Features and Benefits to Consider When Purchasing a Micro-dermabrader

Will the Micro-Dermabrador operate with multiple types of abrasive crystaline material (media)?

At the present time Corundum (AluminumOxide, Alumina) is the most widely used and most abrasive material for Micro-dermabrasion procedures.   There are four reasons for the wide use of Corundum throughout the dermabrasion industry.   First is that the product is widely available (it is a naturally occurring crystal and very abundant in the earths surface); second, it is an inert crystal and non-toxic; third, it is the third hardest crystal (behind diamond and ruby) and since it is a crystal it has multiple sharp edges for abrasive contact; fourth, the crystal of Corundum is impervious to moisture (does not absorb liquid).

Two other materials that are also presently used in micro-dermabrasion procedures are Sodium Bicarbonate (Baking Soda) and Salt. Both of these materials are of a crystal structure and both work quite well as the abrasive media material.  Neither of these materials are as hard as Corundum nor do the materials have the mass (weight per particle) of Corundum.  Therefore neither material will have the abrasive power of Corundum because of the softer edges of the crystal and the lower kenetic energy per particle.  Another drawback, in stratum epidermal micro-dermabrasion, of both of these materials is that both are soluble in water and suseptible to moisture so care must be taken to insure proper storage and handling.

Regardless of the material selected as the medium for micro-dermabrasion the abrasive material needs to be manufactured and packaged in pre-measured packages to insure purity and quality of the product. Pouring crystals from a large jar, bag etc through a funnel is not a good idea.

Is Corundum (Aluminum Oxide) Safe to Use?

Absolutely! Corundum (Aluminum Oxide) is not an unsafe material as some will try to lead you to believe in fact it is the only FDA approved abrasive for micro-dermabrasion. Corundum is an inert, naturally ocurring, substance and is a crystal, not a metal. Corundum has never been linked to any medical condition in any study performed by any of the research laboratories not just in the U.S. but also in Europe.  A good quality micro-dermabrader, with proper design, that utilizes quality, pure, properly sized Corundum (Aluminum Oxide) crystals, will not clog and will not emit airborne particles. Impure media not properly sized will contain a finer powdery substance, smaller that 20 microns, that when emptied into wastebaskets or purged from clogged systems, can create a small amount of airborne contaminants and could be irritating to both client and technician. There is no correlation of this material to potential concerns of risks to Alzheimers that has ever been suggested by any study.  In point of fact the material used in dentistry to polish the teeth after cleaning is a fine Corundum abrasive mixed with a pleasant tasting paste and approved by the FDA for this procedure.

Is the device FDA Approved?

Microdermabraders are all considered a Class I Medical Device and do not need to be individually FDA approved. The FDA has approved the micro-dermabrasion procedure, not individual units. There are currently thirty-two different companies that manufacture micro-dermabraders, of the thirty-two only five of these companies are currently registered with the FDA as manufacturers of micro-dermabraders. Any company who is serious about staying in this business will be registered with the FDA and follow all of the guidelines required to track and control the quality and functionallity of each unit.  

Type of Media Fill and Disposal System

Most all of the units currently on the market incorporate two containers, one (new media container) that is manually filled with new Corundum (Aluminum Oxide) Crystals and the other to collect the contaminated media after use for disposal. Typically with these systems you will use a funnel and pour crystals from a larger container to fill the new media container prior to the procedure. At the completion of the procedure the operator will unscrew a plug in the bottom of the contaminated media glass receptacle to drain the used crystals into a wastebasket or on some micro-dermabraders unscrew the actual contaminated media container and pour the contaminated crystals in a trashcan. This is a very messy procedure, causes spillage and possible contamination of the surrounding area, this contaminated material could be a biohazard based on the health of the patient and thus could be a hazard to both the operator, future patient/clients or other individuals present in the area. Any prefilled and sealed new media and closed (sealed) waste system eliminates this hazardous exposure and mess. The waste media will contain not only dead skin cells, it can also contain blood and other bacteria from the treatment and should be handled as you would normally handle potentially hazardous bio-waste.

