Patrick W. Blake, MD

I understand your concern here. Fractora does wonders for skin rejuvenation but is it worth it? In my mind, yes. I always offer patients a pain pill before the procedure as well as nerve blocks (especially around the lips). Typically though, application of strong topical numbing cream for 40-45 minutes is adequate for pain control. If you're too uncomfortable, we work with you to make it an easy procedure. 

Full disclosure here - I own a Fractora and not an Infini. Fractora does have more hand piece options which may make it easier for your doctor to customize the treatment for your skin. I agree with Dr. Novick that microneedling is great on thin, crepey skin. The radiofrequency side of it doesn't add a ton for superficial lines but does really well with deeper lines. Adding in a dermal filler would likely help a lot. Hope that helps!

I agree with Dr. Baird that it's well-worth it for you to get an in-person consultation. All of the technologies that you mention are great, but dermal fillers would be a better choice for you. Even a small amount of Belotero would help with the tear trough and in so doing the shadowing under the eyes will improve. For the color change, I'd start with a sunscreen, retinoid, and hydroquinone product. After that, an IPL might be a nice option.

I'm sorry to hear that you're dealing with hyperpigmentation, and hope that is has since resolved. I can't help but wonder what tips were used during your procedure. Using the deep, coated Fractora tips, I've never encountered hyperpigmentation. If the smaller, superficial tips were used, it is a known risk. Getting rid of hyperpigmentation is a slow process but it will continue to improve.

I'm guessing by now your edema has resolved? Typically it clears within a few days to a week. It is a common side effect, but usually not too bothersome.