Question 1

What is Ellacor micro-coring?

Accepted Answer

Ellacor is a nonsurgical skin rejuvenation treatment that leverages a pioneering technique called micro-coring to smooth wrinkles and tighten skin.

This novel treatment, also called fractional tissue extraction or microexcisional skin removal, uses hollow needles to precisely remove between 6,000 and 12,000 tiny “micro-cores” of excess skin, without thermal energy or plastic surgery.

These tiny cores extend through the full thickness of the skin, but they’re so minuscule (less than half a millimeter in diameter) that they're intended to not leave a scar, as Rosemont, Illinois, plastic surgeon Dr. Stefan Mark Szczerba explains. “I tell anyone interested in Ellacor to think about when you get your blood drawn. That hollow needle does not leave a scar. This is the same size needle—just attached to suction! The goal is to remove the little core of skin, without leaving a scar.”

As much as 8% of the skin’s volume can be removed in a single session, and a series of treatments can create more significant skin tightening and smoothing benefits than many nonsurgical treatment options.

“When the Ellacor treatment is repeated a few times, the removed surface area can approximate what is removed with a mini facelift,” says Dr. Szczerba. “This impressive amount of skin tightening that happens with micro-coring has a significant change to the wrinkles of the skin, all without scars from incisions.”

Ellacor is FDA-cleared to treat both moderate and severe wrinkles in the mid- to lower face. According to Dr. Jason Pozner, a plastic surgeon in Boca Raton, Florida, who was involved in Ellacor clinical trials, treatment areas commonly include the cheeks, around the mouth, and under the chin. Some doctors are also using it “off label” on areas like above the knees and on the décolletage.

The minimally invasive procedure typically takes less than 30 minutes and requires only a few days of downtime.

RealSelf Tip: Micro-coring doesn’t tighten the underlying muscles or fascia and isn’t FDA approved for skin tightening, so like all nonsurgical treatments, results don’t match those of a traditional surgical facelift.

Question 2

What are the pros and cons of Ellacor treatment?

Accepted Answer

Pros

Micro-coring treatments can reduce the appearance of wrinkles and tighten mild to moderately sagging skin.
Clinical study results, presented at the 2019 annual meeting of the American Society for Dermatologic Surgery, showed a 90% improvement in moderate or severe wrinkles within six months of up to three treatments, while 86% of the patients reported being “satisfied” or “extremely satisfied” with their results.
The treatment is quick: it takes about 30 minutes to treat your face and under your chin.
It only requires local anesthesia.
Because it doesn’t involve lifting or pulling back the skin (like a surgical facelift does), the chance of having an unnatural-looking result is extremely low: your body’s own healing response does the work.
Ellacor can remove as much skin as some surgical procedures, according to Boston-based plastic surgeon Dr. William Austen, whose research contributed to the development of Ellacor.
Ellacor can treat areas of the face that a surgical facelift cannot reach, without distorting the face, says Dr. Szczerba. “Prime examples of these difficult to treat areas include the upper lip, ‘accordion lines,’ and areas around the mouth and chin.”
“Recovery is much faster than after a laser peel taken to the depth that Ellacor goes to,” Dr. Szczerba notes.

Cons

Downtime can range from several days to weeks, depending on your treatment intensity and how well you heal. You'll need to ask your provider for their best estimate during your initial consultation, so you can take enough time off for the initial healing phase.
For best results, two to three Ellacor treatment sessions are usually recommended.
The Ellacor system is FDA-cleared only for Fitzpatrick skin types I-IV (fair to light brown skin tones); it has not yet been clinically evaluated for skin types V and VI.
Though some improvement can be seen after a few weeks, it can take several months for new collagen to develop so you can see your final result.
While it’s being touted as a facelift alternative, results aren’t as dramatic as what you’d see from a surgical facelift. Most people with a significant amount of excess, sagging skin will be better candidates for facelift surgery.
The treatment is relatively new, so it may not yet be available outside of major metro areas.
Like most cosmetic procedures, results can be very provider-dependent. Seek out an experienced provider (ideally a board-certified plastic or dermatologic surgeon) with a strong track record of glowing patient reviews and photos.

Related: Doctors Debate the Case for and Against Ellacor

Question 3

How much does Ellacor cost?

Accepted Answer

The price you pay will depend on the number of treatments you have (two to three are recommended, in most cases), your provider's practice location, their level of experience, and whether you have complementary procedures.

Dr. Szczerba often combines Ellacor with BroadBand Light treatments or a light laser peel, to speed up recovery and enhance results. “These treatments can be an additional cost or can be worked into your original price,” he notes.

Question 4

Who’s a good candidate for Ellacor treatment?

Accepted Answer

Ellacor is FDA cleared for the treatment of moderate to severe wrinkles in adults who are 22 or older, with Fitzpatrick skin types I-IV.

The treatment can also tighten mild to moderately sagging skin. “Ellacor provides a nonsurgical solution for patients who aren’t yet ready for surgery,” writes NYC dermatologic surgeon Dr. Roy Geronemus, in an article in Practical Dermatology. “I would typically recommend this to someone looking for that next level of results who is in their mid-40s to 60s.” He reports that his patients “have seen a very natural-looking reduction in facial wrinkles, without any scarring.”

Miami dermatologic surgeon Dr. Jill Waibel, who wrote about micro-coring in a 2020 article, says that Ellacor works well both for people with lax skin and as a maintenance treatment for “younger patients who want to stave off a future facelift.”

Your provider will determine if you’re a good candidate for Ellacor, based on your goals, skin tone, and the severity of your skin laxity.

