As long-time facial aesthetic specialists, the surgeons and skin experts at Buckingham Center regularly evaluate emerging non-surgical modalities, striking a balance between safety, efficacy, and longevity. In this post, we’ll explain how microneedling (especially combined with radiofrequency) can help reduce early aging signs, and when it can (and can’t) substitute for BOTOX® or dermal fillers.
What Is Microneedling?
Microneedling, also known as percutaneous collagen induction therapy, uses arrays of ultra-fine needles to create controlled micro-injuries in the skin. These microchannels activate the body’s natural healing response, prompting the dermis to rejuvenate itself from within (Recent Advances in Microneedling-Assisted Cosmetic Applications).
This process:
- Stimulates fibroblast activity, initiating cellular repair
- Increases collagen and elastin synthesis, strengthening the skin’s structural foundation
- Encourages dermal remodeling, resulting in smoother, firmer, and more resilient skin
When radiofrequency (RF) energy is introduced through advanced microneedling devices, controlled thermal energy reaches deeper layers of the dermis. This added heat further enhances collagen remodeling and tightening without significant surface damage (Radiofrequency Microneedling: Technology, Devices, and Indications in the Modern Plastic Surgery Practice).
These effects happen gradually. After each session, the dermis continues renewing for weeks or even months as new extracellular matrix is laid down.
What the Clinical Evidence Shows
- A recent systematic review of microneedling for facial rejuvenation found that 83% of patients reported satisfaction, with low rates of side effects (SpringerLink)
- In the neck (a challenging area), a study with monthly microneedling treatments showed significant wrinkle improvement and high patient satisfaction scores (~87.5%) at 90 days (OUP Academic)
- RF-augmented microneedling has demonstrated enhanced tightening compared to microneedling alone in some small studies (Wiley Online Library)
What Microneedling Cannot Do
Even RF Microneedling has its limitations. For example:
- Volume loss (midface fat descent, nasolabial creases) cannot be fully addressed by microneedling alone
- Dynamic lines driven by muscle movement (like forehead creases) respond better to Botox or neuromodulators
- Issues like deep skin laxity or significant sagging are often beyond non-surgical devices
- Variable results depending on device quality, depth selection, technique, patient skin type, and consistency of treatment
In other words, microneedling can delay the use of injectables but may not fully replace them in some instances.
How We Use Microneedling at Buckingham Center
At Buckingham, we bring a surgical-level mindset to non-surgical treatments. Here’s how we incorporate RF microneedling:
Careful candidate selection
- We evaluate medical history, skin health, and aesthetic goals
- Patients with early signs of aging, good collagen reserve, and mild laxity are the ideal candidates
Customized protocol
- We choose needle depths and RF energy personalized to each facial zone
- For example, higher depth in cheeks or gentler near delicate periorbital skin
- We also take a series approach, stretching treatment over multiple sessions (typically 3–5, spaced 4–6 weeks), which yields cumulative benefits
Combination strategies
- When needed, we layer with complementary modalities—like BBL or resurfacing—to target pigmentation or vascular concerns
Realistic expectations & planning
- We map out when (or if) injectables may complement microneedling later as aging progresses
- These suggestions are always made with the patient’s comfort, integrity, and natural result at the top of mind
Should You Try Microneedling Instead of Fillers or BOTOX®? Let’s Find Out.
If you’re noticing faint lines, mild sagging, or changes in skin texture and would prefer to wait before considering injectables, microneedling—especially RF microneedling—can be a scientifically backed and lower-risk option. While it won’t provide the same lifting effects as fillers or the muscle-relaxing benefits of Botox, it can help soften the appearance of aging and buy you some time. To determine if microneedling is suitable for your skin condition and goals, please contact us to schedule a consultation today.
