Industry Experts Discuss the Subnovii Plasma Pen
In the February 2022 edition of Observations in Aesthetics, top skincare experts discussed some of the most popular questions related to the popular Subnovii Plasma Pen treatment.
The panel includes the following industry experts:
- Monica Bonakdar, MD: Board Certified Aesthetic Laser Surgeon
- Stepen Eubanks, MD: Dermatologist
- Regina Kaufmann, MD: OB/GYN, Cosmetic Surgeon
- Carey Nease, MD: Plastic Surgeon
- Ardis Schmitt, RN, BSN: Medspa Owner
- Lauren Siso, Medical Aesthetician: Medspa Owner
- Josie Tenor, MD: Family Medicine, Cosmetic Specialist
Subnovii – the only FDA cleared handheld plasma device to utilize LF+ technology – has made a splash in the non-invasive aesthetic market. Over 500 practices have purchased the device and many more are quickly recognizing the exceptional design and benefits of Subnovii versus plasma “pens” – from better patient experience to more precise, reproducible results.
As plasma is becoming an increasingly sought after treatment in the aesthetic space, we interviewed leading clinicians about this in demand procedure, why they chose to integrate Subnovii into their practice and how it earned the title of “the ultimate aesthetic tool”. Below are excerpts from that discussion.
Q: What makes Subnovii different than anything that you have used before?
Carey Nease, MD: For 20 years, my non-invasive business has been about lasers. Subnovii has opened a whole new world given it is small, lightweight and battery operated so I can keep it in my lab-coat pocket all day. It’s easy to pull out and use for a number of applications.
Josie Tenore, MD: Subnovii is a handheld device that delivers precise low frequency plasma energy to the tissue. This is unlike any other device on the market and fills a definite void. It is fantastic for the sensitive tissues around the eyes and is the gift that keeps on giving in that we see ongoing improvement over several months. If you are serious about looking after skin and want the best possible outcomes for your patients, this is a powerhouse tool in your cabinet.
Monica Bonakdar, MD: Subnovii is great for addressing problem areas and for many patients, those most bothersome spots are the small and isolated areas. For example, when you talk to patients they point out that one wrinkle that bothers them. With Subnovii, I can quickly target these specific areas and get them results without the downtime that comes from treating a full face.
“Subnovii’s LF+ energy is more controlled and precise – I can place the energy exactly where I need it to be while offering my patients the best possible experience.”
– Dr. Kaufmann
Ardis Schmitt, RN, BSN: To start, Subnovii is a different way to deliver energy. It is not a laser. Subnovii sublimates the tissue going from solid to gas immediately and from a skin to scab immediately. Subnovii can offer less post- treatment pain, risk of infection and downtime compared to traditional ablative treatments and the results are extremely impressive. Sometimes I just stare at my patients in amazement, it’s like magic.
Regina Kaufmann, MD: I have worked with high frequency plasma technologies and compared to Subnovii, they are like blow torches. The delivery and downtime of high frequency is aggressive – from having to numb fully and provide a relaxing agent to the downtime they are put through…it’s a sledge-hammer approach.
Subnovii’s LF+ Technology is more controlled and precise – I can place the energy exactly where I need it to be while offering my patients the best possible experience. Additionally, in my experience, Subnovii can achieve results in one session that may require four to six treatments with other plasma devices.
Josie Tenore, MD: I felt that there was a void in my practice that could be filled with plasma. I ultimately chose Subnovii because I believe in the science behind LF+ Technology, especially when you compare LF+ to the other plasma devices that use either low frequency or high frequency alone.
Q: What makes the patient consultation with Subnovii different than with other treatments?
Stephen Eubanks, MD: It’s a little bit longer of an educational process, but when you compare that to the results it’s a very positive experience for patients.
Monica Bonkadar, MD: I’m very, very specific about downtime. I mean I will go as far as telling them, “I am not going to be your favorite person tomorrow or for the nextfew days. I show them pictures of what they’re going to look like.
Carey Nease, MD: I like to be very specific about what they can expect in the days following in terms of swelling and scabbing. Recovery is dependent on what area you’re treating, and how aggressively you are treating it. It can be little downtime or you could look red and swollen for five to seven days. This is typically worst case scenario and possible when we’re doing both upper and lower eyelids or aggressively treating deep lines along the perioral area.
When we’re aggressive, downtime is similar to that of a fractional CO2 laser but the results are really nice.
Q: When do you start to see results?
Ardis Schmitt, RN: The results with Subnovii are phenomenal. Typically, I begin to see some results at the 14-day mark and then by month three, the outcomes are impressive. I have a client that had crow’s feet lines that extended down the side of her face… and they’re gone. When I see her, I’m amazed by Subnovii’s results.
