Whats the real difference between Infini RF, Fractora and the new Vivace? So many options, which is the most effective?

Question

Some doctors have told me vivace needs 3-5 sessions, and infini Rf 1-2.. but then I hear Fractora is more effective! Which is best for a 33 year old with enlarged pores and general minor loss of volume?

Nelson Lee Novick, MD · Answer

The very fact that you wish to know which device is better for enlarged pores, rather than what treatment is best, demonstrates the enormous power of marketing hype to influence the way we think. The fact is that unfortunately the machines you mentioned are far more supported by device manufacturer backed marketing hype than hard science. Microneedling, on the other hand, is a relatively inexpensive, tried and true method that has proven helpful in reducing enlarged pores. Likewise, TCA CROSS, another simple, quick and relatively inexpensive and tried and true approach has been used to treat dilated pores. To learn more about these techniques, you may check out the archives or RealSelf.com. You would do well to seek consultation and treatment by a board certified aesthetic physician and avoid medspas and others hawking this or that supposedly "next big thing, " relatively expensive bells and whistles devices. Best of luck.

Jason Pozner, MD · Answer

1  - Post some photos2  - The RF Microneedle devices like Infini, Fractora, Genius, Vivace, Morpheus etc etc all work in a similar fashion. Differences are insulated vs non-insulated, size of needles and settings among other things - best to find an experienced doc rather then worry about devices and settings3 -  For pores - Sciton Halo is probably the best technology to date4 - none of these technologies help with volume

Davin Lim, MBBS, FACD - Account Suspended · Answer

Like Dr Novick has implied, treat the condition with a method. How effective a treatment is depend on WHAT we are treating and most importantly the skill sets of your doctor. For pores, it depends on the size and your skin type. TCA for large deep pores, lasers and or RF for other sizes. Volume loss? Fillers. Why? Predictable. You should not correct volume loss with RF. In some cases deep RF with pulse stacking can make volume loss worse. Why? Energy delivered into the fat layer. 
Acne scar revision comprises of many specialised procedures. For the best results, one should target the acne scar type with appropriate treatments METHODS. Using one or two devices is not optimal. As everyone has a unique pattern of acne scarring, the best solution is a tailored one. Remember, scar revision is a medical procedure that is technical to perform. It is not dependent on the clinic, branch, machine, or laser but by the skill of your dermatologist of plastic surgeon.

Take for example deep ice pick scars, and narrow box car scars. These are best treated with TCA CROSS and focused angled Co2 fractional laser in low density. Deep narrow scars respond better to this treatment than even the most expensive lasers. On the flip side, rolling, and atrophic acne scars can improve with fractional devices such as Fraxel, fractional lasers, ProFractional erbium lasers, Infiini –Intensif –Intracel radiofrequency microneedling. Atrophic scars (depressions) can be treated with either fat graft, PRP or dermal fillers. Tethered and anchored scars are best treated with surgical techniques such as subcision. Other surgical techniques that I use include punch elevation, surgical elevation, punch excision and traditional excision for focal scars. Early and very mild acne scars respond well to eMatrix and non-energy microneedling, as well as vascular lasers. Skin colour changes such as PIH or dark marks respond best to sun protection, creams, and Q switch lasers in the nano and pico pulse durations.

In the vast majority of patients, different patterns of acne scars will be present. Monomorphic acne scarring (scars of the safe subtype) are extremely rare. Careful examination, especially under angled lighting with scar mapping will give you an understanding of what are the best options for your scars. Additionally tactile examination namely touch will give me an understanding of the amount of subdermal fibrosis, as special equipment is needed for this sub-set of acne scars.  In the majority of patients its finding the correct combinations that yields the best results. It is never about the device, it is about the specialist behind the equipment that will deliver the best outcomes.

Global leaders in acne scar revision will always use manual methods to revise scars, and employ lasers and energy devices as instruments to assist. All the best, Dr Davin Lim. Acne scar dermatologist specialist. Brisbane, Australia.

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