- Procedure time
- 30 minutes to an hourTime in the treatment room
- Anesthesia
- Topical numbingApplied about an hour beforehand
- Setting
- Our procedure suite
- Downtime
- Two to three daysMild redness
- Results last
- PermanentThe gain holds; the face ages on around it
Two different problems
A face ages in ways that need different tools. Tissue descends, and that is a structural problem which surgery addresses. Separately the skin itself changes: it thins, loses elasticity, roughens, and collects the marks of sun exposure it has been accumulating for decades.
A facelift moves skin. It does not improve it.
I say this to facelift patients regularly, because the two things get conflated. If your skin quality is what bothers you when you look closely in the mirror, an operation is the wrong answer and this kind of treatment is a reasonable one.
How it works
Fine needles pass through the surface and deliver radiofrequency energy into the dermis, the deeper layer where collagen and elastin sit. Controlled heating there provokes a remodeling response over the following weeks and months.
The reason this matters is that the surface is largely spared. Heat is deposited at depth while the top layer stays intact, which is what keeps the recovery short and makes the treatment more predictable in darker skin tones, where surface resurfacing carries a higher risk of pigment change.
The result builds gradually. You are watching your own collagen respond, and that takes months. Anyone promising you a visible change the following week is describing swelling.
Where PRP fits
Platelet-rich plasma is prepared from a sample of your own blood, spun in a centrifuge to concentrate the platelets and the growth factors they carry. Applied immediately after treatment, the channels left by the needles give it a route into the skin it would not otherwise have.
I want to be straight about the evidence. PRP is one of the most aggressively marketed things in aesthetics, and the published data on it for skin quality is genuinely mixed. There is a plausible mechanism and there are patients who do well with it. There is not the weight of evidence that would justify the way it is sold.
So here is how we handle it. PRP is included in the price of the treatment. It is part of what you are getting, and it will never be presented to you as an upgrade halfway through a course, which is the usual way it reaches a patient. Being candid about mixed evidence is easier when there is no separate invoice riding on the answer.
You should also know what a realistic course looks like. Three to six sessions about a month apart, and the change is gradual enough that people who stop after one often conclude nothing happened. What you build is permanent, though your face carries on aging around it, so most patients keep going at three to six sessions a year.
What it treats well
Texture and pore size respond, as does the fine crepey quality that skin develops on the cheeks and under the eyes. Acne scarring is one of the better indications, because the mechanism suits a problem that lives in the dermis. Mild laxity along the jawline can firm.
It does less for deep static lines, for significant sun damage where resurfacing does more, and for anything caused by tissue having moved downward. Those want a different plan, and there is no harm in hearing that before you spend money.
Recovery and risks
Expect redness and swelling, a sensation like sunburn, and a fine grid pattern on the skin that settles over a few days. Most people are presentable well before a laser patient would be.
Risks include pigment change, which is less likely here than with resurfacing and still possible; infection, which is uncommon; and prolonged redness. Sun protection afterward is not optional if you want to keep the result and avoid pigmentation.
Tell me if you have a history of cold sores, if you are on isotretinoin or have been recently, or if you scar unusually. Each changes the plan.
Common questions
- What does the radiofrequency add to microneedling?
- Plain microneedling injures the surface to provoke a healing response. Adding radiofrequency delivers heat from the tips of the needles into the deeper layer, where collagen actually lives. The needle makes the channel and the energy does the work at depth.
- Is this a substitute for a facelift?
- No, and I will tell you so at consultation if that is what you are hoping for. This treats the quality of the skin and can firm mild laxity. It does not reposition tissue that has descended. If the problem is descent, tightening the surface over it will not address what is bothering you.
- What is PRP and does it help?
- Platelet-rich plasma is made by drawing your blood and spinning it down to concentrate the platelets, which carry growth factors. Applied after microneedling, the channels let it reach the deeper layer. The evidence for it in skin quality is mixed and it is oversold across the industry. I use it where I think it adds something and I will not pretend it is transformative.
- How does it compare to the CO2 laser?
- The laser resurfaces the surface and gives the bigger change in texture and pigment, with real downtime. Radiofrequency microneedling works deeper without removing the surface, so recovery is much shorter and the change is more gradual. Darker skin tones also tolerate it more predictably.
- How many treatments?
- Three to six sessions, spaced about a month apart. That is a course, and most people need the whole of it before the change is obvious. Judging this on one visit is the commonest reason someone decides it did nothing for them.
- Do I need to keep having it?
- If you want to hold what you gain, yes. I recommend maintenance of three to six sessions a year, as your time and budget allow. What the treatment builds is permanent, and the face goes on aging around it, so maintenance is how you stay ahead of that.
- Is the PRP an extra charge?
- No. PRP is part of what we do here and it is included in the treatment price. You will not be offered it as an upgrade partway through a course, which is how it is usually sold.
Not sure this is your problem? Skin texture, tone and sun damage
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