Balanced Delivery and Removal System

Most all systems incorporate a venturi-style system for the delivery of the media to the patient.  Some units will contain a separate vacuum and air compressor, and will most likely have independent control knobs that regulate the two pressures. With these types of two motor systems, you stand the chance of having; 1) too little suction with increased particle usage resulting in messy residual excess media on the skin surface of the patient 2) too much suction combined with too little media output resulting in "over-sucking" causing unwanted micro-capillary breakage, edema, etc., Either of these two conditions is not truly microdermabrasion of the epidermal layer of the patient’s skin. Under either of the above conditions there will not be inhanced and continued epidermal exfoliation after the treatment procedure and therefore the effectiveness of the treatment will be significantly reduced if not completely eliminated in the first instance and significant healing time will be required in the second instance which will delay any gain from continued treatment. 

A balanced system will automatically adjust the two settings and not create “over media” or  "over-sucking", ie..  as the operator increase the patient vacuum the crystal flow will increase proportionately and the patient will receive a good micro-dermabrasion treatment with a residual 3 to 4 day enhanced epidermal exfoliation period between treatments.

Design of the Handpiece 

The important features to look for are; angle of delivery of the media; the pattern of the media impact zone (media delivery accelerator); media retrieval (vacuum) pattern; and the material used to construct the handpiece. The design of the handpiece is of paramount importance to the clinical and operational benefits that you can expect. The angle of delivery and spray pattern that the handset creates at the patient port will determine the quality and depth of exfoliation that will actually occur. The media pickup after impact and delivery of waste products to the waste canister is where most of the clogging and problems will occur in most systems. There are vast differences in the various designs and you need to look closely at them. Here’s what to look for: 

Angle of Delivery

Most handpieces will deliver the media at 45 degrees. This allows you to hold the handpiece as you would a pencil and initially feels most comfortable. That 45 degree angle is also a common site for the handpiece to clog. The disadvantage to the 45 degree angle is that it will not provide an even peel.  In the 45 degree handset (the patient port is on the outer edge of the application tip) the media is delivered by an off-center orifice and strikes the patient in the lower corner of the application window.  The media is then ploughed up through the window and is retrieved through a exit port by vacuum on the opposite side of the handset from where it entered.  This single path for media causes the media to dig into the epidermus at the strike point with subsequent heavy abrasion at the strike point and very little abrasion in the continuing path of the media due to inter particle collisions at all other location in the media travel path.  To better illustrate this, think of the handpiece as you would a flashlight.  If you hold the light at 45 degrees, you will get an oval shape with the light being brighter proximally and dimmer distally. The same principle holds true with the delivery of the media and will result in an uneven peel and striping due to the very small target area for energy transfer.

A 90 degree or perpendicular angle to the skin is the optimum angle for a properly designed handset for a smooth and consistent abrasion if all of the parameters are taken into account. 

 With a perpendicular angle to the skin the beam of media from a properly engineered accelerator, centrally located in the application tool, can be flared to provide an impact area, within the limits of the application tip, on the skin where all of the particles of media will impart  the stored kinetic energy of the media particle into the skin surface in a circular pattern.  If the exit path for the media is controlled by a circular pattern of multiple bores on the outside circumference of the application tool all of the media will be drawn away from the target site with a minimum of collisions between particles thereby providing a pattern of abrasion equal to the diameter of the application port in the handset tip.

Point of Media Output (accelerator)

This is an often overlooked but extremely important point to look for. It will determine the spray pattern of the crystals and also is a factor in determining the strength or speed with which the crystals are being delivered to the skin. If the exit hole in the accelerator is too small, you will have a very strong peel and a very small dermabrasion spot size. Do not assume that the hole in the removable cap is the same size as the area being abraded. If the hole is too large in the accelerator, then the crystals will not be delivered strong enough to abrade the skin. Also a larger hole will result in a larger spot size and also use more crystals accordingly. An extremely important factor to keep in mind is that the crystals will eventually even abrade the exit hole and inside surface of the accelerator causing the media pattern to grow byond the window of the patient application port. Therefore, the accelerator should be of a very hard material and also be easily replaceable and inexpensive.  The material used to manufacture the handpiece should be of sufficient hardness and durability to provide years of service.  The main product to stay away from in handset selection is glass or plastic because the abrasive media will alter it very quickly.  Also dropping a handset made of glass or plastic will almost always destroy or severly damage the handset.

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IMPORTANT

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An effective way to determine the abrasion qualities of a handpiece is to hold the patient application port over a dark area of newsprint with the media delivery system operating. Hold it in the same place only for three or four seconds then check the markings left by the application. A good spray pattern will show up as a lightened area with consistent shading where the paper has been abraded removing the dark ink. The pattern should be the same size as the hole in the removable application tip of the handset. If the affected area is not the same size as the opening or if the affected area has different shades, then the effect to the skin will be uneven and will result in striping.

