Kare Plastic Surgery & Skin Health Center · Santa Monica & Los Angeles
Vbeam Laser in Los Angeles
804 7th Street, Santa Monica, CA 90403 · Near Montana Avenue · (310) 998-5533
Rosacea, red scars, keloids, port wine stains, spider veins, angiomas & stretch marks — treated by board-certified dermatologist Dr. Tiffany Sierro and board-certified plastic surgeon Dr. Raffy Karamanoukian at Kare Plastic Surgery in Santa Monica
Call (310) 998-5533 Request a Consultation
📍 804 7th Street, Santa Monica CA 90403
📞 (310) 998-5533
🏠 Near Montana Avenue & Brentwood
🕘 Mon–Fri 9:00am–5:00pm
595nmVbeam Perfecta Pulsed Dye Laser
DualDermatologist + Plastic Surgeon Team
UCLASchool of Medicine Graduate
30+Laser Systems at Kare Plastic Surgery
5,000Square Foot Laser & Surgery Center
The Gold Standard in Vascular Laser
Vbeam Laser in Los Angeles: The 595nm Standard for Redness, Scars & Vascular Skin Conditions
The Vbeam Perfecta — a 595-nanometer pulsed dye laser manufactured by Candela — is the most clinically validated vascular laser in cosmetic dermatology and the instrument of choice at Kare Plastic Surgery & Skin Health Center for the treatment of the full spectrum of red, vascular, and pigmented skin conditions affecting patients throughout Los Angeles and Santa Monica. Its mechanism is precisely targeted: the 595nm wavelength is selectively absorbed by oxyhemoglobin in red blood cells within dermal blood vessels, producing photothermal destruction of abnormal vessels without any thermal damage to the surrounding epidermis or dermis.
This selectivity — called selective photothermolysis — is what makes the Vbeam both effective and safe: it eliminates the vessels driving rosacea, feeding hypertrophic scars, sustaining port wine stains, and causing spider veins while leaving all surrounding tissue completely unaffected. The result is progressive reduction of redness, flattening of raised vascular scars, fading of port wine stains and angiomas, and clearance of telangiectasias — with virtually no recovery time for most patients.
At Kare Plastic Surgery, Vbeam treatment is performed by two nationally recognized specialists whose individual areas of expertise are directly complementary: board-certified dermatologist Dr. Tiffany Sierro, MD, who evaluates and manages the full spectrum of medical and cosmetic skin conditions that Vbeam addresses, and double board-certified plastic surgeon Dr. Raffy Karamanoukian, MD, FACS, who applies Vbeam within the context of his nationally recognized scar management expertise for post-surgical and post-traumatic scar indications. Together, they offer a depth of Vbeam clinical expertise that is unmatched.
Vbeam Conditions Treated at Kare Plastic Surgery
- Rosacea — erythematotelangiectatic & papulopustular
- Persistent facial redness & flushing
- Red & hypertrophic scars — post-surgical & traumatic
- Keloid scars — vascular component management
- Post-facelift & post-rhinoplasty scar erythema
- Port wine stains & vascular birthmarks
- Cherry angiomas & spider angiomas
- Facial spider veins & telangiectasias
- Hemangiomas — infantile & adult
- Stretch marks (striae rubra — active red/purple phase)
- Flat warts & periungual warts
- Psoriasis plaques
- Poikiloderma of Civatte (neck & chest)
- Leg veins & reticular vessels (selected)
The Kare Vbeam Team
Los Angeles’ Only Dual Dermatologist & Plastic Surgeon Vbeam Team
The clinical advantage that Kare Plastic Surgery offers every Vbeam patient is not a single expert — it is two specialists whose expertise covers every dimension of the conditions Vbeam treats. Every Vbeam patient benefits from the diagnostic precision of a board-certified dermatologist evaluating the skin condition and the reconstructive perspective of a board-certified plastic surgeon managing the scar and wound-healing component. No solo provider can offer both.
