Same here! I don’t actually want to get one, but I went down a total facelift rabbit hole recently. Since I’m in Europe, I was surprised to see that even top surgeons doing state-of-the-art facelifts charge around €15k.
My husband’s a plastic/reconstructive surgeon, and he’s always told me that if I ever plan on getting a facelift down the line, I should stay away from energy devices or biostimulators like Sculptra or Radiesse. Apparently they cause a type of scarring that makes it harder to get the best results later on.
Another thing that caught my attention is that facelifts can actually be kind of preventative and getting one younger can help maintain facial structure and slow down visible aging (aside from bone loss, of course).
And honestly, the most practical reason is just that I don’t want a big, drastic change. I just want to keep what I have for as long as possible
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I’m no surgeon and wouldn’t debate this with your husband but the point re: scar tissue is hotly debated by plastic surgeons themselves. Many surgeons are completely fine with it, and by my understanding, if you go for a deep plane face lift, the surgeon would be working too deep for any of those issues to be a concern.
Probably true.
My main concern with any treatment is to make sure we are not using the ones that can melt the fat in our faces.
In that vein, I’m sharing a video where Karam, a respected plastic surgeon, addresses this issue at minute 10:30
ULMW Hyaluronic Acid is non-cross-linked.
Ultra Low Molecular Weight = below 6000 daltons
The other 5 versions of HA are too big to penetrate the skin to any extent.
This is what I’ve been using in my skin care product over the past 4 years.
If you use it as a topical (cream, serum) it doesn’t penetrate deep enough.
Indeed! Whether an energy device can cause facial fat loss is a function of depth of energy and amount (in joules). Hifu does have the potential to cause some fat loss and that can be desirable based on the presentation of the patient (fat face). I’m not fat but have a tendency towards heaviness in my lower face so I need a bit of tha extra power to keep it nice and snatched. Someone with a thinner face would need less energy and lower depth of penetration. It’s all in the parameters of the machine and I think everyone could do worse than take a selfie and discuss the areas of concern with Mr. GPT to fine tune the ideal settings.
That being said, to get proper fat loss you really would need to max out the machine’s power settings because the lipolysis is pretty minimal. When used FOR fat loss, say in the abdomen, you need many sessions, spaced closely apart, with pretty big energy settings. So in practice I wouldn’t be too concerned.
Medaura, have you looked into using multiple modalities together to boost their effectiveness?
I put this into CGPT5:
Can you find any examples of people trying dermo-electroporation with microneedling together to get greater benefits or efficacy?
and the Response:
Yes — there are studies and clinical-device descriptions showing the use of combining microneedling with electroporation (or electroporation-assisted microneedles) to boost efficacy of transdermal delivery and skin rejuvenation. Here’s a summary of what I found, including caveats for your longevity/derm-bio interest:
Evidence of combination
- A 2014 in-vitro study:The combination of microneedles with electroporation and sonophoresis to enhance hydrophilic macromolecule skin penetration (Petchsangsai et al.)
- They used porcine skin and a hydrophilic macromolecule (FITC-dextran) as a model.
- They compared microneedles (MN) alone, electroporation (EP) alone, sonophoresis (SN) alone, and combinations (MN+EP, MN+SN, EP+SN, MN+EP+SN).
- Result: The MN + EP + SN combo had the greatest cumulative permeation. Even MN+EP outperformed single modality.
- Importantly: This was in vitro, with porcine skin, and focused on delivery/permeation rather than long-term skin remodeling or clinical rejuvenation endpoints.
- A 2023 case report:Microneedle Electroporation for Intralesional Administration of Corticosteroid Treatment of Keloid Scar (Karina et al.)
- They describe a case where microneedle electroporation was used for intradermal delivery of triamcinolone into a keloid.
- They note: “The combination of microneedling with electroporation can yield an even better result in skin permeation” for the context of delivering steroids.
- This is a clinical scenario, but a case report (n = 1) and specific to scar/keloid treatment, not broad-based rejuvenation.
- A recent review (2024) on electroporation/iontophoresis assisted microneedles:Iontophoresis and Electroporation‑Assisted Microneedles: Advancements and Therapeutic Potentials in Transdermal Drug Delivery (Abbasi & Heath)
- They cover the technology of MN + EP (and iontophoresis) for transdermal drug delivery in a range of therapeutic areas (vaccines, DNA, dermatology drugs).
