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SkinPen® Microneedling

SkinPen® MicroneedlingSkinPen® Microneedling

Also known as collagen induction therapy (CIT) and percutaneous collagen induction (PCI), microneedling involves the use of a needling device to create micro-injures in the skin for the purpose of skin rejuvenation. In the past few years, it has increased in popularity due to its ability to improve skin texture and firmness, and to diminish scars, pore size, and stretch marks.

Microneedling is administered in various ways. One of the most well-known are dermal rollers, which are cylindrical drums covered in microneedles that are rolled over the skin. Similarly, a dermal stamp punctures a specific area using a stamping action. In 2010, the mechanical microneedling pen was introduced, dramatically boosting the number of micro-punctures in the same amount of time. This latter device is lauded for its precision and ability to reach more difficult areas of the face such as the eyes.

One of the greatest benefits of microneedling is the broad range of application. Microneedling can be used anywhere on the body to improve texture, reduce scarring, and diminish the look of discoloration.  Even commonly “off-limits” regions such as the delicate skin around the eyes can be treated (carefully!) with microneedling. This procedure also works well on sunken areas of the skin such as acne scars.

The SkinPen® by Crown Aesthetics is the first FDA-cleared microneedling device on the market and is clinically proven to improve the appearance of wrinkles of the neck and acne scars in patients ages 22 and older. In as few as three minimally invasive treatments spaced 30 days apart, you can improve your appearance and step out with confidence.

How Does Microneedling Work?

Microneedling is a method of triggering the repair response of skin. The needles on a microneedling device puncture the skin to create a controlled skin injury. Each puncture of the needle creates a microscopic channel, or empty space. The skin recognizes this channel as tissue loss and begins to produce collagen and elastin to “fill” the channel. The result is an improvement in skin texture and firmness, as well as a reduction in scars, pore size, and stretch marks. Sometimes, skincare professionals will combine microneedling with topical formulas such as Platelet Rich Plasma(PRP), also dubbed a “Vampire Facial” or SkinCeuticals C-E Ferrulic to help complement results.

When opting for microneedling treatment, it is important to consider the length of the needle being used, as this determines the depth and scope of the treatment. Needle sizes start at 0.1 mm, which only affects the epidermis (the outermost layer of the skin), and can range up to 3.0 mm, thus affecting the deepest layer of the skin (the reticular dermis). Lengths between 0.1 mm and 0.3 mm are used for more superficial, cosmetic purposes such as increasing the penetration of topical serums. Fine lines and wrinkles are addressed with needles ranging from 0.5 mm – 1.5 mm. More invasive procedures use needle lengths from 1.5 mm up to 3 mm to reduce scarring, deep wrinkles, and stretch marks.

SkinPen® Microneedling


The Microneedling Procedure

In-office microneedling treatments can take anywhere from 15® minutes to an hour depending upon the area being treated and whether topical anesthetic or PRP will be utilizied. First, you will arrive at Graham Plastic Surgery and have a full skin assessment by one of our registered aesthetic nurses. You will express your concerns and a full treatment plan tailored to your needs will be developed. At this time the length of the SkinPen® needle will be determined as well as the need for any adjunctive treatments(PRP, Vitamin C serum, Tranexamic Acid). The length of the needle will affect whether there will be any discomfort or bleeding. A specially compounded topical anesthetic will then be applied to your skin. After 10-15 minutes, your skincare professional will then roll the microneedling device over your skin to create tiny punctures. The sensation is often described as feeling”hot” or “prickly”.

Immediately after treatment, your skin may experience redness and minor swelling. These effects generally subside within a day, but can take up to one week to fully resolve. Since your skin is more sensitive following a procedure, it is highly recommended to avoid sun exposure immediately after. Additionally, we will advise you to avoid wearing makeup 24-48 hours following the treatment.

Graham Plastic Surgery Microneedling Protocols

Literature based protocols for specific skin conditions.

  • Anti-Aging Protocol-SkinPen® Microneedling at medium to deep depth complemented by a Vitamin C serum to increase skin tightening and collagen formation. 3-4 treatments recommended
  • Acne Scarring Protocol-SkinPen® Microneedling at deep depth complemented by Platelet Rich Plasma(PRP) therapy to increase collagen remodeling and soften acne scars. 6 treatment series recommended
  • Melasma/Pigment Protocol-SkinPen® Microneedling at medium to deep depth complemented by Tranexamic Acid to decease melanin synthesis. 3-4 treatments recommended
  • Customized Protocols-SkinPen® Microneedling at a customized depth with any combination of topicals, depending on individual skin types and goals. 3-4 treatments recommended

Microneedling Frequently Asked Questions

What are the risks associated with microneedling?