Board-Certified Dermatologist
Dr. Tiffany Sierro, MD
Dr. Tiffany Sierro is a board-certified dermatologist at Kare Plastic Surgery whose clinical expertise spans the full spectrum of medical and cosmetic dermatology, with particular depth in vascular laser treatments, rosacea management, and the diagnosis and treatment of pigmented and vascular skin lesions. Her formal dermatology residency training provides the diagnostic foundation that distinguishes the dermatologist-performed Vbeam treatment from the aesthetician-administered or non-specialist laser treatment that many Los Angeles laser clinics offer.
For every Vbeam patient, Dr. Sierro performs a comprehensive skin assessment, lesion characterization, differential diagnosis of vascular vs. pigmented lesion components, and assessment of concurrent skin conditions that require treatment coordination or parameter modification. Her dermatologic assessment ensures that the Vbeam treatment is not only performed correctly but is performed for the correct indication, at the correct parameters, in the correct patient.
- Board-certified dermatologist — rosacea, vascular lesions, pigmentation
- Vbeam specialist for medical and cosmetic dermatology indications
- Protocol-specific algorithms for treatment
- Concurrent medical dermatology management for rosacea and skin disease
- Expert in Laser Specific Scar Treatments
Double Board-Certified Plastic Surgeon
Dr. Raffy Karamanoukian, MD, FACS
Dr. Raffy Karamanoukian is a graduate of the UCLA School of Medicine and a double board-certified plastic and reconstructive surgeon whose nationally recognized expertise in wound healing science and scar management makes him uniquely qualified to apply Vbeam within the context of post-surgical scar care. His Vbeam practice is inseparable from his broader scar management protocol: every facelift, rhinoplasty, tummy tuck, or breast surgery patient at Kare Plastic Surgery is enrolled in a structured post-operative scar management program in which Vbeam is initiated at 4–6 weeks post-closure to address the vascular component of early scar maturation.
His understanding of the biomechanics of scar formation, the role of abnormal vascularity in hypertrophic scar maintenance, and the integration of Vbeam with intralesional corticosteroid, 5-FU, silicone, and surgical scar revision produces treatment outcomes for his post-surgical scar patients that significantly exceed those achievable with Vbeam alone or with any single-modality approach.
- Graduate, UCLA School of Medicine — double board-certified plastic surgeon
- National scar authority — keloid, hypertrophic scar, post-surgical erythema
- Vbeam integrated into structured post-operative scar management protocol
- Post-facelift, rhinoplasty, and breast surgery Vbeam programs
- Multimodal scar treatment: Vbeam + corticosteroid + 5-FU + surgical revision
“The Vbeam is one of the most versatile and evidence-supported lasers in dermatology and plastic surgery. Vbeam laser requires physician-level clinical judgment.”
— Dr. Raffy Karamanoukian, MD, FACS · Kare Plastic Surgery, Santa Monica
The Science
How Vbeam Pulsed Dye Laser Works: Selective Photothermolysis at 595nm
The Vbeam Perfecta is a pulsed dye laser — a laser that generates its beam by exciting a liquid organic dye with a flash lamp, producing a precisely calibrated pulse of light at 595 nanometers that is tunable in duration from 0.45 to 40 milliseconds. This tunability is the key technical feature that makes Vbeam adaptable across the full range of vascular targets in the skin, from the thin-walled capillaries of rosacea telangiectasias to the thick-walled vessels of port wine stains and the abnormal vascular channels within hypertrophic scars.
Selective Photothermolysis
The 595nm wavelength is selectively absorbed by oxyhemoglobin (the pigment that makes blood vessels red) while passing through the overlying epidermis with minimal absorption by melanin or water. This spectral selectivity means the laser energy is deposited preferentially within the target blood vessels rather than in the surrounding tissue, producing thermal destruction of the vessel without collateral epidermal injury — the defining principle of selective photothermolysis described by Anderson and Parrish.
