Micro-Coring Is a 30-Minute Treatment That Can Help Tighten Skin

Microneedling, microdermabrasion, microblading... That’s a lot of micros to keep straight, but some experts say micro-coring is unlike anything else in the category. 

If you have a backyard, you might know about lawn aeration (stick with me). This involves using an aerator machine to pull small cores of soil out of the ground every three inches or so in a grid pattern. The holes that are left behind allow water and oxygen to permeate the root zone, helping grass grow stronger. 

The same principles are at work in micro-coring: During a procedure, your doctor uses a micro-coring device with hollow needles to poke thousands of tiny holes in your skin, suctioning away the removed "core" of the tissue as it goes. Yikes, right? But fear not: With the use of local anesthesia, experts say, the procedure is relatively painless.

"This technology was created as a result of research into how nearby skin tightens and contracts when little portions are removed," says Hardik Doshi, MD, a board-certified facial plastic surgeon in Long Island, New York. "The skin's natural healing processes kick in to close those holes," resulting in a tighter, smoother appearance. You might be thinking, Isn’t that what microneedling does? Kind of. 

"It's reasonable to infer a similarity when you hear the words 'micro' and 'needles,'" says Dr. Doshi, "but micro-coring technology is entirely different from microneedling." Both treatments use microneedles to pierce the skin and kickstart collagen production, but micro-coring has the added benefit of removing dermal tissue, rather than displacing it — the idea being, this should make room for the skin to shrink and tighten. 

Board-certified dermatologist Dhaval Bhanusali, MD, says micro-coring is actually more similar to fractional laser treatments, which use heat to create microscopic holes in the skin. But with micro-coring, he says, “you get that same result without the need for heat, or the resulting thermal injury," or the often crusty burn-recovery process that comes with it. 

The micro-coring Ellacor system, developed by medical technology company Cytrellis, came on the scene just last year, after being approved by the FDA in 2021. Since its launch, micro-coring has made headlines as a "nonsurgical facelift alternative." And while it can remove some excess skin (up to 8% in the treated area), our experts say it's not comparable to a traditional facelift.

We speak to several plastic surgeons and dermatologists to get to the, well, core of micro-coring. Here's what it can and can't do.

• Konstantin Vasyukevich, MD, is a board-certified facial plastic surgeon based in New York City.
• Dhaval Bhanusali, MD, FAAD, is a board-certified dermatologist based in New York City.
• Jaimie DeRosa, MD, is a board-certified plastic and reconstructive surgeon based in Boston and Palm Beach.
• Hardik Doshi, MD, is a board-certified facial plastic surgeon based in Long Island, New York.
• Melissa Doft, MD, is a board-certified plastic surgeon in New York City.

In this story:

• What is micro-coring and what are its benefits?
• Does micro-coring hurt?
• What is the recovery process?
• How much does micro-coring cost?

With the goal of tightening skin, micro-coring uses hollow needles to remove small columns of skin in a grid formation across the treatment area, which is typically the cheeks, jowls, jawline, or chin. The handheld Ellacor — the only device that can perform the procedure — is guided by a doctor as it punches out thousands of tiny pieces of skin, suctioning the removed tissue as it goes. These skin "micro-cores" are so small they're invisible to the naked eye. 

The procedure removes about 4-8% of the skin in the treated area. The hollow needles are less than half a millimeter in diameter, about half the size of a standard ear-piercing needle. The holes they leave behind (about 10,000 of them!) are so small that "the skin closes nearly immediately, which allows it to heal completely over several days," says Dr. Doshi.

Theoretically, the resulting inflammation and healing response in your skin can lead to increased collagen production and subsequent tightening, says Jaimie DeRosa, MD, a board-certified plastic and reconstructive surgeon in Boston and Palm Beach. How much tightening? Unfortunately, we don't know the answer to that one — currently, there's no data on the tightening results you can expect. 