- While not entirely for cosmetic skin‐rejuvenation, it shows the mechanistic plausibility of combining MN + EP to enhance penetration/delivery.
- Industry/Clinic device descriptions:
- For example the EPN Pen (a professional microneedling pen that claims electroporation + microneedling) is marketed for aesthetic use (skin texture, laxity, pores) via combined MN + EP. This shows that the aesthetic device field is using the concept — though not necessarily backed by high-level randomized clinical evidence.
Important caveats / what to watch
- Most of the strong evidence is for enhanced penetration/delivery, not yet for long-term durability of collagen remodelling, longevity of results, or randomized controlled trials in rejuvenation contexts.
- The clinical evidence is sparse: e.g., one case report for keloid; few peer-reviewed RCTs for cosmetic anti-aging endpoints.
- Device parameters matter (needle depth, pulse voltage, frequency of EP, serum/active agent used) and there is little standardisation in published literature for aesthetic endpoints.
- Safety: Adding electroporation increases complexity and potential risk (electrical pulses, skin barrier disruption, etc.). For your longevity/bio-hacker hat, want to ensure dose, parameters, skin type, recovery, side-effect profiles are well controlled.
- Marketing vs. evidence: Devices claim “maximised results” by combining MN + EP, but that doesn’t always mean strong peer-reviewed clinical outcomes for skin aging endpoints.
- Mechanistic plausibility: Creating microchannels (MN) + temporarily increasing cell‐membrane permeability (EP) = greater uptake of actives (serums, peptides) and possibly deeper dermal impact. But the bigger question: does this translate into meaningful effects (eg. improved collagen/elastin architecture, slower aging) beyond standard microneedling or other modalities?
My assessment for your context (longevity / skin optimization)
Given your interest in detailed, iterative, high-fidelity optimizations:
- If you’re considering this combo as part of a longevity/dermal optimization strategy (e.g., boosting delivery of high-molecular-weight actives, peptides, growth factors, etc), the mechanistic logic is sound: combine microinjury (collagen induction) + enhanced delivery (via EP) = potentially superior results.
- But you should treat this as emerging rather than established. It might be appropriate as a “next‐level experiment” in your skincare/dermal stack, but not yet as a guaranteed “step‐change” unless you monitor metrics carefully (before/after imaging, biopsy or non-invasive measurement of dermal thickness/collagen, side‐effects).
- For real longevity outcomes (deep dermal remodeling, true reversal of aging processes), more evidence would be helpful. If you go ahead, I’d recommend documenting: device parameters (needle length, EP voltage/pulse), active delivered (what serum/peptide), timepoints (baseline, 3 mo, 6 mo, 12 mo), objective measures (ultrasound dermal thickness, collagen/elastin density via imaging, biomarkers of skin aging), and safety outcomes.
If you like, I can pull together and tabulate all known published protocols (needle depths, voltages, delivery agents) for microneedling + electroporation (in aesthetics and transdermal drug delivery) so you can evaluate what’s been done and what gaps remain. Would that be helpful for your project?
Here’s a concise evidence table of microneedling + electroporation (MN+EP) use, with the best-available parameters pulled from peer-reviewed sources and device docs. I also gave you a downloadable CSV.
Key protocol evidence (MN+EP)
- In-vitro parameters with explicit settings (gold for dialing in): Porcine skin; MN pretreat 2 min at 10 N using ~1.0 mm needles (9-needle array, 4 mm spacing), then EP 50–300 V, 1 ms, 99 pulses; MN+EP increased permeation vs single modalities, and MN+EP+sonophoresis was highest; histology showed no notable damage.
- Clinical signal (scar/keloid): Case report using microneedle electroporation to deliver triamcinolone into a keloid—symptom relief and thickness reduction; authors explicitly note MN+EP can further improve skin permeation. Parameters aren’t fully disclosed.
- Reviews on EP-assisted microneedles: Integrating EP with MN enhances transdermal delivery (vaccines, dermatology, drugs). EP efficacy generally favors short, high-voltage bursts over prolonged low-voltage pulses; commonly cited field strengths ~100–1000 V/cm (context, not a single fixed recipe).