Dynamic Cooling Device (DCD)
The Vbeam Perfecta incorporates a Dynamic Cooling Device that delivers a cryogen spray to the skin surface immediately before each laser pulse, cooling the epidermis to −20°C and protecting it from thermal injury during the underlying vascular treatment. The DCD allows higher fluences (energy densities) to be delivered to deeper vascular targets without risk of epidermal damage, and significantly reduces the discomfort of treatment by pre-cooling the nerve endings in the superficial skin before each pulse.
Pulse Duration & Target Selection
Short pulse durations (0.45–3ms) produce purpura (bruising) as the rapid thermal expansion of the vessel wall creates rupture — the most effective approach for thick-walled port wine stain vessels and large telangiectasias. Longer pulse durations (6–40ms) produce subpurpuric heating that coagulates vessels without rupture — preferred for rosacea, facial redness, and post-surgical scar erythema where purpura is cosmetically unacceptable. The clinical decision between purpuric and non-purpuric settings is made at consultation by Dr. Sierro or Dr. Karamanoukian based on the condition, location, and patient’s social downtime tolerance.
Scar Vascular Mechanism
Hypertrophic scars and keloids maintain their raised, red, firm character through a dense network of abnormal blood vessels that deliver the pro-inflammatory cytokines and growth factors sustaining ongoing collagen overproduction. By destroying this pathological vascularity with Vbeam, the blood supply driving the inflammatory scar maintenance process is interrupted — producing progressive softening, flattening, and fading of the scar as the inflammatory stimulus is withdrawn and the excess collagen undergoes normal remodeling. This mechanism is why Vbeam produces both the cosmetic improvement (fading redness) and the structural improvement (softening thickness) of hypertrophic scars simultaneously.
595nmOptimal oxyhemoglobin absorption wavelength
0.45–40msAdjustable pulse duration range
−20°CDCD cryogen skin surface cooling temperature
3–6Typical sessions for rosacea and red scar treatment
Conditions Treated
Skin Conditions Treated with Vbeam Laser at Kare Plastic Surgery Los Angeles
Each condition has a distinct vascular pathology, optimal Vbeam parameter setting, and expected treatment response. Dr. Sierro and Dr. Karamanoukian individually characterize each presentation at consultation.
01
Rosacea & Facial Redness
Dermatology
Rosacea is the most common Vbeam indication and one of the most satisfying to treat. The persistent background facial erythema of erythematotelangiectatic rosacea — the flushing, diffuse redness, and visible capillary network across the nose and cheeks — is driven by the same abnormal vascularity that Vbeam targets at 595nm. The telangiectatic vessels of rosacea absorb the laser energy and undergo thermocoagulation, dramatically reducing both the baseline redness and the flushing response that makes rosacea socially limiting. Dr. Sierro typically uses extended pulse duration settings (6–10ms) for rosacea to achieve vascular coagulation without purpura, allowing patients to return to work the same or next day. Most rosacea patients see 50–80% reduction in baseline erythema after 3–4 sessions and require maintenance every 6–12 months.
02
Red & Hypertrophic Scars
scar treatment
Post-surgical, post-traumatic, and acne scars that remain persistently red, raised, and firm beyond 3 months of healing are actively maintained by the abnormal vascularity of the immature scar tissue. Vbeam at 595nm selectively destroys this pathological microvascular network, producing progressive reduction in scar erythema and simultaneously interrupting the vascular supply for ongoing collagen overproduction — resulting in scar softening and flattening in addition to the cosmetic color improvement. Dr. Karamanoukian initiates Vbeam as early as 4–6 weeks post-closure for all surgical patients and combines it with silicone tape, sun protection, and intralesional corticosteroid as clinically indicated. Most post-surgical red scars show 60–80% improvement in erythema after 3–5 sessions.
03
Keloid Scars
keloid inflammation
Keloids — scars that expand beyond the original wound boundary driven by an aberrant fibroblast overresponse — have a dense vascular component that Vbeam addresses as part of the multimodal keloid management protocol at Kare Plastic Surgery. Vbeam reduces the erythema and pruritus (itching) of active keloids, suppresses the vascular growth signals sustaining keloid expansion, and is most effectively combined with intralesional triamcinolone and 5-FU injections in the combined protocol that Dr. Karamanoukian has refined through two decades of keloid management experience. For keloid excision cases, Vbeam is incorporated into the post-excision protocol immediately after wound closure to prevent recurrence in the healing excision site.
