The machine surfaces (focus on outer case, front panel, N2O concentration knob, key lock area) should be wiped down in between patients using Super Sani-Cloth Germicidal Wipes. The breathing circuit, mask, and mouthpiece accessories are considered single-use items unless they use the bacterial/viral filter in which case the patient circuit tubing can be reused. The filter and mouthpiece/mask must still be changed after every use. The inside of the inlets, gas supply hoses, or connection ports should not be cleaned. It comes with a warranty for 3 years of maintenance service (1 each year), after the warranty is $250

One of the safety features of this device is that it’s pneumatically driven and an on-demand system. This means that there will not be a continuous flow of nitrous without need, which could possibly leak out into the general area wasting gas and impacting the provider. There needs to be enough resistance provided by the demand valve so that the user needs to make a conscious effort to inhale/exhale. Quick or shallow breathing (requiring less force) may mean the patient is becoming too light headed or sedated, and the Nox Plus will switch over to regular room air. The Pro-Nox has a recalled mixer and the FDA has recommended using an O2 monitor with the device because the concentration delivered to the patient cannot be verified without an external monitor.

• If the end-user is having a tough time breathing or feels noticeable resistance, then I wonder if there’s something strange with their setup. There really shouldn’t be any huge resistance when breathing the system and I personally haven’t heard this complaint before. If you can take photos of their setup, specifically of their front headpiece gauges when the device is in use, that will help with troubleshooting.
• • https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfRES/res.cfm?id=165228

The luer-lock on the patient circuit is known as the capnography port. This port is used by anesthesiologists to monitor CO2 return from the patient. For on-demand systems, it is never used and is relevant to continuous flow and sedation systems where the patient isn’t completely conscious. The clean, nitrous oxide mixture is supplied through the lumen of the blue tubing. When the patient exhales, their breath comes through the lumen of the clear portion around the blue tubing, which is where the port is. Opening this valve will not make it easier to breathe through the system and it isn’t designed to be open to the atmosphere. It isn’t connected to the nitrous mixture supply. It is there just for monitoring and it should remain closed for our use. I have never tried to open this port but based on the device’s requirement to have the patient breathing steadily and evenly, I think opening it would make the nitrous supply worse. The exhaled breath may cause the machine’s emergency air intake system to take over and supply just normal room air.

Nox Plus is considered a transient (less than 60 min) in terms of continuous use (meaning the patient is only breathing in and out of the device) when providing analgesia (minimal to moderate sedation.) Procedures occurring over several hours are also considered transient, and Nox Plus can be safely administered intermittently throughout the duration. Upper limits of use are at the discretion of the providers. When training, I recommend having the patient do a ‘loading dose’ where they breathe the nitrous oxide continuously for at least 5 minutes. Then, they should hold on to the mouthpiece and if they feel pain/anxiety, to take another few hits of the Nox.

• I have never experienced a patient throwing up with the nitrous but nausea is a known side effect of nitrous, especially at higher concentrations. If this happens, you can turn off the nitrous supply and provide straight oxygen to help relieve the symptoms before there’s actual vomiting.

• For B2B marketing, we have our Nitronox and Nitronox Plus one pagers. We hand those out at conferences. We can send #25 of each to your sales reps. Please have them request the one pagers with our Customer Service Team at customerservice@plymouthmedical.com. Please note that we only have a limited stock of the legacy Nitronox devices available. Porter no longer manufactures the legacy Nitronox model. Once the remaining legacy models are sold, we will only sell the new Nitronox Plus so it’d make sense for your sales reps to quote the Nitronox Plus to future leads.
• In terms of patient education brochures, we have those available for the Nitronox/Nitronox Plus devices which clients can purchase (100x Brochures $75 + $9.99 shipping). You can find the brochures on our marketing page: https://www.plymouthmedical.com/marketing-msk
• We include information on available marketing in the onboarding email.

