using very conservative settings, patients can easily resume their daily social activities the day after treatment. With more aggressive settings, patients may experience approximately 2 days of downtime. Histology of Tixel-treated skin demonstrates a zone of thermal damage similar to or less than most ablative laser treatments, depending on the settings used. In terms of downtime, patients can apply makeup and resume their daily social activities the day after treatment when lower parameters are used, and approximately 2 days after treatments with higher parameters. The micro-crusting is quicker and the transient edema and erythema resolve sooner when compared to fractional CO₂ laser. This is understandable when one looks at the histopathological cross sections we performed with various parameters on patients. Tixel achieves a remodeling of the skin with much less of the unnecessary thermal effect produced by laser.

Monica Elman, M.D.

The most important advantage of Tixel over other modalities including CO₂ lasers is the low level of pain without sacrificing good aesthetic results. Of all the other modalities that I’ve used (CO₂ lasers and RF) the CO₂ has been my gold standard. However, it is very painful and requires the application of an analgesic cream at least 40 minutes prior to treatment.
With Tixel, I don’t use topical anesthesia or cooling at all and both my patients and clinic benefit greatly from the valuable time saved.
Regarding healing time, in my experience the Tixel is very similar to or shorter than laser, depending on the settings used.

Another advantage is safety. I don’t have to worry about general laser safety issues such as eye safety. Because of its compact and portable size, Tixel can easily be used in any room in my clinic. Laser warning signs, safety goggles, etc, are not required. I feel very comfortable and can work fast with Tixel, helping me to streamline my busy schedule. Tixel is also pleasant environmentally: no noise, no smell, no smoke and no debris.
One of the central advantages of the Tixel is its versatility. I can perform an aggressive treatment as with a high power fractional CO₂ laser and perform a very delicate treatment as with an erbium laser. For example, I have obtained nice results on the dorsum of the hands, which are more difficult to achieve with a CO₂ laser.

Nathalie Fournier, M.D.

Tixel is a very versatile device and depending on the settings used, can achieve cosmetic outcomes similar to both ablative and non-ablative fractionated lasers or RF devices.

Monica Elman, M.D.

The efficacy in facial treatments appears to be identical to CO₂ fractional lasers.

Nathalie Fournier, M.D.

The ability to treat with very mild settings or more aggressive settings allows me to individualize Tixel treatments for each of my patients. Despite treating patients with Fitzpatrick Skin Types I-IV, I did not see any post-inflammatory hyperpigmentation (PIH) in any of the patients I treated. The histology of Tixel-treated skin demonstrates a mild injury with rapid healing, which may explain the lack of side effects seen in my study.

Monica Elman, M.D.

The device is very safe. To date, I haven’t seen any adverse effects. Patients appreciated their results (similar to CO₂ lasers). They enjoyed greater comfort with Tixel treatment due to much lower pain levels.

Nathalie Fournier, M.D.

Yes, I would recommend Tixel to my colleagues because it is easy to use, versatile enough to treat patients with mild to severe photodamage, inexpensive in comparison to lasers and in my experience, results in fewer side effects than comparable laser devices and treatments.

Monica Elman, M.D.

I would definitely recommend Tixel. It is compact, affordable and easy to use. The handpiece is very small and light, and allows you to easily view the targeted skin during treatment. It’s fast and treatment is nearly painless. Tixel opens more treatment possibilities on delicate areas, and the learning curve is very fast. The device is simple and the service and operating costs are very low. There are no disposables and the tips are reusable. It is portable and folds into an attaché-like case. I can easily carry it around to all my clinics, and my patients spend less time in the waiting room.

Nathalie Fournier, M.D.

Tixel will be strongly competitive in the fractionated laser space and due to its versatility, can compete with a number of devices from mild, non-ablative lasers all the way to ablative fractionated carbon dioxide lasers.

Monica Elman, M.D.

Tixel offers the treatment spectrum of CO₂ and erbium lasers in a single compact affordable device with nearly no pain and with the potential of treating any condition in an optimal way, just by the appropriate selection of parameters. With Tixel, I am able to produce smaller craters with cleaner walls when compared to CO₂ laser. I am able to selectively treat the epidermis and papillary dermis very accurately. I was even surprised to see the capability of Tixel to produce minor thermal damage to the stratum corneum and epidermis without damaging the dermis.

Eric F. Bernstein, M.D., M.S.E.

“Tixel is a very interesting technology. I have been performing histopathologic studies for numerous ablative and non-ablative devices for many years, analyzing the zone of thermal damage and looking at collagen deposition. The histopathologic changes seen after Tixel treatment are very similar to carbon dioxide laser treatments, or at lower settings erbium lasers. I also notice a resemblance to the histopathologic changes following plasma skin resurfacing, where the stratum corneum on many specimens remains intact, while the zone of thermal damage occurs underneath. This means that a physiologic ‘dressing’ may stay in place while the underlying dermis reorganizes with new collagen deposition”.

Gary P. Lask M.D.

“Fractional resurfacing has become very popular and new technologies are aimed at trying to find a better way of doing that. Some of the limiting factors of laser devices include their complexity, size and price, however the Tixel is a smaller, more compact and much less expensive technology. The histopathological results of the Tixel are basically the same as CO₂ or lower-grade fractional lasers however, I believe there are still more things you can do with the Tixel to achieve even better results in wrinkles, skin tone and texture.”


Scientific Publication: Fractional Treatment of Aging Skin with Tixel, a Clinical and       Histological Evaluation

An Overview on Melasma

Download :A novel thermo-mechanical system enhanced transdermal delivery of hydrophilic       active agents by fractional ablation

Download Aesthetic Buyer's Guide Editorial, Sept. 2014

Scientific Publication about TMA:

The following publication presents the scientific basis for Novoxel’s technology:

Fractional vaporization of tissue with an oscillatory array of high temperature rods – Part I: Ex vivo study
October 2012, Vol. 14, No. 5 , Pages 218-223 (doi:10.3109/14764172.2012.698284)
Gary Lask, Monica Elman, Nathalie Fournier & Michael Slatkine

Background: Short pulse duration (0.1–5 milliseconds) CO₂ lasers are perceived as excellent tools for vaporization of crater arrays in fractional skin resurfacing. Objectives: To present a thermo-mechanical ablation technology, which affects tissue identically to fractional CO₂ lasers, however at a fraction of the size and cost of a standard laser. Materials and methodology: The new technology is based on heating an oscillating array of thin metallic rods to a temperature of 400°C (752 degrees Fahrenheit) and advancing the rods into tissue down to a precise pre-selected depth for a duration of 0.1–5 milliseconds. As a result, a crater array is vaporized with identical properties of those produced by CO₂ lasers. An ex vivo test was performed with a thermo-metallic rod array prototype.
Results: Arrays of 10 × 10 vaporized micro-craters of 350 micron diameter, 200 micron depth have been produced with lateral thermal damage of 80 micron, while thermal damage below craters was 80–250 micron. Conclusions: A resonating thermo-mechanical array of high temperature (350–400°C) rods is capable of producing an array of craters identical to those produced with pulsed CO₂ lasers.

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