04
Port Wine Stains & Vascular Birthmarks
congenital birthmarks
Port wine stains (capillary vascular malformations) are the historical foundation of pulsed dye laser therapy — the Vbeam was originally developed specifically to treat these lesions, which the laser addresses with greater efficacy than any other available technology. The ectatic vessels of port wine stains absorb the 595nm energy and are thermally coagulated, producing progressive lightening with each treatment session. Lighter, thinner port wine stains may achieve near-complete clearance in 6–10 sessions. Thicker, more deeply pigmented lesions require more sessions and may achieve meaningful but incomplete clearance. Early treatment in childhood produces consistently better outcomes than treatment of mature adult port wine stains, and Dr. Sierro is experienced in treating pediatric vascular birthmarks.
05
Cherry Angiomas & Spider Angiomas
common skin vascular spots
Cherry angiomas — the bright red, dome-shaped benign vascular lesions that develop with age on the trunk, face, and extremities — are among the most efficiently treated Vbeam indications, with most lesions clearing in 1–2 sessions. Spider angiomas (central feeding vessel with radiating peripheral capillaries, most commonly on the face and upper chest) similarly respond to Vbeam with high clearance rates after 1–3 sessions. Both lesions are superficial, thin-walled, and highly oxyhemoglobin-dense, making them ideal absorbers of the 595nm wavelength. The treatment is fast, minimally uncomfortable, and requires no recovery time for most patients.
06
Spider Veins & Facial Telangiectasias
santa monca vein center
Facial spider veins — the fine red, blue, or purple capillary networks across the nose, cheeks, and temples — are one of the most common cosmetic dermatology concerns in the Los Angeles population and respond excellently to Vbeam at 595nm. The laser is most effective for superficial facial telangiectasias up to 1mm in diameter; larger, deeper, or blue-toned vessels may require the addition of sclerotherapy or the Nd:YAG 1064nm laser available at Kare’s comprehensive laser center. Dr. Sierro assesses the specific vessel caliber, depth, and color to select the optimal parameter combination and recommend any adjunctive treatment at the initial consultation.
07
Stretch Marks (Striae Rubra)
post pregnancy and weight loss
Vbeam is most effective for stretch marks in their active, red-to-purple phase — striae rubra — when the pathological vascularity sustaining the inflammatory response within the stretch mark is still active and accessible to 595nm photothermolysis. Treating striae in the red phase produces significantly better outcomes than treating mature white striae (striae alba), where the vascularity has involuted and the primary remaining deficit is collagen architecture rather than active vascular inflammation. For complete stretch mark management, Vbeam for the vascular component is combined with Morpheus8 radiofrequency microneedling for collagen remodeling at Kare Plastic Surgery.
08
Poikiloderma of Civatte
sun damage
Poikiloderma of Civatte — the chronic photodamage condition of the lateral neck and upper chest producing a mottled pattern of telangiectasia, erythema, hyperpigmentation, and skin atrophy — is a common and cosmetically significant concern in the sun-exposed Los Angeles population. The vascular (red) component of poikiloderma responds well to Vbeam, while the pigmented (brown) component may require complementary treatment with IPL or fractional laser. Dr. Sierro develops a combined treatment protocol for poikiloderma that addresses all three components — erythema, pigmentation, and texture — in a sequenced treatment plan.
09
Warts (Verruca Vulgaris)
warts and molluscum
Vbeam destroys the microvascular supply feeding HPV-induced warts, producing wart clearance in recalcitrant lesions that have failed topical salicylic acid, cryotherapy, and other conventional treatments. The mechanism is direct photothermal destruction of the glomus vessels within the wart dermis combined with possible immune-activating effects. Vbeam for warts is most effective for palmoplantar (hand and foot) warts resistant to conventional management and for periungual warts (around the nail), where other destructive modalities may damage the nail matrix. 3–5 sessions at 2–4 week intervals typically produce 70–80% clearance rates in recalcitrant wart presentations.
