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The One Area You May Want to Avoid Microneedling—According to Experts

The One Area You May Want to Avoid Microneedling—According to Experts featured image
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Radio-frequency microneedling has become a celebrity favorite for skin rejuvenation, with stars like Kim Kardashian and Chrissy Teigen praising its ability to tighten, smooth, and refresh the skin. Combining the collagen-boosting effects of microneedling with the heat of radio frequency, it effectively addresses concerns such as large pores, acne scars, fine lines and skin laxity. But what else can it do? A quick search on fat loss with microneedling reveals numerous Reddit threads discussing an unexpected side effect—some users worry that the treatment could “melt” facial fat. So, where should you avoid getting radio-frequency microneedling if maintaining facial volume is a top priority? We’re diving in to find out ahead.

Featured Experts

  • Macrene Alexiades, MD is a board-certified dermatologist in Wainscott, NY
  • Yula A. Indeyeva, MD is a double board-certified facial plastic surgeon in Austin, TX
  • Kenneth Beer, MD is a board-certified dermatologist in West Palm Beach, FL

Does Microneedling With Radio Frequency Cause Fat Loss?

While microneedling with radio frequency is generally considered safe, there is a risk of facial fat loss if not performed correctly. According to Wainscott, NY dermatologist Macrene Alexiades, MD, the depth of the treatment is crucial. “I’ve had two patients who’ve come in from outside offices who’ve had it done at depths that were inappropriate on the face. We’re talking about depths of three millimeters, which is not appropriate for that area. You’re going to cause fat injury and fat loss, which is probably semi-permanent because those fat cells are not going to necessarily regenerate,” she explains.

The underlying issue is that microneedling paired with powerful heat-based energy can affect not only the skin but also the fat layer beneath. The heat from radio frequency targets collagen, but if applied too deeply, it can damage the fat cells responsible for volume in areas like the midface, leading to hollowing or gauntness over time. This concern is especially relevant for younger patients who may want to preserve fat for a more youthful look later in life.

The Midface Is a No-Go Zone

The treatment is excellent for addressing skin laxity, particularly in areas like the lower face and neck, where sagging is common. However, Austin, TX facial plastic surgeon Yula A. Indeyeva, MD, warns against the treatment in areas such as the midface, where fat contributes to a youthful, healthy look. “Areas like the lower face and neck often benefit from this technology because they are prone to laxity,” says Dr. Indeyeva. “However, in regions where the skin is naturally firm and where fat is valuable, such as around the midface, using a tightening device aggressively might not make sense.”

Dr. Indeyeva emphasizes that an aggressive approach could disrupt the natural balance of facial fat and structure. “We should be careful not to over-tighten areas that don’t need it, as this could compromise the natural balance of facial fat and structure. I believe that anything done aggressively, particularly in aesthetic treatments, can have negative consequences. That’s why it’s essential to follow the specific guidelines of the devices we use and avoid over-treating. It’s important to follow the treatment’s indication.”

Understanding the Risks of Inappropriate Depth

The primary danger with microneedling with radio frequency comes from not understanding the facial anatomy and depth required for different areas. “Having an understanding of the depth of your fat cells in all areas of the face is critical,” says Dr. Alexiades. She points out that a one-size-fits-all approach can be risky, and the devices used should have a safety mechanism in place.

West Palm Beach, FL dermatologist Kenneth Beer, MD, echoes this sentiment, adding, “The depth matters, especially when treating the face. It’s important to see a qualified physician as they must be cautious with the depth and intensity of the treatment because it can impact the layers beneath the skin.”

While the risk of fat loss is not extremely common, Dr. Beer reassures that it is unlikely to occur without significant pain. “I don’t think it would melt fat without a lot of pain. I have not had anyone that had that happen, so probably not a big concern,” he says. However, careful monitoring and precision are key to minimizing any risks, as every millimeter counts.

“People need to be careful not to over-tighten areas that don’t need it,” adds Dr. Indeyeva. “This could compromise the natural balance of facial fat and structure, which is something we don’t want.”

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