The primary mechanism of action for the Long-pulsed Mode is the delivery of sustained thermal energy to induce deep tissue remodeling. Operating with pulse widths in the millisecond range—typically around 1000 ms—this mode bypasses the surface to generate controlled heat within the underlying tissue structures.
The Long-pulsed Mode functions as a deep heating agent rather than a surface ablator. By creating broad zones of coagulative damage within the lamina propria, it forces the denaturation of existing proteins and triggers the body’s natural production of new collagen and elastin.
The Biological Mechanism
Deep Thermal Penetration
Unlike modes designed for immediate surface ablation, the Long-pulsed Mode utilizes a much longer duration of energy delivery.
By extending the pulse width to the millisecond range, the laser allows heat to accumulate and diffuse deeper into the tissue without instantly vaporizing the surface.
Targeting the Lamina Propria
The specific anatomical target for this thermal energy is the lamina propria.
This layer of connective tissue sits beneath the epithelium and is crucial for structural integrity. Delivering energy here ensures that the remodeling process occurs where it will have the most significant impact on tissue density.
Coagulative Damage and Denaturation
The heat generated by this mode causes controlled coagulative damage.
This process creates a thermal injury that denatures (tightens) existing collagen fibers. Simultaneously, this specific type of damage signals the body to initiate a repair response.
Role in Dual-Mode Protocols
Sequential Treatment Logic
In a dual-mode protocol, the Long-pulsed Mode is typically employed as the second step.
The primary reference indicates it follows a micropulse mode, which is responsible for creating initial openings in the epithelial surface.
Enabling Deep Access
Once the micropulse mode has breached the epithelial barrier, the Long-pulsed Mode can deliver its thermal payload more effectively.
The initial openings essentially clear the path, allowing the long-pulsed energy to reach the deep lamina propria without unnecessary surface resistance.
Stimulation of Neo-synthesis
The ultimate goal of this mechanism is the neo-synthesis of collagen and elastin fibers.
The deep thermal injury stimulates fibroblasts to produce new structural proteins, resulting in enhanced long-term tissue firmness and elasticity.
Understanding the Trade-offs
Delayed Results vs. Instant Gratification
Because this mechanism relies on the body's biological healing response (neo-synthesis), results are not immediate.
While the denaturation of fibers provides some immediate contraction, the true structural firmness develops over time as new collagen is formed.
Thermal Management
The generation of "deep thermal effects" and "broad areas of coagulative damage" requires precise energy management.
There is a fine line between therapeutic heating that stimulates remodeling and excessive heating that could cause unwanted thermal injury. The long pulse duration mandates careful control to ensure safety.
Making the Right Choice for Your Goal
To determine if the Long-pulsed Mode is the primary driver for your specific clinical objective, consider the desired depth and timeline of the results.
- If your primary focus is immediate surface resurfacing: This mode is secondary; you should rely more heavily on the initial micropulse mode to address epithelial texture.
- If your primary focus is long-term structural tightening: The Long-pulsed Mode is critical, as it is the only component capable of stimulating deep collagen and elastin synthesis in the lamina propria.
Success with this mode relies on understanding that it is a tool for stimulating deep biological repair, not just surface correction.
Summary Table:
| Feature | Long-pulsed Mode Details |
|---|---|
| Pulse Width | Millisecond range (~1000 ms) |
| Target Tissue | Deep Lamina Propria (Connective Tissue) |
| Primary Action | Coagulative damage & protein denaturation |
| Biological Result | Neo-synthesis of collagen and elastin |
| Clinical Focus | Long-term structural tightening and firmness |
| Protocol Order | Secondary step (following surface micropulsing) |
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References
- Min Seok Lee. Treatment of Vaginal Relaxation Syndrome with an Erbium:YAG Laser Using 90^|^deg; and 360^|^deg; Scanning Scopes: A Pilot Study ^|^amp; Short-term Results. DOI: 10.5978/islsm.14-or-11
This article is also based on technical information from Belislaser Knowledge Base .
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