The Treatment Experience
What to Expect: Vbeam Laser in Santa Monica
Consultation & Skin Assessment
Every Vbeam treatment at Kare Plastic Surgery begins with a physician consultation — not a patient coordinator or aesthetician. Dr. Sierro or Dr. Karamanoukian evaluates the specific skin condition, characterizes the vascular vs. pigmented components, assesses Fitzpatrick skin type, reviews medication history for photosensitizers and anticoagulants, and develops an individualized treatment plan specifying the pulse duration, fluence, spot size, and number of sessions anticipated. For patients with rosacea, concurrent oral or topical rosacea therapy may be recommended in parallel with the Vbeam series for optimal disease management.
Pre-Treatment Preparation
Sun exposure and self-tanning products are avoided for 4 weeks before treatment. Blood thinners and anti-inflammatory medications (aspirin, ibuprofen, fish oil) are discontinued for 7–10 days before treatment to minimize bruising (purpura) risk. Topical anesthetic cream is applied 45–60 minutes before the session for treatment of larger surface areas. Patients with a history of herpes simplex (cold sores) in the treatment area receive prophylactic antiviral medication beginning 1–2 days before treatment to prevent laser-triggered outbreak.
The Vbeam Treatment Session
Protective eye shields are placed. The Vbeam handpiece is moved systematically across the treatment area, delivering overlapping pulses with the Dynamic Cooling Device providing a burst of cryogen spray before each pulse. Each pulse feels like a brief snap or sting — most patients describe it as tolerable to mildly uncomfortable. A full-face rosacea treatment takes 15–20 minutes. Isolated lesion treatment (angiomas, warts, specific scars) takes 5–10 minutes. Immediately after treatment, the skin may appear pink to red with mild swelling that typically resolves within 24–48 hours. Purpura (bruising) from short-pulse settings resolves in 7–14 days.
Recovery & Post-Treatment Care
Most Vbeam patients have minimal to no social downtime when treated with non-purpuric (long pulse) settings. Makeup can be applied the following day. Sun protection (SPF 50+) is mandatory for 4–6 weeks after treatment to prevent post-inflammatory hyperpigmentation in the treated areas. Gentle skincare with non-irritating cleansers and moisturizers is recommended. For patients treated with purpuric settings (port wine stains, thick telangiectasias), bruising resolves within 7–14 days and can be covered with concealing makeup. The full result of each session is assessed at 4–6 weeks, which is also the earliest appropriate timing for the next treatment session.
Vbeam Parameter Guide by Condition
| Condition |
Pulse Duration |
Purpura? |
Sessions |
Interval |
| Rosacea / facial redness |
6–10ms (non-purpuric) |
No |
3–5 |
4 weeks |
| Hypertrophic / red scars |
6–40ms (non-purpuric) |
No |
3–6 |
4–6 weeks |
| Keloid scars |
6–10ms |
No |
4–8 |
4–6 weeks |
| Port wine stain |
0.45–1.5ms (purpuric) |
Yes — 7–14d |
6–15+ |
6–8 weeks |
| Cherry angioma |
0.45–3ms |
Mild |
1–2 |
4–6 weeks |
| Spider veins / telangiectasias |
3–6ms |
Minimal |
2–4 |
4 weeks |
| Stretch marks (striae rubra) |
6–10ms |
No |
3–5 |
4–6 weeks |
| Warts |
0.45–1.5ms (purpuric) |
Yes — 7–14d |
3–5 |
2–4 weeks |
Common Questions
Frequently Asked Questions: Vbeam Laser in Los Angeles
Where can I get Vbeam laser treatment in Los Angeles and Santa Monica?