- Baseline EP parameter anchors (no MN): Optimization work reports ~60 V, 0.5 ms single pulses affecting barrier properties—useful for bounding EP dose when combining with MN.
- Clinic device norms: EPN-type devices pair MN with EP; they publish needle depth guides (e.g., 0.25–0.5 mmfine lines; 1.0–1.5 mm acne scars; 1.5–2.0 mm stretch marks). EP “intensity” is device-set; voltage/pulse specifics aren’t public. Treat as practical heuristics, not peer-reviewed dosing.
What this supports (and what it doesn’t)
- Supports: MN+EP does improve permeation/delivery versus either alone; explicit, tunable parameters exist (voltages, pulse width, counts) from controlled models.
- Doesn’t (yet) prove: Superiority for cosmetic anti-aging endpoints in humans (wrinkles, laxity) vs good MN alone—clinical RCTs with objective outcomes are sparse. The best human datapoint is a keloid case, not rejuvenation.
Practical, evidence-aligned starting ranges (if you’re building a protocol)
- Needle depth: 0.25–0.5 mm (fine lines/superficial), 1.0–1.5 mm (acne scars), up to 1.5–2.0 mm (stretch marks/scars)—device heuristics; adjust by anatomic site and Fitzpatrick type.
- EP after MN: Square-wave bursts in the 50–300 V band, ~1 ms, ~99 pulses are documented in vitro and are a reasonable experimental bracket; translate to field targets (order 10^2–10^3 V/cm) if using plate or multi-needle electrodes. Start low and titrate.
- Sequence: MN → EP → (optionally) sonophoresis gives the highest delivery in vitro; if you’re not adding ultrasound, MN → EP still outperforms single methods.
- Actives: Hydrophilic macromolecules (e.g., FD-4 model) show clear gains. For steroids in keloid, MN-EP delivery has clinical face validity. For cosmeceuticals/peptides, expect better uptake, but you still need objective measuresto prove benefit.
Sources synthesized into the table/CSV
- Petchsangsai et al., Biol Pharm Bull 2014 — explicit MN+EP parameters; MN+EP+SN best.
- Karina et al., Acta Derm-Venereol 2023 — keloid case with MN electroporation delivery.
- Abbasi & Heath, Drug Deliv Transl Res 2024 — review of EP/IP-assisted MN systems; high-level parameter logic.
- Akimoto et al., JAAD (parameter note) — 60 V, 0.5 ms benchmark for EP effects on SC.
- Rajput et al., 2024 review — 100–1000 V/cm EP field context.
- EPN device docs/web — needle-depth guidance for aesthetic indications; EP specifics not disclosed.
If you want, I can extend this with a second tab covering safety ranges (max current density, pulse counts per site, downtime/adverse events by skin type) and a third tab for measurement plans (HF ultrasound dermal thickness, polarization imaging for erythema, TEWL recovery curves).
Here are the key studies supporting the combination of microneedling + electroporation (MN + EP), with direct links to each source:
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The Combination of Microneedles with Electroporation and Sonophoresis to Enhance Hydrophilic Macromolecule Skin Penetration (Petchsangsai et al., 2014)
• Link: The combination of microneedles with electroporation and sonophoresis to enhance hydrophilic macromolecule skin penetration - PubMed 
• Full text: https://www.jstage.jst.go.jp/article/bpb/37/8/37_b14-00321/_html/-char/en 
• Summary: In vitro using porcine skin, compared MN alone, EP alone, SN alone, and combinations (MN+EP, MN+SN, EP+SN, MN+EP+SN). They found MN+EP+SN had the greatest cumulative permeation; MN+EP also outperformed single modalities. 
• Key parameters: MN insertion force ~10 N for 2 min; EP using square-wave pulses at 50–300 V, duration 1 ms, 99 pulses.  -
Microneedle Electroporation for Intralesional Administration of Corticosteroid Treatment of Keloid Scar (Karina et al., 2023)
• Link: Microneedle Electroporation for Intralesional Administration of Corticosteroid Treatment of Keloid Scar - PMC 
• Alternative view: https://medicaljournalssweden.se/actadv/article/view/13402/39680 
• Summary: A clinical case (n=1) where microneedle electroporation was used to deliver triamcinolone intradermally into a keloid. Authors state that MN+EP “can yield an even better result in skin permeation”. 
