Is Fractora Firm A Good Substitute For A Facelift?

Q: Dr. Eppley, I am really interested in a new procedure called “Fractora Firm”. Do you do that and if not, do you know anyone in the state of IN or surrounding states who does? This would be much less costly than a facelift.

A: The procedure or technology behind the Fractora Firm is radiofrequency (RF) energy driven into the skin to creatre a mild firming or skin toning effect. What has caught your attention to it most likely is its recent appearance on the Dr. Oz show. The use of RF and a variety of other energies (ultrasound, pulsed light, galvanic electrical currents, etc) to try and improve sagging skin is not new. Over the past decade there have been a slew of these energy-driven technologies, all of whom capture media attention as they have become available for patient use. They capture the public’s attention due to the widespread concern of sagging facial tissues as one ages and the hope that it will avoid the need for a ‘facelift’.

It would be a far reach to consider it or any similar technology as a replacement or substitute for what a surgical facelift does. Calling it a non-surgical facelift is a marketing concept not a clinical reality of what actually happens. It is better to think of it as a skin toning or firming method not a sagging tissue lifting method. As a result it is best used on younger patients with early signs of facial aging such as a small amount of jowling or just a little loose neck skin. It is not for someone who has more moderate to advanced facial aging with really evident jowls and a neck wattle. Its success, therefore, is highly dependent on proper patient selection.

What is also not evident on the Dr. Oz show is that Factora Firm requires multiple treatments, usually 4 to 6 treatments spaced a week or so apart, to get the optimal facial toning effect. Thus the cost is not really $300 (as stated on the show and the website) but $1200 to $1800 for a series of treatments. Whether that cost and the effect that it creates is a better value than a ‘facelift’ would depend on the degree of facial aging that one has. If one does not really need a facelift then it is a good treatment that may be worth the cost. If one really needs a surgical facelift, then such treatments are a poor value.

In my practice, we offer a similar non-surgical treatment to Factora Firma using RF energy (Exilis) combined with more superficial fractional laser resurfacing for skin tightening and a mild amount of facial skin lifting. This combined treatment is superior because it combines heating up the underside of the skin (dermis) with a more superficial (epidermis) treatment. This produces the combined effect of skin tightening AND wrinkle reduction. For some patients a more intense single treatment is fine while others may be best served by lighter treatments done in a series.

I would be happy to review any pictures of you to determine whether you are best served by considering a non-surgical RF skin tightening approach or whether something more surgical is more appropriate. While every patient wants to avoid surgery and their associated costs and recovery, most patients would also like to avoid throwing their money away on a treatment concept that never had a chance to achieve what they wanted.

Dr. Barry Eppley

Indianapolis, Indiana