Kare Plastic Surgery and Skin Health Center at 804 7th Street in Santa Monica near Montana Avenue offers Vbeam laser treatment performed by board-certified dermatologist Dr. Tiffany Sierro and board-certified plastic surgeon Dr. Raffy Karamanoukian. We serve patients from Santa Monica, Beverly Hills, Brentwood, Pacific Palisades, Malibu, West Hollywood, and all of Los Angeles. Call (310) 998-5533 for a consultation.
Does Vbeam laser hurt?
Vbeam with the Dynamic Cooling Device is well-tolerated by most patients without topical anesthesia for small or isolated treatment areas. Larger surface areas — full-face rosacea treatment, extensive scar treatment — benefit from topical anesthetic cream applied 45–60 minutes before the session. Each pulse feels like a brief rubber band snap followed by a cold spray. Most patients describe it as mildly uncomfortable rather than painful. The discomfort lasts only milliseconds per pulse and is significantly reduced by the DCD cryogen cooling.
How is Vbeam different from IPL (intense pulsed light)?
Vbeam is a laser — a single-wavelength coherent light source at precisely 595nm. IPL (intense pulsed light) is a broadband light source emitting across a spectrum of wavelengths (typically 515–1200nm) filtered to target specific chromophores. Vbeam’s single-wavelength specificity allows more precise targeting of oxyhemoglobin at the optimal absorption peak, producing more complete vascular destruction with less epidermal heating than broadband IPL. For purely vascular indications — rosacea, angiomas, hypertrophic scars, port wine stains — Vbeam is consistently more effective than IPL in peer-reviewed clinical studies. IPL has advantages for mixed pigmented and vascular conditions (such as poikiloderma) where the broadband spectrum addresses both components simultaneously.
Can Vbeam be combined with other treatments?
At Kare Plastic Surgery, combination treatments are the standard rather than the exception. Vbeam for rosacea is combined with topical or oral rosacea management by Dr. Sierro. Vbeam for hypertrophic scars is combined with intralesional corticosteroid, 5-FU, and silicone therapy by Dr. Karamanoukian. Vbeam for stretch marks is combined with Morpheus8 RF microneedling for collagen remodeling. Vbeam for poikiloderma is combined with IPL or fractional CO2 for the pigmented and textural components. The Kare advantage is that this combination planning is performed by two specialists who can each contribute their expertise to the treatment protocol.
Find Us in Santa Monica
Kare Plastic Surgery: Vbeam Laser
Montana Avenue, Santa Monica
Kare Plastic Surgery & Skin Health Center is located at 804 7th Street in Santa Monica on Montana Avenue — Los Angeles’ most comprehensive laser and surgery center, with over 30 laser systems and a dual physician team of a board-certified dermatologist and a board-certified plastic surgeon. We serve patients from Santa Monica, Beverly Hills, Brentwood, Pacific Palisades, Malibu, West Hollywood, Westwood, and throughout Los Angeles.
Practice Information
- Address: 804 7th Street, Santa Monica, CA 90403
- Phone: (310) 998-5533
- Hours: Monday–Friday 9:00am–5:00pm
- Neighborhood: Near Montana Avenue, Santa Monica
- Vbeam Provider: Dr. Sierro (derm) + Dr. Karamanoukian (plastic surgery)
- Laser Systems: 30+ at our 5,000 sq ft facility
- Zip Codes: 90402 · 90403 · 90404 · 90405
Communities Served
- Santa Monica (all neighborhoods) — 90402, 90403
- Brentwood — 90049
- Pacific Palisades — 90272
- Malibu — 90265
- Beverly Hills — 90210
- West Hollywood · Culver City · Mar Vista
- Westwood · West Los Angeles — 90025
- Los Angeles — all Westside communities
Kare Plastic Surgery & Skin Health Center · Santa Monica · Los Angeles
Schedule a Vbeam Consultation
Schedule a consultation with Dr. Tiffany Sierro, board-certified dermatologist, or Dr. Raffy Karamanoukian, graduate of the UCLA School of Medicine and double board-certified plastic surgeon — Los Angeles’ only dual-physician Vbeam team for rosacea, scars, keloids, and vascular skin conditions near Montana Avenue in Santa Monica.