• Note: While not a cosmetic aging study, this shows feasibility of MN+EP for dermal delivery in humans. -
Iontophoresis and Electroporation‑Assisted Microneedles: Advancements and Therapeutic Potentials in Transdermal Drug Delivery (Abbasi & Heath, 2024)
• Link: Iontophoresis and electroporation-assisted microneedles: advancements and therapeutic potentials in transdermal drug delivery | Drug Delivery and Translational Research 
• Summary: Review article covering MN + EP (and iontophoresis) systems broadly — mechanism, parameter logic, therapeutic potential (vaccines, drugs, dermatology). Strong mechanistic support for combining MN + EP.
• While not a specific cosmetic protocol, highly relevant for your interest in combining these modalities for enhanced delivery.
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Here’s the short version of “what people actually do” when they combine microneedling (MN) with dermo-electroporation (DEP/EP), plus the best-documented depths, sequencing, and pulse ranges.
Main clinical/bench protocols
1) Integrated device: MN + EP in one pass (most common in clinics)
How it’s done (per operator manual):
- Cleanse → (optional) topical anesthetic (~20 min) → apply active/serum to skin → run EPN handpiece (needling + electroporation simultaneously) → cool/soothe → sunscreen.Depths & passes (face): cheeks/nasolabial 1.0 mm, other facial areas 0.5 mm, 2–3 passes; avoid prohibited zones; typical every ~3 weeks. Scalp: needling-only 1.0 mm; MN+EP 0.5 mm, 2–3 passes. Device offers 0–2.0 mm and 5 EP “levels.”
Takeaway: This protocol places the serum on first, then the device performs needling and electroporation together (no separate second machine). Depth = 0.5–1.0 mm for most face work, with EP “intensity” set on the device (no public voltages).
2) Sequential, two-step: MN first → EP after (bench and some clinic flows)
How it’s done (bench model with explicit parameters):
- MN pretreatment creates microchannels (9-needle array, ~1.0 mm exposed length, 4 mm spacing).
- Then EP via the MN array acting as the electrode; in the study they varied pulse voltage (reported across a range) and showed MN→EP increased macromolecule permeation vs either alone; MN→EP→sonophoresis was best of all.
Takeaway: If you’re running two separate boxes, a documented sequence is MN → EP (and optionally ultrasound last). This is in-vitro porcine skin but it’s the best source with concrete sequencing and shows the combo outperforms single modalities.
3) Post-procedure DEP as an add-on (marketing/clinic guidance)
How it’s done: Perform your invasive step (MN, RF-MN, laser), then run DEP immediately post-treatment to “expedite recovery” and drive actives while the barrier is most permeable. (This is vendor guidance, not RCT-level evidence.)
Takeaway: Same-session MN → DEP is the intended flow in these materials.
4) Microneedle electroporation for drug delivery in lesions (clinical niche)
Example: Keloid treated with microneedle electroporation delivering triamcinolone intradermally; improvement reported (case report). Shows clinical feasibility of MN+EP for targeted drug delivery, but not a rejuvenation RCT.
Parameter ranges for EP (what’s actually published)
- Field strength matters: Reviews and modeling papers place reversible skin EP roughly in the few-hundred V/cm range; >~1200 V/cm risks irreversible EP. Pulse duration (µs–ms), number of pulses, and shape also govern effect.
- MN-assisted EP (reviews): Combining MN with EP (or iontophoresis) boosts delivery across drugs/biologics; specifics vary by device, but the short high-voltage bursts paradigm dominates.
Practical translation: If your device exposes “levels” rather than volts, stay with manufacturer guidance (as in EPN). If you’re using research-grade EP, typical targets are on the order of 10^2–10^3 V/cm with micro- to millisecond pulses and finite pulse counts; start conservative and titrate for endpoint/safety.
Depths, sequencing, and timing — what to copy in practice
- Face (integrated MN+EP devices): 0.5–1.0 mm, 2–3 passes, serum applied before running the handpiece; device applies EP concurrently. 3-week spacing is a common manufacturer cycle.
- Two-box workflow (separate MN + separate EP): MN first → EP second, in the same session; if using ultrasound, add it after EP (that exact order produced the highest permeation in vitro: MN → EP → SN).