Carey Nease, MD: In my experience, you see significant improvement at or about 90 days post treatment. Once the swelling subsides, skin looks tighter and we see continuing improvement with time.
Q: Who is an ideal candidate for a Subnovii treatment?
Lauren Siso, LE: Subnovii is a good option for someone who may be a candidate for an invasive approach (ie. blepharoplasty) but isn’t ready for surgery. I work for an ocular plastic surgeon and the ideal candidates are those who want tightening and improvement in sagging skin around the eyes but don’t want to undergo an invasive procedure. We are also treating acne scars on younger patients and have seen beautiful results.
Stephen Eubanks, MD: The patients that respond best are between 45 to 60 years old who are seeing congenital problems around their eyes, under-eye bags and wrinkles.
Monica Bonakdar, MD: I don’t think there is one particular patient because Subnovii can treat so many concerns. I have treated individuals across the age spectrum – from retired patients that can have downtime to those still in the workforce who want the wow results and the time is right to accept some downtime.
Q: Do you combine modalities with Subnovii? If so, what treatments and why?
Ardis Schmitt, RN: I like combining Subnovii with VirtueRF microneedling and Tetra CO2 especially for acne scars.
Typically, I will start with a series of VirtueRF and Tetra CO2 treatments. At the end of the series, I use Subnovii as the final, most aggressive treatment to get their tissue back to where it belongs.
Stephen Eubanks, MD: I routinely combine Subnovii with other modalities. For instance, I will target around the eyes with Subnovii and the rest of the face with a CoolPeel (no downtime CO2 treatment exclusive to the Tetra CO2).
Carey Nease, MD: I frequently combine Subnovii with VirtueRF Microneedling and CoolPeel. The layering of treatments adds a lot of value and we get really, really incredible results with this synergistic approach. As a cosmetic plastic surgeon, I’ll use Subnovii and my Tetra CO2 to touch up results post-surgery. For example, if I do an upper and lower eye lift and a couple of months later they still have some skin laxity, Subnovii is the perfect tool to precisely care for areas that are still concerning.
Q: What are you charging for a treatment and what has been the business impact?
Lauren Siso, LE: I start treatments at $400 and I don’t charge less than that no matter what, even if it’s a small little area. Treatment of the lower lids are about $600, upper lids are $800, and then I customize.
Carey Nease, MD: We charge around $600 for a full perioral area. Upper and lower eyelids cost between $1600 and $1800 for one session. If I spend a couple of minutes zapping a few lesions, I we will charge about $300, even if it’s only five minutes of my time.
Josie Tenore, MD: We saw a return on our investment in less than ten treatments. And those treatments didn’t take long to do and so we quickly paid off our device.
“We saw a return on our investment after less than ten treatments.”
– Dr. Tenore
The patient response has also had a big impact on our business. We have patients who are so happy with their first treatment area that they immediately want to treat others. Our patients’ reactions are similar to what we see with laser hair removal – once you start and have a good experience, they just keep adding packages.
What’s interesting to me is that they do so even with Subnovii’s associated downtown. I’d say at least 20% of the patients that I’ve treated with Subnovii are coming back and asking for more.
Q: Can you share how you market and educate your patients about plasma and other technologies?
Monica Bonakdar, MD: I have what I call my “Five R’s of Facial Rejuvenation” – Relax with Neurotoxin, Reflate with fillers, Resurface, Redrape, and Retain. This covers almost everything that my practice offers and I try to touch on each “R” with every patient. And so, I very often like to do my neurotoxin and fillers first because it’s instant gratification and then talk about how Subnovii fits in to my “Five R” approach.
Stephen Eubanks, MD: When selling treatments within my practice (and others) it comes down to whether or not the provider believes it will work. If they can tell that you believe in the device you’re recommending, and you educate them on what to expect, they’ll opt to do it.
Q: What is your advice for someone in the market for a hand-held plasma device?
Josie Tenore, MD: Buyer Beware. Spend time looking at the science behind the technology. Make a decision based on the science and talking to other providers who use the device versus hype and price. I know providers who have the less expensive plasma pens and once the buzz in their practice has come and gone, they stopped doing treatments. The pen sits there collecting dust and nobody wants that, even if you got it at a discount. Then I would say, put yourself in your patients’ shoes – if you can have a treatment that can heal quicker and produces better results, wouldn’t you prefer that?
Ardis Schmitt, RN, BSN: I’ve used other plasma pens on the market and they’re very small, with a small arc and small imprint. Subnovii is not a pen, it is a device. You’re never going to get, in one treatment, anything near what you would get with the Subnovii, in any area.
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