Yes, we have 4 types of threads, with different lengths, uses and variations on each:

• Filler Effect:
  • Mono (Smooth)
  • Screw (Twisted)
• Lifting Effect:
  • Cog (Barbed)
  • Sculpted (Pressure Molded Barbed) these ones have a larger tensile strength

Les Encres Threads are made of synthetic biodegradable materials. We offer PDO, PLLA and
We are the only provider in the US to carry PCL threads. They are all FDA approved, to be used for surgical sutures:

• PDO (Poly-dioxanone): The most Versatile for Lifting, Volume and Collagen Production, they are cost effective with a higher tensile strength.
• PLLA (Poly L Lactic Acid): Creates Volume to lift the skin with a natural look
• PCL (Poly-caprolactone): They work better for Collagen Production to Increase Volume in the skin as they last more.
• PCL Threads with HA: The HA Boosts the collagen production

They are all absorbable by the body, by hydrolysis and their duration depends on the compound that they are made of:

• PDO (Poly-dioxanone): They have an absorption rate of 6 months, and their effect lasts for 24 months
• PLLA (Poly L Lactic Acid): They have an absorption rate of 8 months, and their effect lasts for 24 months
• PCL (Poly-caprolactone): They have an absorption rate of 24 months, and their effect lasts for 2-4 years

Yes, to ensure your success, we have a dedicated Clinical Specialist available for you to answer all your questions, and ensure your team is confident and skilled in the art of thread insertion.

• Yes, Les Encres is registered with the FDA as a re-packager of FDA approved PDO, PLLA/PCL sutures for soft tissue approximation.
• Les Encres is also the only thread company in the industry to have $1,000,000 liability policies, both General and Product liability.

Yes, we offer 3 training options:

6-hr Custom private session held in the comfort of your own facility – Up to 4 injectors: Requires a minimum order of $4800 + $199 registration fee.

8-hr Intimate group session led by Dr. Jonathan Sykes, at the Roxbury Institute in Beverly Hills, CA – Up to 5 injectors: No minimum order required. $1699 registration fee to confirm session date

• For this option the invoice must be created with the object – Sykes Face Sculpting Institute Session – instead of Canvas Session
• Contact Number: 424-274-2363
• Website: http://www.SykesFaceSculpting.com
• Email: booking@sykesfacesculpting.com

5 days, 40-hr Intensive training led by a highly skilled mentor, at the Wake-Up Beautiful Spa & Academy, Laguna Niguel, CA – $10.000

• Participants may apply a $2,000 voucher to the course or receive $2500 in threads. (Have to confirm)
• For this option the invoice has to be created with the object – Wake up Beautiful Session – instead of Canvas Session
• Contact Number: 888-378-0572
• Website: http://www.wakeupbeautiful.com

• Yes, The Artistry Points Program offered by Les Encres is a points-based program where active Les Encres Thread users may accrue points to redeem Les Encres discounts and recognition.
• Artistry points may be redeemed for free products and session discounts.
• Points may accrue to become eligible for the Master Les Encres Account designation.

• Routinely inserted via a 26-30g mounted needle, threads are placed with precision into the subcutaneous (intradermal, hypodermal) layer of the skin, for soft tissue augmentation or lifting.
• Due to the minimally invasive technique and through the use of topical anesthetics, the patient experiences minimal discomfort.
• We have a new blunt tip needle, that allows moving the thread position multiple times before releasing and placing the thread in the right place.

Yes, we have Special Introductory Packages:

• Package 1 – 25% discount: $5,733
• Package 2 – 15% discount: $3,499
• Package 3 – 10% Discount: $2,100

Each order MUST have one of the following selections added:

• ‘Delivery Fee’ 3-5-day delivery charge for all orders under $1799: $30
• ‘Complimentary 3-5-day Delivery’ charge for all orders above $1800
• Selected ‘Supplemental Overnight Delivery’ if an account would like to upgrade the 3-5-day delivery to overnight*. There is a $40 fee for this upgrade
• ‘Standard Overnight Delivery’ for delivery by close of next business day: $75
• ‘Rush Overnight Delivery’ for delivery by 10:30 am next business day: $95

*All overnight orders MUST be received by 2pm, no exceptions

• Customer must report any errors and/or discrepancies in orders within 48 hours of receipt, Les Encres is not obligated to issue credit for errors on discrepancies not reported within such time period.
• Refunds or exchanges will not be given on any open pouches of threads or product after 10 days of receipt of order.
• Credit for returned merchandise will be assessed upon receipt of the merchandise and only for items that are authorized for return by Les Encres, LLC. Issuance of a return authorization does not guarantee a credit will be issued.
• Credits will be issued at the original purchase price shown on the invoice or current program price (whichever is less), less the amount of off-invoice allowances or adjustments, including but not limited to a 10% handling charge, restrictions and/or adjustments.
• All credits will be reflected in Customer’s account to apply toward future purchases.