Derms Debate: Is Micro-Coring the Next Big Innovation in Skin Tightening?


A first-of-its-kind nonsurgical treatment called Micro-Coring could potentially change the skin-tightening game. However, as with any new device touting revolutionary claims, and because very few doctors have even gotten their hands on it, there will be skepticism. These are the pros and cons based on industry learnings so far.

PROS

01 It tightens skin without surgery.

FDA-approved and minimally invasive, Micro-Coring is a device that uses tiny hollow needles to remove skin on the cheeks, along the jawline and under the chin, thereby producing a tightening effect and reducing moderateto- severe wrinkles. “It manually extracts between 10,000 and 12,000 tiny little micro-cores of skin, removing 4 to 8 percent of skin in the treatment area,” Nanuet, NY dermatologist Heidi Waldorf, MD explains. “The reduction in skin surface area combined with the contraction and production of collagen while healing, results in smoother, tighter skin. It has the potential to add a new and novel technique to our nonsurgical antiaging armamentarium.”

02 It purportedly doesn’t cause scarring.

According to doctors who have used the device, there’s no perceptible scarring involved. Boston dermatologist Mathew Avram, MD says, “The reason for that is because the tissue removals are small enough—less than 500 micrometers in width—that they don’t create scars. If you look under a microscope on a histology slide, you won’t see a scar, and you certainly won’t see one looking at a patient.”

03 Downtime is minimal.

“The studies that have been done show great results with minimal downtime,” says New York dermatologist Julie Russak, MD. “Healing takes about three to four days, which is faster than the downtime associated with many energy-based procedures, like ablative lasers. It’s a nice option for patients who still have good collagen production, but have skin laxity that is not amenable to other skin-tightening devices or fillers, or they’re not ready for a facelift.”

CONS

01 It doesn’t tighten skin like a facelift.

Though it’s been dubbed a “facelift alternative,” La Jolla, CA plastic surgeon Robert Singer, MD stresses that the two procedures are not interchangeable. “Micro-Coring does not manipulate the facial musculature like surgery does and can produce only minimal tightening. Contemporary facelifts aren’t just about pulling skin tighter; they’re about repositioning and shaping tissue and fat to make the face look more youthful and natural.” Eugene, OR plastic surgeon Mark Jewell, MD agrees: “Micro- Coring only addresses skin laxness and not the supporting SMAS layer that supports the skin, which can be tightened with surgery or Ultherapy at a certain depth. At this time, more studies and scientific evidence of Micro-Coring’s efficacy are needed.”

02 Its effects on darker skin tones are undetermined.

“Unfortunately the clinical studies were only done on Fitzpatrick Types 1–4 [lighter skin tones], so it remains unclear as to whether or not it is safe for darker skin,” explains Dr. Avram. “However, given the fact that there isn’t a lot of energy or heat being used with this treatment, it’s reasonable to expect that there won’t be a great difference in the degree of hyperpigmentation or complications, but until patients are treated, we can’t be definitive.” Longterm studies are also needed, adds Dr. Singer. “Any time you make an incision and there is trauma to the skin, there is an alteration of the collagen and elastin that could lead to scarring.”

03 The results are not instant, and more than one treatment may be necessary.

According to Dr. Avram, one treatment can be more than sufficient for significant improvement in patients with mild skin laxity; those with moderateto- severe laxity may need several. “It takes three months to see the full benefits of the treatment, and if you’re doing a series, I’d wait at least six weeks in between.”