Ellacor shouldn’t be performed on people who:

Have had dermal fillers in the treatment area during the previous six months.
Are pregnant or nursing.
Take high doses of blood thinners or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil), aspirin, and naproxen (Aleve), for 14 days prior to having the procedure.
Have a history of keloids, collagen disorders, hyperpigmentation, bleeding disorders, anesthesia allergies, or autoimmune conditions that may affect the treatment outcome.

It’s also not recommended for people who have skin cancer, birthmarks, open wounds or sores, or facial implants in the treatment area.

Question 5

What happens during an Ellacor treatment?

Accepted Answer

Here’s what to expect.

Your provider will start by injecting local anesthesia into the treatment area or applying a strong topical numbing cream, to minimize discomfort. “Tumescent fluid (a dilute epinephrine and local anesthetic solution) can also be used for tougher areas,” says Dr. Szczerba.
Once you’re numb, your provider will move a mechanical handpiece methodically across the treatment area, creating the micro-cores in a grid-like pattern (similar to a microneedling procedure).
Each of the three hollow needles in the device is extremely thin—about .02 inches in diameter—and the needles move rapidly, to treat a 10mm x 10mm square area in less than 3 seconds.
When a core is made, a vacuum system in the device provides suction that immediately removes the micro-cores of skin from the needles.
Your provider can specify the percentage of skin removed, up to 8% of the total surface area of skin.
Pinpoint bleeding is common immediately afterward, but it should stop once some pressure is applied with a damp, sterile cloth.
Like a fractional laser treatment, “The procedure leaves bridges of normal skin between the micro-cores, allowing for skin contraction and a lifting effect,” Dr. Waibel explains.
The remaining skin also helps the micro-cores heal more quickly. They begin closing before patients even leave the office, according to Dr. Waibel—so no stitches or bandages are required.
Results should continue to improve over the coming months, as new collagen develops.

Question 6

How long does recovery take?

Accepted Answer

The makers of Ellacor say that "Recovery time ranges from several days to weeks, which can vary by patient and treatment settings." Your provider should be able to give you their best estimate during your consultation, when you discuss the details of your treatment plan. Everyone heals differently, so you may find that you recover more quickly or that it takes longer than you both expect.

The healing process is very important to a good result, so follow your provider’s instructions carefully.

You’ll be asked to use an occlusive dressing, such as petroleum jelly, on the treated area for 24–48 hours after the procedure.
You’ll also be advised to steer clear of makeup (which can carry bacteria and increase your risk of infection) until the holes have completely closed up—usually about a week.
During this first week, use a gentle cleanser and avoid skin care products with irritating active ingredients, such as retinol or acids.
Avoid sun exposure during the initial week of recovery.
To “speed up any minor bruising in the early phase after the treatment,” Dr. Szczerba recommends a BroadBand Light (BBL) photofacial. “A light laser peel or BBL can also help address redness in the later phases of recovery.
After your skin has healed, wearing a broad-spectrum sunscreen with 30+ SPF when you're in the sun will help prolong your results.

Question 7

How soon will you see results after an Ellacor treatment?

Accepted Answer

Improvement can be seen within a few weeks of your first treatment, according to Dr. Pozner.

Most patients need 2 to 3 treatment sessions for optimal results, and it takes 3 to 6 months from your final treatment for full results to develop.

Question 8

How long do Ellacor results last?

Accepted Answer

How long do Ellacor results last?

Ellacor results are long-lasting, but because skin aging continues, you’ll need occasional follow-up sessions to maintain them. How soon you’ll need a maintenance treatment will depend on your age, skin quality, and lifestyle factors like your skincare routine, how well you stay out of the sun, and whether you smoke.

Following an effective skincare regimen—including daily use of sunscreen with an SPF 30+—will help to prolong the benefits.

Question 9

Is Ellacor safe?

Accepted Answer

Ellacor treatment is considered safe when it’s performed by an experienced provider, on patients with fair to light brown skin tones.

However, your provider should be transparent with you about potential side effects. Cytrellis (the manufacturer) says that side effects may include:

some pain or discomfort during treatment
swelling
bruising
numbness
tightness
dryness
roughness
peeling
circular marks on the skin from the needles

All of these potential side effects should resolve on their own over time.

Like RF microneedling or laser treatments, Ellacor can trigger post-inflammatory hypo- or hyperpigmentation, which may or may not resolve on its own.

Also note that while this procedure is touted as a scarless alternative to surgery, scarring is possible, especially on patients with brown or deeply pigmented skin, or a history of hyperpigmentation or keloid scars. Recent exposure to sun or tanning beds can also increase your chances of scarring or pigmentation problems.

More rare side effects include:

persistent itching
infection (so be especially diligent about keeping your skin clean as you heal)
skin irregularities
tissue death
an uneven appearance.

Again, seek out a skilled, experienced provider who will know how to mitigate these risks or treat any side effects that do arise.

Question 10

Sources & studies

Accepted Answer

Geronemus, Roy. “New in My Practice: Device.” Practical Dermatology. September 2021.

Waibel, Jill, et al. “Dermal Micro-Coring 101.” Practical Dermatology. October 2020.

ELLACOR

Dr. Stefan Mark Szczerba

Karyn Repinski

Dr. Stefan Mark Szczerba

Karyn Repinski

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Dr. Stefan Mark Szczerba

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ELLACOR QUESTIONS

Loose skin and wrinkles around mouth - Am I am good candidate for Ellacor or facelift? (Photos)

Will this procedure actually address the gathering of skin by the corners of my lips? (Photos)

57 year old female with very pale skin. Collagen stimulation not working for me - what are other options?

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