Microneedling has now come of age and is considered as its own unique and specific skincare treatment category. In this exclusive interview with Aesthetic Insider™ Radio, Dr. Asher Milgrom of AMA Skincare, discusses how they incorporate the advanced Innopen from Clinical Resolution Laboratory, Inc .into their aesthetic treatment protocols for wrinkles, scars, cellulite and Pigment correction. To learn more about AMA Skincare, visit www.amaskincare.com. To learn more about Clinical Resolution Laboratories, visit www.skincarecrl.com
                                                                                
Tell us how AMA Skincare began?
Dr. Pien, who is also my wife, has a background in emergency-medicine and pediatric trauma and I come from a MD, PhD program that specialized in medical sciences. Eventually, we became interested in integrated medicine which later evolved into developing a practice that had an expertise in aesthetic and regenerative procedures. Since we opened AMA Skincare over twenty years ago, we have completed over eighty-five thousand diverse procedures in our office.
How frequently do you use microneedling in your practice?
We work with over twenty-five unique lasers and as our practice has developed, microneedling came to our attention and we use it quite frequently for the numerous procedures we perform. Microneedling is an extremely effective tool that we have at our disposal, and as a practice that specializes in developing integrated procedures, we are married to the results not to the technology. We continuously participate in various research projects and investigation and review boards for the FDA as new technologies emerge.
How is microneedling an effective aesthetic treatment?
Microneedling is quite efficient for stimulating the collagen. We induce micro columns of damage into the dermis and the needling stimulates and turns on the regeneration of the collagen. It is also an effective treatment for acne and surgical scars that are keloid because it powerfully stimulates and remodels the scar tissue. Additionally, microneedling can be used to infuse serums, stem cells, growth factors, and physiological regulating medicine into the tissue. We have several patients that seek our help after surgeries because they have concerns regarding the unsightly appearance of surgical scars and microneedling is an effective modality that we use for remodeling those scars, and is often much less expensive than laser treatments.
Tell us a patient story where Clinical Resolution Laboratory and  the InnoPen has been significant in treating the patient.
We recently treated a young lady who was bitten in the face by a dog. She got a little too close to the dog’s personal space. Consequently, the dog bite did not produce a clean cut, which is expected, thus the scars result was quite obvious and microneedling was a tremendous treatment in that case.
Does microneedling technology help cellulite?
Cellulite is tough because it is the issue of excess fat coupled with how the subcutaneous fat layer in women is fractured. We have been exploring the best technologies for years and have not used microneedling a lot in that exploration as of yet.
Do you think microneedling would be helpful with stretch marks?
Absolutely. We have been working on a research project for over a year that is addressing stretch marks from all different sources including: pregnancy, obesity, and muscle building. In our research project, we have been utilizing stem cell research on stretch marks and microneedling has become a critical part of that because we need to infuse the stem cells into the stretch mark at various points in order to generate new skin, which reforms and remodels the stretch marks.
What role does microneedling play regarding skin rejuvenation for patients?
We specialize in combining several modalities to stimulate natural physiological course and to rebuild a young, healthy, new, and beautiful complexion. Since we have a multitude of lasers, we use them in tandem with microneedling. Many patients want the microneedling over the entire face sometimes for an easy, quick, and extensive stimulation of tightening and rejuvenation, and that closes all the pores.
Is microneedling a technology that is easily accessible for practitioners to learn that want to incorporate it into their practice?
The practitioner would need the necessary coordination that is required to be applying this technology to a patient’s face. Typically, it takes about ten trials to learn the proper depths of the needle and different parts of the face. Also, the practitioner will have to be knowledgeable in the different types of skin on the face in order to use the correct depth of penetration and learn the expected and potential response of the skin as they are microneedling.
Tell us the benefits of the microneedling pen used with a closed tip stamping motion and can the patient feel the difference?
Patients can definitely feel the difference. The first microneedling devices were rollers, similar to a paint roller but with tiny needles and it would roll over someone’s skin and tear on the way in and on the way out, which was quite painful. Additionally, the damage caused by the tearing was unnecessary. It is important to create a balance between stimulating the collagen regeneration and stimulating scar tissue generation. Contrastingly, the InnoPen needles are on a rotating motor, they move quickly and move up and down perpendicular to the pen. It is similar to an acupuncture needle that is inserted directly into the skin in an up and down motion. The damage that is created is in the insertion to the skin, which is extremely precise and measured in its effect. It stimulates the kind of regeneration of collagen that will close the pores and tighten the upper layers of dermis and the papillary dermis. For ultimate patient comfort, a practitioner has to learn how to precisely utilize it around the face.
Is microneedling an effective choice for all skin types?
In regards to the stimulation of generating collagen it is effective for all skin types; however, there are certain skin types that are prone to post-inflammatory hyperpigmentation, which typically are Asian Hispanic, and Pakistani skin types. We proceed cautiously on patients if we are unsure of how their skin will react regarding hyperpigmentation. In this case, we test a small patch of skin and wait roughly three days to see if microneedling will be the right treatment for the patient and take precautions to avoid hyperpigmentation. Also, it is critical that a practitioner does not perform any microneedling on skin with an infection or active cystic acne.
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What are some safety aspects to consider with microneedling?
Practitioners need to fully understand how to set the pen for the correct depth given the thickness of skin, which changes based on which area of the face you are utilizing the microneedle. Additionally, if you use supplements or different formulations that you are infusing, you need to be certain that you are using the correct formulations.
What motivated you to choose Clinical Resolution’s InnoPen over the other designs available on the market?
We have tried them all. When new technologies emerge, manufacturers seek us out and ask if we will evaluate them, and we are involved in the investigational review board, IRV for the FDA, which gives us the opportunity to try several technologies and we report back to the FDA on the efficacy, safety, and reliability of the technology. It is a deliberate choice that we use InnoPen in our practice because it is an extremely reliable technology.
What would you recommend to the practitioner searching for the right device for their practice?
It is all about individual customization for each patient. It is important to assess the patient’s unique physiological landscape and match that assessment with the proper protocol, using the correct modalities, and tools. Microneedling is an effective tool, but I encourage competition amongst different devices and manufacturers, whichever tool is going to be most beneficial to the patient. You need to be clear in what your goals are for the patient, know what will be best for their physiological makeup and apply the right technology accordingly.
To learn more about AMA Skincare, visit www.amaskincare.com
To learn more about Clinical Resolution Lab, Inc. visit www.skincareCRL.com
To listen to Dr. Asher Milgrom’s full interview at Aesthetic Insider™ Radio,CLICK HERE!