Possible microneedling side effects include:

  • Mild swelling and redness
  • Pain
  • Color change of skin
  • Temporary irritation resulting in blistering, crusting, scarring or other changes in skin texture
  • Infection
  • Visible skin patterns
  • Distortion of anatomy
  • Damage of skin

How do I prepare for my microneedling procedure?


Discuss and disclose any healing disorders such as caused by diabetes mellitus, connective tissue disease or radiation/ chemotherapy.

Discuss and disclose if there is an active infection or history of herpes simplex of the lips, mouth or face.

Do not proceed with the microneedling treatment if the patient is pregnant or breast feeding.

Discuss and disclose allergies to topical anesthetics, antibiotics, or other medications.

Do not proceed with the treatment if Isotretinoin (Accutane) has been used within the past 12 months.

Discuss the history of any hypertrophic scarring or keloid formations or other skin diseases.

An accurate diagnosis by a medical professional is necessary prior to the treatment.

Prior to the treatment, clean the treatment area. The treatment area should be free of any makeup, creams, perfumes, and lotions. Male patients should shave just prior to treatment (the pigment in your beard could increase discomfort).

Always use an SPF 30 or greater sunblock on all exposed treatment areas. Wear sun protective hats and clothing.

Discontinue the use of exfoliating creams/peels, including retinols,  1 week prior to the entire treatment.

If the patient has a history of herpes outbreaks in the areas being treated, a prescribed medication, like Valtrex is recommended for one week prior to the treatment prior to the treatment to help prevent an outbreak.

Patients will need to have:

  • A mild facial cleanser.
  • A high-quality sunblock SPF 30
  • A good moisturizer available for your after-care.

Is microneedling painful?

Microneedling patients have minimal pain. We routinely use a strong topical anesthetic cream obtained from a compounding pharmacy in New York City. In addition to our topical, unlike a hair salon and unique to a medical practice, Graham Plastic Surgery is able to offer Pro-Nox nitrous oxide as well as  local anesthetics as a treatment to relieve pain.

Are there instructions for after my microneedling treatment?

After Treatment
Erythema (redness) will be present in the treatment area and can last from a few hours up to a few days. Treatment areas almost always become erythematous. Immediately following the procedure, patients will experience a moderate sunburn sensation that may include some discomfort. Ice packs (not direct ice) maybe applied to help soothe areas with discomfort.

Aquaphor and repair cream may be used after microneedling treatments.

  • It is important to protect your skin from environmental elements; therefore, a sunscreen with a SPF protection of at least 30 should be used daily.

General Skincare

Proper skin care is important to protect the new refreshed skin. Your medical professional will discuss a proper skincare regimen following your microneedling treatment.


  • Do not rub, scratch, or pick at the treated area. Treat the area gently. Pat skin dry after bathing or showering. An antibiotic ointment such as Bacitracin may be applied. Neosporin and Polysporin are not recommended.
  • Avoid strenuous exercise for 48 hours post procedure.
  • Avoid shaving the treated area for 48-hours after the procedure.
  • If you have any questions, please call or text our office 585-300-4575.

How frequently should I get microneedling treatments?

When scheduling your procedure, it is important to remember that while you may see results after one session, it is generally recommended that microneedling be completed in a series of 3-5 treatments every 4-6 weeks, followed by a maintenance program. The frequency of treatments depends upon the desired effect and needle length used. Your skincare professional will work with you to design a treatment plan specifically for your skin.

Why should I choose Graham Plastic Surgery to perform my microneedling?

Graham Plastic Surgery is a plastic surgery practice. As a Board Certified Plastic Surgeon, Dr. Graham adheres to the highest standards in safety and efficacy. While microneedling can be an effective treatment in improving fine lines and wrinkles, acne scars, skin texture, and stretch marks, it is not without risks. If not administered under the right care, it can lead to infection. As a result, it is essential that the procedure is performed by a licensed skincare professional with extensive experience. Experienced skincare professionals will ensure that your treatment is performed in a sterile environment and that you are provided with proper post-procedure instructions. They can also work with you to create a customized advanced homecare regimen to help enhance and maintain results.

What is the recovery time after microneedling?

The microneedling downtime is 24 hours.

How much does microneedling cost?

Microneedling pricing can vary greatly.  Adjunctive topical treatments such as Vitamin C and PRP can also increase the price of the procedure. You can see Dr. Graham’s pricing here