ALMI FAT/ NANO FAT with dermapen for texture. Will that break up fibrosis?

I have been doing fat and stem call micro needling and injections for years this isnt new.  price is dependent on expertise, skill and the type of processing with PRP, stem cells etc or not.
For facial rejuvenation I would suggest a combination approach of :

1) skin care with products and PRP/microneedling
2) PDT light therapy few times a month with growth factors
3) laser treatments like clear and brilliant regularly and a few times a year Fraxel, Viva, Co2/Erbium
4) Sculptra injections a few times a year for collagen production with fillers like juvederm/restylane/belotero/radiesse/bellafill
5) thermage/ultherapy for yearly skin tightening with or without PDO or cone based instalift threads for lifting
6) botox every 2-3 months to stop movement lines and prevent lines at restBest, Dr. Emer.

Yes this procedure with stems has been around for the past decade. Dermapen from the surface down is a NOVEL method for implanting stems back into the dermal layer. The amount of viable stems for differentiation into FB fibroblasts and adipocytes will be minimal compared to say modified dermal grafting / implantation and fat transfer. If you are set on the 'idea' of Dermapen and external fat needling, sure, you can go for the procedure. Having said that, fibrosis is best broken down with horizontal blunt and controlled trauma- subcision. Diluted Sculptra can or should be considered if you have significant atrophy, or traditional fat transfer. Microneedling has come a long way over the past few years and can help skin via several methods. Firstly it releases cytokines and growth factors in the epidermis and dermis- the top and bottom layers of your skin. This in turn remodels scars and the dermal layer of the skin. Additionally needles can break up scars themselves. This leads to new collagen formation, and in practice can provide limited skin rejuvenation. 



Microneedling is both user dependent and method driven. Simple needles can be used, growth factors can be added after the procedure, including PRP, or controlled heating during the procedure. This controlled heating is delivered via RF, and is called RF microneedling. RF can then be delivered via insulated or insulated needles. Even the energy level, depths, density, pulse duration and so many other variables can be controlled. This together with the added benefits of growth factor infusion makes this one of the most complex procedures in procedural dermatology. I use everything from Dermapen, though to newer generation insulated and non-insulated devices including INFINI micro-needling radiofrequency, Intensif and others. Newer generation devices can provide an added advantage in some, but not all patients. In my practice, I combine microneedling with many different forms of energy devices, depending on the expectations of the patient. Tailored microneedling combination will always give the best results. 



Like most procedures, its 80% skill level of the specialist and 20% dependent on the brand of the energy device- microneedling system. All the best, Dr Davin Lim. Brisbane. Australia. Realself Advisory Board Member