The ellacor® System with Micro-Coring™ technology is indicated for use by medical professionals for the treatment of moderate and severe wrinkles in the mid and lower face in adults aged 22 years or older with Fitzpatrick skin types I-IV.
I am Marla Klein MD, a board-certified dermatologist. I have been chosen to be among the FIRST 50 physicians (anywhere) with the privilege to use the new Ellacor technology.
I'm so excited about this upcoming procedure. Let me share with you some of the things I have learned over the years as a MD and dermatologist, which will all come together in this advancement in dermatology.
My skin journey started in 1985 when I was critically burned in a boat explosion off the coast of Catalina island. With 60% of my body 2nd degree burned, I was (pleasantly) surprised to learn that (with excellent wound care) the skin can actually regenerate itself. When it was time to be discharged from the hospital, the surgeon warned me, "Be careful about the sun, because burn victims have an increased risk of SCC due to the thermal injury." #1 : Thermal Energy is BAD for the skin.
I decided to become a dermatologist, and during residency I was taught during procedures to minimize the amount of heat we used during cautery, because thermal injury of the skin can lead to scars. Again, heat/thermal energy is bad for skin.
This is the reason I do not recommend RF (radiofrequency) treatments to my patients, because it creates thermal energy "to tighten the skin" which denatures proteins. The RF salespeople say that like it is a good thing, but it is not. I have seen patients with weird over-cooked skin from RF done in other offices. I don't know how to reverse that sort of damage to the skin. In addition, the "tightening" effect of these treatments if very short.
#2 Fractionated lasers were an improvement over ablative lasers in terms of safety. The original CO2 ablative lasers did miraculous work at removing the appearance of sun damage on the surface of the skin, but sometimes led to unacceptable scarring. The fractional lasers helped to stimulate collagen, but did not actually remove much skin, because they only create very shallow tiny holes in the skin, never full thickness.
#3 Hyper-diluted lidocaine local anesthetic solution is a good thing. I performed tumescent liposuction and facial fat grafting for several years. I only stopped because I feel Sculptra is better. In that process, I learned about diluting lidocaine to safely anesthetize large surface areas, thus making it safer for the patient.
#4 Sculptra is a wonderful collagen stimulating agent, but it doesn't work on everyone. About 85% patients are satisfied with Sculptra, and the others are "non-responders".
#5 Microneedling is a good thing, but again because it requires the patient's body to respond to the treatment to create new collagen, it only works on about 85% of people.
CoolSculpting uses cold temperature to target and kill fat cells without hurting the overlying skin. However, the body must get rid of those dead fat cells afterwards. In doing so, that healing process creates inflammation, which translates to redness, tenderness and swelling. Liposuction mechanically removes the fat, so afterwards there is very little pain from inflammation. #6 Leaving dead tissue behind is uncomfortable for the patient.
As a dermatologist, I have performed thousands of punch biopsies. I noticed that the very small punch biopsies (1.5 mm) were not leaving scars behind. #7 Tiny punch biopsies don't scar.
MODERN DAY CONUNDRUM: We really need a way to remove excess skin without leaving a scar behind, if we hope to lift the lower face without resorting to a full face lift. Because as we know, facelifts can have serious complications and leave long scars behind, not to mention the expense.
Now in 2022, from the genius mind of dermatologist Rox Anderson at Harvard in partnership with Harvard's Plastic Surgery Department comes MICRO-CORING TECHNOLOGY, with the ELLACOR machine. This is a full thickness removal of skin in small 0.5 mm punches, in the realm of 20,000 of them, to reduce the quantity of the skin by 5-8% each treatment. After the machine causes the small punches or cores, there is a vacuum action to remove the skin cores. The skin collapses on itself in 1-3 minutes and does not require any sutures. In fact, the patients have similar downtime to our microneedling procedure, just a few days.
Because Ellacor is mechanically removing the skin, there is no way there won't be some kind of improvement, and because it is like microneedling (with bigger full-thickness needles) we should see an additional synergistic effect take place in the following 3 months after the procedure in 85% of the patients. It will come down to a decision of whether a 5-8% skin reduction will be worth $2500-$3000 to the patient.
I cannot wait to start using this ellacor tool. It is already FDA-approved for lower face, but I can already envision how much it will help stretch marks, acne scars, and help left the neck and possibly other body areas like around the knees and elbows.
My machine should arrive sometime in Quarter 4 of 2022. I will be the only one in Oregon to have Ellacor for about one year. I will be working with the company to create optimal patient outcomes. This will be a treatment that should only be performed by someone who has been residency trained in facial surgical procedures, such as a dermatologist or plastic surgeon.
We have started a waiting list for this procedure.