PracticalDermatology

What is it? Also known as fractional tissue extraction or micro-exisional skin removal, dermal micro-coring involves making tiny punches in the skin using an energy-free, small-gauge needling device (Cytrellis*). Similar to those achieved with punch biopsies, each micro-core is less than half a millimeter in diameter; they are placed in a fractional pattern across the mid- and lower face, scarlessly removing up to eight percent of the total surface area to shrink and tighten the skin and stimulate collagenesis and elastogenesis. You can see the cores close through optical coherence tomography before patients leave the office.

The procedure leaves bridges of normal skin between the micro-cores, allowing for skin contraction and a lifting effect. Unlike a surgical facelift, micro-coring does not affect the muscles or fascia of the face. Treatment areas to date include the upper and lower cheeks, perioral areas, and the submentum.

What do the studies show? We have seen high overall subject improvement and satisfaction. The results are natural and reflect the underlying anatomy. Specifically, combined data from two studies of 30 patients who had 60 areas treated and were followed to 90 or 180 days showed that subjects experienced an average 1.1-grade improvement on the Lemperle Rating Scale and an 80 percent improvement in moderate or severe wrinkles. In addition, 91 percent of investigators rated treatment areas as “improved” or “very much improved” on the Global Aesthetic Improvement Scale, and 88 percent of subjects were “satisfied” or “extremely satisfied” with the results. These findings were presented at the 2019 annual meeting of the American Society for Dermatologic Surgery (ASDS) in Chicago.

Who can benefit from dermal micro-coring? This treatment works well for severely lax patients and younger patients who want to stave off a future face lift.

How long does it take? The dermal micro-coring procedure takes about 20-25 minutes to treat the face and submentum.

Is it painful? Some patients may require 2% lidocaine with epinephrine 10-12cc total injections. Most patients report about three days of downtime. Patients should be instructed to use petrolatum occlusive for 24-48 hours after the procedure. Patients heal without evidence of scarring since the needles are so small. There have also been virtually no adverse effects.

The bottom line. Clinical data establishes this novel dermal micro-coring device as an effective treatment of moderate-to-severe facial wrinkles. Excellent results can be achieved without the use of thermal energy. The new technique offers the ability to remove a significant amount of damaged skin without adverse events, such as scarring. Moreover, treatment demonstrates consistent and significant wrinkle improvement in a large population of treatments.

*The Cytrellis device is an investigational product limited by federal law to investigational use. It has not been cleared for marketing by the FDA.

Based on a presentation from Cosmetic Surgery Forum (CSF) 2019. Visit CosmeticSurgeryForum.com for information about the 2021 meeting and updates on virtual events coming soon.