What is RF microneedling?

RF microneedling is a non-surgical treatment in which radiofrequency energy is delivered directly into the dermis via insulated microneedles. Because the needles are insulated, the upper layer of the skin is largely spared, and the energy reaches the depth where the connective tissue is located.

The difference from classic microneedling is the added heat, which provides an extra tightening effect. Radiofrequency treatments are always performed by the physician personally, following an assessment of skin type, skin thickness, and indication.

How does it work?

The controlled heat in the dermis has two effects. Immediately, existing collagen fibers contract, which gives a slightly tighter feeling shortly after the treatment. This is not yet the final result.

This is followed by the slower and most important effect: the fibroblasts are stimulated to produce new type I and III collagen and elastin. This remodeling process is gradual and usually only becomes clearly visible after approximately six to twelve weeks.

The microneedles also form temporary channels, allowing a suitable active substance to be introduced in the same movement. A vacuum function keeps the skin stable and softens the sensation. Finally, there is a regulating effect on sebum production, which also makes the treatment useful for oily skin and certain forms of acne.

Who is this treatment suitable for?

• early to moderate sagging of the face, jawline, or neck
• loss of firmness and a less defined facial contour
• enlarged pores and irregular skin texture
• fine wrinkles
• acne scars and other recessed scars
• oily skin with overactive sebum production

The treatment is particularly effective when skin quality and firmness are the primary concerns. In cases of pronounced sagging with excess skin, it does not provide an adequate solution.

What happens during a session?

The skin is cleansed and degreased. Approximately twenty to thirty minutes beforehand, a numbing cream is applied, which is then completely removed.

During the treatment, we work zone by zone. You will feel pressure from the device, the suction of the vacuum function, and distinct heat. The intensity is built up carefully, especially with thinner skin and during a first treatment.

Heat is part of the process. Sharp, stabbing, or burning pain is not, and is a reason to interrupt the treatment and adjust the settings. Please always indicate this during the session.

Afterwards, the skin is red and warm and feels tight. Sometimes a fine grid pattern is visible for one to two days.

Number of sessions and results

Typically, two to four sessions are planned, with three to eight weeks in between. The exact schedule depends on the indication, skin thickness, and the reaction to the first session.

The visible result builds up slowly. Collagen remodeling usually becomes apparent after six to twelve weeks and often continues to improve in the months thereafter. The result varies from person to person; there is an obligation of means and not an obligation of result.

What this treatment does not do

• RF microneedling does not replace a facelift or neck lift. In cases of clearly excess skin, the effect is limited.
• No volume is added; sunken cheeks or temples are not restored with this treatment.
• Deep folds and heavy wrinkles will not disappear with it.
• Fat accumulation under the chin is not eliminated with this treatment.
• The effect is not permanent; the skin continues to age.

Safety and contraindications

The treatment will not proceed in cases of, among others, pregnancy, an active skin condition, infection or cold sore in the area, active inflammatory rosacea, nodulocystic acne, a tendency toward keloid formation, anticoagulant therapy, a pacemaker or other implanted electrical device, and epilepsy. Autoimmune diseases are assessed on a case-by-case basis. Please also report any metal implants in the treatment area.

Waiting periods are observed relative to other treatments: approximately two weeks after botulinum toxin, two to four weeks after fillers, two to four weeks after laser or light treatment, and one to four weeks after a peeling. Retinol and fruit acids are stopped several days beforehand.

Aftercare

• Use only mild care for the first few days, for example with hyaluronic acid, panthenol, or niacinamide.
• No makeup for twelve to twenty-four hours.
• SPF 50, daily and for at least one week.
• No sauna, intensive exercise, or hot showers for forty-eight hours.
• No retinol, fruit acids, or scrubs for five to seven days.

Expect a mild recovery time of one to two days of redness. For more intensive treatment of scars, this may increase to three to five days.

Combination with surgery and other treatments

The treatment is often combined with an active substance introduced during the session. Only suitable products may be used for this; cross-linked fillers, vitamin C, and acids are not combined with radiofrequency.

After a facelift or neck lift, the tissue is repositioned, but the skin quality itself does not change as a result. A regenerative trajectory works on that quality and can help maintain the achieved result. See also microneedling and regenerative aftercare after a procedure.

Frequently asked questions

Is RF microneedling painful?

With a numbing cream, the treatment is well-tolerated by most patients. You will primarily feel pressure and distinct heat. Sharp or burning pain is not part of the process and is a reason to interrupt and adjust the treatment.

When will I see results?

Shortly after the session, the skin often feels tighter due to the contraction of existing collagen fibers, but this is not yet the final result. The build-up of new collagen usually becomes visible after six to twelve weeks and often improves further thereafter.

Does this replace a facelift?

No. RF microneedling provides slight to moderate tightening and improves skin quality, but does not remove excess skin. In cases of pronounced sagging, a surgical procedure provides a different and more distinct result.

How much recovery time should I allow?

Typically one to two days of redness and a warm, tight feeling. For more intensive treatment of scars, this can last three to five days, with light flaking.

Can I combine this with botulinum toxin or fillers?

Yes, but not at the same time. After botulinum toxin, a wait of approximately two weeks is required; after fillers, two to four weeks. The sequence and timing are determined together beforehand.

Is the treatment suitable for darker skin?

Because the energy is delivered into the depths via insulated needles and the epidermis is largely spared, the risk of pigment shifts is more limited than with some light treatments. Nevertheless, the intensity is built up more cautiously and strict sun protection is necessary.

Read also

• Treating acne scars
• Skin tightening without surgery