Microcoring Technology: Our Experience
Dermal microcoring technology is a minimally invasive, nonenergy-based approach to skin rejuvenation. The basis of the technology involves the fractional removal of full-thickness skin cores to tighten skin and improve skin quality. The goal of this study is to describe our technique and share our experience with treating 205 patients over the past two years using a dermal microcoring device.
Methods/Technique:
The technique used in the treatment of 205 patients with Ellacor (Cytrellis Biosystems, Inc.) between 7/2023 – 9/2024 at a single plastic surgery practice was reviewed. Most patients treated were female (194, 94%), with an average age of 56.5. All Fitzpatrick skin types (I-IV) were represented, with the majority (86%) being Fitzpatrick II-III. The number of treatments ranged from 1-4, though most patients underwent two treatments (95%). The areas treated included the face and neck (83%), abdomen (7%), lower extremities (7%), and upper extremities (2%). The skin removal percentage and core depth used varied depending on the location of treatment and operator judgement, but remained within manufacturer guidelines and recommendations, where applicable.
In our practice, dermal microcoring has been used to treat skin laxity in a variety of scenarios. The most common and ideal patients treated with microcoring were those with mild to moderate skin laxity of the lower face and neck. Another common patient population seen were those with more severe lower face and neck skin laxity. These were patients who could be considered for surgical management but desired less invasive treatment.
Microcoring was also utilized for the treatment of recurrent mild to moderate skin ptosis after surgical treatment, most frequently following face and neck lift. Less common scenarios included patients with mild recurrent laxity following body contouring procedures, such as abdominoplasty, brachioplasty, or thighplasty.
Lastly, microcoring was frequently used to treat skin laxity in areas difficult to address by surgical means, such as perioral during face and neck lift.
Pre-treatment:
We ask that patients avoid sun exposure for 2 weeks leading up to their procedure. From our experience with using lasers and post-inflammatory hyperpigmentation, we also provide patients with hydroquinone. We have them start this 2 weeks before microcoring and continue it for 2 weeks post-treatment. Lastly, to help condition the skin, all patients are started on tretinoin prior to treatment, if possible.
Post-treatment:
Our post-treatment regimen continues to evolve, and various therapies have been used over the study period. Immediately following treatment, the area is cleaned thoroughly, and a petroleum-based ointment is applied. Once at home, we advise the patients to cleanse the treated area three times daily with a gentle soap. In our experience, SkinCeuticals Epidermal Repair has been the most effective post-care therapy at reducing post-treatment erythema. Patients are advised to apply this to the treated areas after each cleansing for 7 days post-treatment. Oral antibiotics and antivirals (if indicated) are prescribed.
Results/Complications:
Our practice has found dermal microcoring technology to be a safe and effective tool at treating skin laxity, with improvements in both the appearance of wrinkles and skin quality and texture. Overall, patient satisfaction is high, and the treatment is well-tolerated with little downtime.
Persistent redness lasting 4-6 weeks in the treated areas of patients with lower Fitzpatrick skin types (I-III) was the most common complication identified. We have found pulsed dye laser (PDL) therapy to be an effective treatment for this. Initially, post-treatment redness was only treated if present at 1 month follow up. Since then, we have adopted a more aggressive approach and will treat post-microcoring redness with PDL at the 1 week follow up. PDL treatment is repeated every 1-2 weeks until redness is resolved. Most patients only required 1-2 laser treatments. Anecdotally, we have also found the addition of TXA in our tumescent solution to decrease the incidence of post-treatment persistent redness.
In the 16 patients with Fitzpatrick skin types IV-VI, there were no cases of dyspigmentation or abnormal scarring. There were no cases of post-inflammatory hyperpigmentation. In one patient, there was an infection at the treatment site, which was likely related to patient factors.
Conclusion:
Dermal microcoring is safe and well-tolerated treatment for skin laxity, with good patient satisfaction and results. Persistent redness in the treated areas of patients with lower Fitzpatrick skin types was the most common complication identified. This was treated with good effect using PDL therapy.