Ellacor is a device that is FDA cleared for cosmetic skin tightening in the mid- and lower face. The device’s tiny needles remove micro-cores of skin that are full thickness. The skin shrinks as the micro-cored sites heal, tightening the skin by about 8% per treatment. During the procedure, the removed micro-cores of skin are suctioned into a sterile filter. When treating a patient for purely cosmetic purposes, the micro-cores are thrown away. However, these micro-cores are in essence super tiny (full thickness) skin grafts. Full thickness skin grafts are commonly used for soft tissue reconstruction, including skin cancer reconstruction. Dr. Desrosiers has pioneered the use of Ellacor-harvested microcores for cosmetic skin cancer reconstruction.
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Skin cancer requiring surgical resection is first removed via MOHs or standard surgical excision. MOHs surgery involves removing rings of skin around the skin cancer with a scalpel. Each ring is examined under a microscope to see if the tissue is healthy or diseased. Standard surgical excision uses a scalpel to cut out the cancer plus a standardized margin of normal skin. Both procedures leave a hole that must be reconstructed.
Reconstruction can leave large scars on the face. This is because large holes commonly require flap surgery to close the hole. Flap surgery involves moving adjacent tissue into the hole where the cancer was removed. Moving tissue often requires more cuts to be made – i.e., to free up tissue and move it into the hole.
Alternatively, a full-thickness skin graft can be used in some cases. A full-thickness skin graft requires cutting out tissue from another part of the body and transferring it to the face. This leaves a noticeable scar at the harvest site. Also, the quality and color of the skin are often different on different body parts. This means the graft may standout when placed on the face.
Ellacor is intended to be a scarless facial skin tightening procedure. Dr. Desrosiers has adapted Ellacor for skin cancer reconstruction because Ellacor harvests micro-cores from the face. These micro-core are approximately 400 microns wide (0.4 millimeters), Thus, instead of using one large graft from a different body site, Dr. Desrosiers has used thousands of Ellacor micro-core grafts. The Ellacor approach is designed to leave no additional scars on the face nor on any other body part. Additionally, because the micro-cores are taken from the face, the color and texture of the reconstructed site tends to blend better than traditional skin grafting.
The first stage of healing on the donor site (commonly, the face) typically takes only 2-3 days with our innovative use of liquid amnion. Some patients do have social downtime of up to 5 days before they can start wearing makeup. The first stage on wound healing on the recipient site (i.e. the skin cancer reconstruction site) typically takes an average of 14-21 days. However, some people take longer to heal. Persons on medications for autoimmune diseases and people who are immune compromised commonly take longer to heal.
Second, increased sun exposure elevates the risk of developing skin cancer and this risk may rise further in people that have had a prior diagnosis of skin cancer. Thus, appropriately protecting skin from the sun is important.
First, sun damage to new skin impedes optimal cosmetic appearance.
During the first stage of healing, Dr. Desrosiers places a secondary non-stick dressing over the skin graft site (e.g., Adaptic or Mepitel). Sometimes this secondary dressing is secured with Dermabond (glue) and steri-strips. Less often, temporary sutures may be required depending on the anatomic location of the reconstruction. After the secondary dressing is removed (typically 14-21 days), Dr. Desrosiers may use activated collagen gel to assist in wound healing or may proceed to Perfection X (advanced silicone scar gel; www.perfection-X.com). Once a dressing is no longer needed to prevent infection, it’s important to keep the area out of the sun. This is for two reasons:
Starting the day after the procedure, most patients begin washing the donor area with a gentle cleanser – e.g., washing the face with Cetaphil or Johnson & Johnson Baby Shampoo – once or twice a day. Following cleansing, a petrolatum jelly – e.g. Aquafor or Vasoline – is often applied over the treated area. This routine can last 3–7 days for the average healthy patient.
Most patients can return to work the day following the procedure. However, if Ellacor is performed on the face, it will be noticeable that a procedure was performed. Patients wishing to keep their procedure private may want to take additional time off work. Social downtime may be 5 days because this is the soonest that patients can start wearing makeup.
No. Ellacor is FDA-cleared for the treatment of moderate to severe wrinkles on the face. It is a cosmetic procedure that Dr. Desrosiers has adapted to help some patients avoid major skin cancer reconstruction surgery.
Ellacor is a cosmetic procedure and is self-pay.
Each treatment typically costs $3,000 – $6,000. The exact price depends on the size, the number of handpieces used, and whether other products are used (e.g., amnion). This does not include cancer resection which is a separate procedure.
Cancer resection is done first. Margins must be confirmed as “clean” to proceed to reconstruction. “Clean margins” means that the removed tissue had an adequate border of healthy cells around the diseased cells. Depending on a few factors, final pathology can be completed on the day of surgery or take a few days. This means that eligible patients can have reconstruction performed as little as one day later. During this time, most patients will have a temporary dressing placed on the resection site.
Ellacor is an in-office procedure. You can learn about the general protocol for how we numb the area and increase patient comfort in this YouTube video.
Yes, you will need to have a friend or family member drive you home. This is because most patients are given an oral sedative to reduce procedural anxiety and increase patient comfort.
Ellacor was studied in skin colors I-IV and is designed to be scarless. However, this might not be true in persons who have a history of developing dark, thick, and/or keloid-type scars. Research shows that darker skin tones have a greater chance of forming hyperchromic, thick, and/or keloid-type scars relative to other skin types. Therefore, while darker skin tone by itself is not an absolute contraindication, using Ellacor on people with deeper skin tones carries with it certain risks compared to similarly situated persons with lighter skin tones.
You will need to make an appointment for a consultation with the doctor. Please let us know if you need an expedited appointment – we do our best to work in cancer patients as soon as possible. Some of the factors that the doctor will discuss with you are the size of the anticipated resection, the type of skin cancer, and your medical history, including any past history of keloids or hypertrophic scarring.
In West Palm Beach, we are located just off the island. If you are out of town, we also offer telehealth appointments.
In Miami, Coral Gables, Coconut Grove, Aventura, Brickell, Edgewater, Midtown, Kendall, and South Miami, and Pinecrest are short drive away. Also, the South Miami Metro stop is across the street from our Miami office.
Our offices are located in Miami and Palm Beach.
Interested in cosmetic skin cancer reconstruction? Call us for a consult 305-403-2922 or visit our contact page.
Providing Cosmetic, Reconstructive, & Craniofacial Plastic Surgery in Miami and West Palm Beach.