- Post-procedure add-on: MN (or laser/RF) → DEP immediately after to drive actives and “speed recovery” (vendor claim).
- Scalp (from EPN guide): MN-only 1.0 mm, or MN+EP 0.5 mm, 2–3 passes; weekly to biweekly initially.
Links to sources
- EPN operator manual (depths, order of steps, passes): https://prpmed.de/img/epn/EPN%20Manual%201601-EN.pdf
- Petchsangsai 2014 (MN→EP sequencing; MN→EP→SN best): PubMed: The combination of microneedles with electroporation and sonophoresis to enhance hydrophilic macromolecule skin penetration - PubMed ; Full text: https://www.jstage.jst.go.jp/article/bpb/advpub/0/advpub_b14-00321/_html/-char/en ; PDF: https://www.jstage.jst.go.jp/article/bpb/advpub/0/advpub_b14-00321/_pdf/-char/en
- Keloid case report (microneedle electroporation delivery of triamcinolone): Microneedle Electroporation for Intralesional Administration of Corticosteroid Treatment of Keloid Scar - PMC (Acta Derm-Venereol)
- DEP vendor positioning (post-invasive add-on): https://depmedical.com/post-invasive-treatment/ ; Mattioli Engineering DEP page: https://www.mattioliengineering.com/version_eu/catalogo.php?cat=1&prod=91&sott_catt=23
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EP parameter reviews/guidance:
- Abbasi & Heath 2024/2025 review (EP/IP-assisted microneedles): PubMed Iontophoresis and electroporation-assisted microneedles: advancements and therapeutic potentials in transdermal drug delivery - PubMed ; Springer Iontophoresis and electroporation-assisted microneedles: advancements and therapeutic potentials in transdermal drug delivery | Drug Delivery and Translational Research
- Ita 2016 review (EP fundamentals & parameters): Perspectives on Transdermal Electroporation - PMC
- 2024 skin EP review excerpt on reversible vs irreversible fields: (paywalled summary) Skin electroporation for transdermal drug... : Journal of Controlled Release
- EPN device Q&A / clinic explainer (context): https://lynton.co.uk/wp-content/uploads/2021/12/EPN-Pen-QA.pdf ; Microneedling And The Power Of Electroporation Technology · Lynton Clinic
If you want, I can convert this into a one-page protocol card (face vs scalp, single-device vs two-box flows, plus a parameter “sandbox” for EP) and a data-collection checklist (TEWL, dermal ultrasound thickness, polarization imaging, erythema scores) so you can run clean A/Bs.
Tried DEP today and was pleased with the results - skin is visibly tighter, some fine lines are gone after 10 min session. It’s easy to use, especially on neck. No pain sensation or any post-treatment sensation besides some tightening (like skin shrank a bit).
So you ordered and received a device? I am assuming you didn’t go to a commercial service or use other members device.
Yes I ordered it and received today. It’s gen 3 (no syringe).
Please update us as you use it more, how it compares to your regular mesotherapy approach.
• Mesotherapy delivers immediate wrinkle reduction in a single session. Results are often dramatic and visible right away.
• DEP does not erase wrinkles instantly. It visibly hydrates and plumps the skin, but wrinkle reduction likely requires multiple sessions—if achievable at all. DEP may be more effective on younger skin.
• Mesotherapy takes 1–2 hours per session and demands precision, focus, and technical skill. It’s labor-intensive and not easily self-administered, especially on areas like the neck or chest.
• DEP is fast and user-friendly. It’s easy to apply even on hard-to-reach areas.
• Mesotherapy imo is best for targeted, intensive rejuvenation.
• DEP could be used between meso sessions.
• I see it as complementary to mesotherapy—not a replacement.
Yeah, that’s probably what I meant when I described it as feeling a bit “numb.”
In my case it stuck around for about a week or so after I did DEP.
My tightening sensation lasted a few hours only. In the morning I did not see or feel any skin improvements, so I guess I’m back to my mesotherapy. Will apply it by micro injections to target areas and will use the remaining cocktail for DEP application to distribute it evenly.
What cocktail did you use with it?
HA, Ergothioneine serum with Panthenol and Centella Asiatica. Will also try diluted Radiesse in couple days.
How much will you dilute the Radiesse do you think? What ratio?
I’ll try 1:2