You can also use this method to check for linearity of the total system from low settings to high settings and get an overall picture of the total product. On the lowest settings there should be just a very soft abrasion with very little removal of ink. On the highest setting if the spot has all of the ink removed and the paper burnished then it indicates that the machine has the power to do micro-dermabrasion from a low setting to a high setting. This does not mean that the system is a good one. The indication only means that the system will operate softly and agressively by a minimum setting and a maximum setting.  Whether the system can operate in a linear fashion from soft to aggressive is the real test of a system because if a micro-dermabrasion machine is linear in operation according to the adjustment on the dial then all patient settings are consistent and reproducable.

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Materials Used in Handpiece Design

The most logical choice is a medical grade stainless steel or aviation grade aluminum that has the ability to be sterilized if you choose to and is strong enough to withstand the abrasion that occurs with multiple uses. Glass is used in some systems where clogging seems to be a problem. Be aware that glass needs to be inspected thoroughly for cracks and sharp edges caused by abrasion. Plastic is easier to manufacture and might not stand up to the abrasion qualities that it will be subjected to as the crystals move through it. They may also have a problem lasting through multiple sterilizations and the drying that would need to occur so that it won’t clog. The heat generated with metal aids the drying of the handpieces internal components when sterilized. Any company that offers multiple product designs in their handpieces most likely has a problem with some of them clogging. There should be only one inherent design that is proven to work. Having various sizes of that design is helpful. A smaller output hole in the handpiece will make it easier to use, especially around the nasal area. The larger handpieces come in handy when treating the larger areas such as stretch marks, the neck and chest. Most handpieces have a removable cap that actually comes into contact with the patients/clients skin. These need to be replaced after each procedure to minimize any potential for cross contamination. These tips can be made of any material as long as it does not have any sharp burrs that might scratch or cut the skin as it is being advanced along the skin. The design of the handpiece is the most important element of any Microdermabrasion system. It determines the ultimate strength and area of the surfaces that are being peeled. Make sure that its design meets up to the parameters listed here.

Additional features to look for:

• Machine should have a lock to avoid unauthorized use.
• An automatic shut-off or alarm if the waste canister is full.
• A delivery hose long enough so that you are not limited to placement of the unit.
• Check the noise output the machine makes during use. Does it vibrate excessively?
• Who services the unit and where. Check into the availability of technical help.
• What warranty comes with it and what specifically does it cover?
• Ask the company to provide any clinical data on the system or where they are performing clinical trials.

What to stay away from:

• If they say "virtually clog resistant", then it probably clogs.
• Machines that are too powerful. This is supposed to be a progressive, not an aggressive procedure. Some of the newer models are so powerful, they begin to border on being dangerous. This is supposed to be progressive treatment.
• “Diamond-shaped Crystals." What would be the cost for crystals if a company actually manufactured a diamond shape for each crystal at 100 microns?

• Imported microdermabraders, especially if they do not have a reliable known service facility.
• Uses only a teaspoon full of crystals. The only way you could possibly abrade the entire face with only a teaspoon full of crystals is by reusing them or recirculating them so that they will abrade the skin multiple times. Absolutely stay away from this. You only want the particle of Corundum (Aluminum Oxide) to strike the surface of the skin once and then be removed. If the particles are recirculated to minimize the use of media, then you stand a chance of spreading bacteria from one area to another or one patient to another. It is physically impossible to use less than a half a cup of crystals and properly dermabrade the face. If you plan on treating the upper chest and neck as well, your crystal usage will increase correspondingly to the surface area you’re treating.

Concluding Remarks

This document has been an attempt to provide you with a hopefully unbiased review of the Microdermabrader Marketplace. As I have mentioned earlier, there is a lot of misleading information on this subject and the results that you can expect from it. To a large extent, the success you have will be based on having a knowledgeable and skilled technician/aesthetician that has the ability to communicate with their customers/patients and who has a thorough understanding of what happens to the skin during microdermabrasion. Post procedure care with appropriate skin care products is of equal importance. To that extent, make sure you do your homework and follow up on the information given to you after any sales demonstration. The only way to really get a feel of how the machine works is by using it yourself over a couple of days worth of clients. Don’t assume that what they say will really happen when it comes to training and service.

