In Part 2 of their darker Fitzpatrick series, Brian, Elodie, and Mary shift from pigment to texture, tackling ablative vs. non-ablative resurfacing, RF microneedling, HIFU, and the most slept-on tool in the category: fractionated Pico.

The team breaks down why ablative lasers (like CO2) treat skin "from the top down" while wavelengths like 1550 rebuild it "from the bottom up", and why that distinction matters so much for healing response and adverse-event risk in darker skin types. They get real about RF microneedling's reputation, why monopolar RF may be repeating the same mistakes, and how to actually differentiate one RF device from another (hint: it's not the specs).

Plus: an honest take on where HIFU stands in the U.S. market today, why fractionated Pico deserves way more attention for scarring and texture, and a genuinely useful reframe for how practices should be building their treatment menus, around outcomes and time, not device names.

In this episode:

• Ablative vs. non-ablative resurfacing: what actually makes darker skin higher-risk
• Why 1550 is a go-to wavelength for texture, laxity, and scarring on darker Fitzpatrick patients
• RF microneedling and monopolar RF: real talk on safety, reputation, and how to evaluate devices
• HIFU for lifting and fat reduction, where the category stands (and where it's headed)
• Fractionated Pico: the underused tool for safe, heat-free collagen remodeling
• Rethinking your treatment menu: booking for outcomes and time, not just device or service names

They break down the real difference between Pico and Q-switch/nanosecond lasers (spoiler: they're more closely related than most people think), why 1550 and 1927 wavelengths are underrated tools for scarring, texture, and pigment, and how to pair short-pulse lasers with fractionated treatments for better tattoo removal and scar revision outcomes.

They also tackle a persistent myth head-on: does RF microneedling actually treat pigment? The team walks through the study everyone cites and why it doesn't hold up. Plus: who should actually own a Pico device, how to handle adverse events like hypopigmentation, and why inclusive consultations (and a strong chemical peel portfolio) matter as much as the device itself.

In this episode:

• Pico vs. nanosecond/Q-switch: what's actually different (and what isn't)
• Why 1550 + 1927 wavelengths are a powerful combo for darker skin types
• Debunking the RF microneedling-for-pigment myth
• Who really needs a Pico laser (and who doesn't)
• Handling hypopigmentation and other adverse events

Brian Jewkes, Elodie Gourgeon, and Mary Mitchell break down what actually makes an aesthetic practice thrive heading into fall and winter, from quarterly case studies to annual refresher training to the uncomfortable truth that sometimes a device is fine, but it’s simply not the right fit for your practice or your patient population.

You’ll discover how to:

• Spot when a device problem is really a staff alignment problem
• Use quarterly case reviews to uncover better protocols and new treatment opportunities
• Reassess your menu so your team is selling services with the same energy and language
• Identify whether a technology truly matches the results your patients want
• Use polls, email, and visual education to learn what your community actually wants
• Build more inclusive offerings and content for Fitzpatrick 4, 5, and 6 patients
• Protect patient outcomes with preventative maintenance and yearly training refreshers
  

Mary shares a simple but powerful practice rhythm for bringing every provider, front desk team member, and location into the same conversation, while Elodie makes the case for going back to laser physics basics - wavelength, pulse duration, and fluence - so you can separate real demand from industry noise. Brian adds the perspective of what happens when a device or treatment loses momentum because the team behind it is no longer fully bought in.

The episode also gets practical fast: how to tell if your technology is actually safe and effective for your patient mix, why educational content should focus on your patients’ concerns instead of just your services, and how a single quarterly check-in can turn “we should probably fix this” into a concrete seasonal plan.If you’re a practice owner, provider, or team member trying to make the most of laser season, this is your reset button.

Perfect for anyone who wants better outcomes, stronger retention, and a more confident, more connected clinic heading into the busiest months of the year.

They get into:

• Why most "new" skin tightening tech is just a rebrand of what's existed for 15+ years
• RF microneedling's rocky reputation — the FDA letter, the adverse events, and whether it's actually safe now
• Why skin laxity treatment needs to start before patients finish their GLP-1 journey, not after
• The predicate device loophole that lets manufacturers charge double for barely-changed hardware
• How to spot a device that gives an "instant result" that won't actually last
• The $2,500 problem: when a temporary fix gets sold to patients as a lasting one

Whether you're evaluating your next equipment purchase or just trying to figure out which treatments actually work, this episode is a practical, no-BS guide to separating real outcomes from industry noise.