What are the possible side effects after Infini RF micro needling treatment with high fluence and long time exposure settings.

Thanks for your question. There can be side effects associated with any type of procedure. If performed correctly, there should be no side effects with the Infini. Some people may experience redness, bruising, and perhaps hyperpigmentation. 

Dr. Weiner is an expert in infini.  Like he said, with someone who has experience, this device causes very few complications.  However, with any energy based device on the skin you can get scarring, pigmentation changes, and no results.  You should be prepared for any cosmetic treatment to have a series of treatments to get best improvement.  Only go to an expert.  Dr. Emer.

This is a very thoughtful question. However the answer is counterintuitive. When the infini is used at very high fluence, studies have shown the zone of volume ization is actually smaller than when it is used at a lower fluence. The reason for this is that there is excessive coagulation around the tip and the radiofrequency energy does not have the ability to fan out. The most aggressive treatments are done at lower energy  (4) and longer pulse duration. It is important to treat at a deep level when using aggressive settings. I personally have not seen any fat atrophy. Hope this helps. Take care.

We’ve seen very nice results from
microneedling for acne scars.
In my practice, we use the SkinPen™ for microneedling, and the final outcome
for acne scars can be very impressive. One of the benefits of microneedling in
general is the minimal risk of side effects, particularly if you visit a board
certified plastic surgeon who is well-versed in the technique. However, since
the procedure does involve creating controlled micro-injuries to promote the
skin’s natural healing response, it’s common to notice redness and swelling
after a session. Some people may experience a mild acne flare-up, or tiny white
bumps under the skin called milia. Any of these concerns should dissipate
rapidly.

As Dr Rapaport explained, the high energies cause the tissue around the needles to dessicate around the needle and prevents further spread of the heat. So, actually the low energy, long pulse durations turn out to give the largest coagulation zones, more aggressive treatments. There is no harm in doing this and I have played with all the different settings to try to come up with the best ones. This very phenomenon actually contributes to the safety of the device, acting as a "safety valve" so to speak.