Call several sources that currently own and use the microdermabrader being considered. When you do, ask to speak directly to the technician that uses it on a routine basis. See what qualifications they used in deciding on the unit they have. Some have really never researched the marketplace, they have only gone on the recommendation of a friend or fellow physician who doesn’t use it on a regular basis. Be careful and don’t assume that the Physician who owns it knows anything about it other than it is bringing tremendous revenue to their office. Most Physicians, especially Plastic Surgeons, really never were involved in the review and purchase of their machine. They left it up to the person who was going to do the procedures. Again, ask them what they based their decisions on and compare it to what you have seen yourself. After you have narrowed your decision to 2 or 3 different units, ask them to see if they would do a head-to-head evaluation at the same time in your office. You might be surprised at the number of companies that will balk at this offer. Having the units side by side is a great way to compare features like noise, messiness, etc.

Many Physicians have purchased their microdermabraders on factors other than the overall quality and performance of the unit. They were more interested in purchasing a name brand or the marketing program the company offered. Don’t let me mislead you, these things have to be taken into consideration, but in the end you will wish you had bought on performance and reliability.

If you have any additional comments to make on this review of Microdermabraders, please let me know and I will add it to this document. Also if you find any of this information to be inaccurate or misleading, I would like to know this as well so that I can amend those areas and make the appropriate changes.

The Bella Products, Inc. Micro-Dermabrasion machines

Bella Products, Inc. manufactures two micro-dermabrasion machines the Belladerma machine-- designed for use by beauty shops, spas and the estetician marketplace. The Bellamed machine-- designed for use by or under the supervision of a medical practioner.  Both of the machines are based on the same basic design with enhanced features added to the Bellamed machine.  These special features provide the Bellamed with more abrasive power using a foot pedal controlled air boost system and a safety air boost inhibitor to protect against blowing crystals when the application tool is not in vacuum contact with the patient. The air boost feature is implemented by providing conrtrolled air pressure into the media delivery system prior to the media canister.

The control systems of the Belladerma and Bellamed are based on linear vacuum and air control valves (patent pending).  These valves give the operator the ability to make very minute adjustments to the application on the fly and also provide the ability to have the treatment pressures reproducible by the reading on the vacuum guage.

The Bella Products, Inc. handset application tool is designed as a modular device made of four parts, the body, the nozzle, the accelerator and the applicatioin tip.  All of the parts are available as replacement parts, but the only parts that need to be replaced on a use interval basis is the accelerator and the application tip.  The accelerator will wear larger by erosion caused by the media passage over time and the application tips will be contaminated by patient contact.  Both the accelerator and the application tips are sold in multiple component packages.

The handset application tool is a 90 degree device with multiple radial vacuum return bores.  It has been specifically designed to be used with a balanced media delivery/media retreival system.  The handset application tool comes with two different length and application diameter tips.   The application tips are  made from a hard poly-bicarbonate to remove the possibility of wear producing sharpness and injuring the client.

Bella Products, Inc. consumables (100 Micron crystals), Corundum or Bi-Carbonate of Soda, are delivered in premeasured sealed poly bags. The patent pending waste canister is a sealed container with a reverse flow valve to stop used media from being removed from the container.  When the waste canister is full of contaminated media the Bella micro-dermabrader machine automatically shuts off and a “canister full light” comes on signaling the operator to change the waste canister. When the waste canister is removed from the machine a closure cap is supplied to insure that any used media on the top port of the canister will not escape from the canister and contaminate the area.

The Bella machines are designed in such a manner that no crystals will flow to the handset (and therefore to the patient) without having the handset in contact with the patient.  There is no spewing of media into the surrounding area from a Bella Products, Inc. machine.

The Micro-dermabrasion machines from Bella Products, Inc. by design are balanced and all media delivery and removal operations have been optimized for the maximum control of the procedure at all settings with optimal patient comfort.  The reading on the vacuum guage of the machine, as set by the operator with the Vacuum Adjust, is the actual pressure on the skin of the patient not the system pressure of the machine.   We at Bella believe that the operator should be able to control and know the pressure at the contact point of the handset and therefore have the ability to provide the optimum treatment with maximum comfort for the patient.

Bella Products machines carry a ten year warranty for all internal parts and labor from the date of purchase for the original purchaser of the equipment.