Pellevé® Treatment Guidelines

Training Handout

CC12052 Rev B

Pellevé® Training

• This training presentation is intended for both US and

international (non-US) audiences. International

indications for use differ from US indications and these

differences are reflected in this training document

• In general, Pellevé training documents include

treatment of the neck which is not a cleared indication in

the US.

• Current US indications for use: Non-ablative treatment

of mild to moderate facial wrinkles and rhytides for skin

phototypes I-IV

1/7 Forehead

3/9 Mid/lower Face

6/12 Right & left neck*

Treatment Area Planning

2/8 Periorbital & crow’s feet

4/10 Nasal labial folds

5/11 Preauricular

1

3 9

6 12

2 8

4

7

11 5

10

*Not indicated in US. Current US indications for use: Non-ablative treatment of mild to

moderate facial wrinkles and rhytides for skin phototypes I-V

• Treatment Pattern

– Linear overlapping corkscrew rows and columns

– Tight circles

• Minimum of 5 passes: – 3 vertical (pass 1, 3, 5), 2 horizontal (pass 2, 4)

• Stabilize loose skin with slight traction

• Move at speed to achieve 40 - 42ºC before

progressing

• Warming pass to 38 - 40ºC may precede 5 treatment

passes

• Treat area with total number passes before moving

to another area

• Use 2 GlideSafe Handpiece sizes (1 size for thinner

skin areas such as forehead and periocular)

– 20 mm and 10 mm

– 15 mm and 7.5 mm

• No cooling during treatment

Pellevé® Treatment Technique

• Some clinicians treat patient’s “high” side of face 1st

• Half time review produces most

dramatic immediate effect

• Complete all passes on the high side

(1/2 face)

• Allow patient to sit up and view face in

mirror

• Follow by treating the other side for all

passes

Treating the “High” Side

Midface Area

Vertical – 3 Passes

•Treat starting at chin with each

successive column moving from

midline toward ear (1st, 3rd, 5th pass)

Horizontal – 2 Passes

•Treat medial to lateral following the

jaw line, starting at lower face closest

to chin with each successive row

moving upward toward eyes (2nd, 4th

pass)

Use smaller handpiece

for greater number of

passes (i.e. 3 passes

with 10 mm and 2 passes

with 20 mm)

Forehead & Neck Areas

Vertical – 3 Passes

Forehead

•Treat upward direction from midline with

each columns moving toward lateral

hairline

Neck*

•Treat in upward direction from midline

with each column moving in lateral

direction

Horizontal – 2 Passes

Forehead

•Treat midline to lateral margin from closest to

eyes & moving upward with each rows

Neck*

•Treat medial to lateral from lower neck with

each row moving toward jawline

•Treatment to extend to behind ear with skin

pulled taught

• Use smaller handpiece

for greater number of

passes

• Forehead: Use 7.5 mm

or 10 mm handpiece

• Neck*: Use 10 mm and

20 mm handpiece

*Not indicated in US. Current US indications for use: Non-ablative treatment of

mild to moderate facial wrinkles and rhytides for skin phototypes I-V

Periocular Area Use eye shields if treating over ocular globe

Vertical

•Above brow, treat in

upward direction from

midline with each

column moving toward

lateral hairline

•Lateral eye/crow’s feet,

treat in upward

direction from outer

eye corner with each

column moving toward

hairline

Horizontal

• Above brow, treat from

midline to lateral

margin from closest to

eyes & moving upward

with each row

• Below brow & below

eye, treat medial to

lateral in arc following

eye shape

• Retract periorbital skin

over orbital ridge when

treating

Above brow same

as forehead

treatment

Total 5 passes

Use 7.5 mm or 10 mm handpiece

for total periocular area

Nasal Labial Folds & Preauricular Areas

Nasal Labial Fold

• Treat at 90 degree

angle to fold in line

toward temple

starting at fold with

successive columns

moving upward

• 5 Passes in angled

vertical direction

Preauricular

• Retract skin by

pulling earlobe in

posterior direction

• Treat vertically in

upward direction

starting medially

with successive

columns moving

toward ear

• 5 Passes in angled

vertical direction

Use 10 mm or 15 mm

handpiece for both areas

Pellevé Treatment Technique

• Place handpiece on skin before activating

• Move handpiece in tight corkscrew motion

• Moderate pressure like a firm massage

• Activate and move continuously in overlapping

patterns (1.5-3 cm diameter, smaller than size of a

quarter)

• Start slowly to raise the skin temperature to at least

40ºC

• Continue and vary the power or rate to control

temperature

• Do not skip areas

Corkscrew motion for complete

coverage with no gaps

Cream for demonstration

purposes only

Most Experienced Users

• Use at least 2 different size handpieces for most areas

• Assure that there are no gaps in the treated area

• Use a corkscrew motion

• Cover treatment area in 2 directions, horizontal and vertical

• Treat area with a minimum of 5 passes

• Treat below jaw-line, then pull jaw tissue up and retreat over jaw bone

• Ensure skin is taught but not overly stretched

• Perform more than 3 treatments spaced a month apart

Cream for demonstration purposes only

Depth

Energy Penetration Profiles

• Diameter of handpiece electrode matters

• Smaller electrodes targets shallow to mid-dermal layers

• Larger electrodes target deeper dermal layers with less cooling

capacity

• Treating with larger electrode heats deep dermal layer

• The smaller electrode maintains temperature in mid-dermal range

Tissue Surface

Comparable

Energy

Density

15 & 20 mm 7.5 & 10 mm

Generator Settings

Pellevé® Photographic

Protocol

• Patient not wearing makeup or jewelry

• Hair tied back or in head band

• Neutral colored cape and dark background

• Clothing does not obscure area of interest

• Review baseline pictures to achieve same

positioning – chin/nose elevation &

angulation

• Same camera, lens, light

• Releases are signed

Photographic Protocol

Consistency in positioning of patient,

camera and lighting is essential

Photographic Protocol

Front Profile Oblique

Level & Vertically

Straight