But clinical trials sponsored by Cytrellis (the company that makes Ellacor) found that 90% of patients showed improvement on the Global Aesthetic Improvement Scale, a five-point scale used in clinical studies to assess improvement of patient appearance post-treatment. “The scale is a patient-driven grading system in which patients assess if they believe that a treatment has improved their skin or not,” says Melissa Doft, MD, a board-certified plastic surgeon in New York City. “It is a validated scale, but it is also filled with potential bias. In some studies using this scale, it has been found that patients overestimated the results of non-treated areas, stating that they are improved when they have not even been treated.” Participants in this study were treated two or three times with 7-8% skin removal. (Yeah, you'll need a few rounds of treatment to see results – more on that in a bit.) 

Compared with thermal energy devices that can cause irreversible thermal injury, micro-coring offers minimal scarring and downtime. “The downtime is around three days, per their literature, but some patients may have redness for longer,” says Dr. Doft. While the needles are very small, she continues, the treatment is not recommended for darker skin tones, which are more likely to scar than lighter tones, and for patients known to develop keloid or hypertrophic scars, which appear thick and raised. (At this time, micro-coring has only been cleared for patients with lighter skin tones, but not Fitzpatrick skin types V and VI. Cytrellis says additional clinical studies are needed to evaluate the effects of Ellacor on darker skin types.) 

Experts also say you should not consider micro-coring treatment if you are pregnant or nursing, have an autoimmune skin condition (like psoriasis), are prone to infection, or have very thin or thick skin. If "skin thickness" isn't a measurement you know how to make, your doctor can help you decide if micro-coring is the right treatment. 

When patients ask about micro-coring, experts say, they’re generally looking for a minimally invasive way to help treat wrinkles and sagging in the middle and lower areas of the face. But some plastic surgeons have not added the device to their practice, such as Dr. Doft: “​​We do not have it as we offer facelifts and mini-facelifts, which give a much more significant difference.” 

"Punching out pieces of skin" sure doesn’t sound minimally invasive, but our experts say it's not as bad as it seems. The treatment is done under local anesthesia, so it's relatively pain-free. Experts say most patients have little to no discomfort.

A micro-coring treatment takes about 30 minutes from start to finish. Arguably, you could squeeze one in on your lunch break, but our experts definitely don’t recommend doing that. Rather, Dr. Bhanusali says, you should make sure you don’t have anything important on your schedule for at least a week (check out the standard recovery process below).

Most patients need more than one treatment to see full benefits. "For best results, patients typically need three treatments about one month apart," says Dr. DeRosa. "And it takes about four to six months to see the full effect of the treatments." The results you get vary based on the amount of skin removed, the needle-coring depth used by your doctor, the number of treatments, the depth and length of wrinkles, your skin’s unique healing process, and skin thickness. Your doctor can help you develop a treatment plan based on your skin and goals. 

Micro-coring is offered at medi-spas, but you’ll definitely want to see a board-certified medical professional. You want the person poking these tiny but very real holes in your face to know exactly what they are doing. 

"Generally, patients have redness that lasts a few days," says Dr. Bhanusali. Because the holes left by micro-coring are so small, any scars left behind are microscopic and invisible to the naked eye. However, says Dr. Doft, “whenever the skin is punctured and skin is removed there is the potential risk for scarring.” And the treatment does come with other risks such as pain, swelling, bruising, or infection. 

To minimize these concerns, our experts recommend keeping your skin well moisturized for at least two weeks post-treatment (Dr. DeRosa suggests using Aquaphor), using gentle facial cleansers, avoiding retinols, and applying mineral-based sunscreen. To prevent clogging treatment-induced holes, avoid wearing makeup for about a week; after that, says Dr. Doshi, you can use mineral-based makeup to cover any resolving redness.

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Prices for micro-coring, which is still relatively new to the cosmetic procedure scene, vary by provider and treatment area. Generally, you can expect each treatment to cost between $2,000 and $3,500. Remember that a typical treatment course consists of three treatments, so budget for $6,000 to $8,000. 

More info about non-invasive cosmetic procedures:

• 7 In-Office Treatments to Try If You're Not a Fan of Injectables
• The Complete Guide to Laser Treatments for Hair and Skin
• Everything You Need to Know About Microneedling

A Cosmetic Surgeon's Entire Routine, from Waking Up to Surgery: