Patient Guide: Fractora

Fractora is a fractional radiofrequency microneedling treatment, manufactured by InMode, that delivers RF energy directly into the dermis via insulated needles, creating controlled thermal injury that triggers significant collagen and elastin remodelling. It is a more intensive treatment than standard microneedling, with a correspondingly stronger result for skin laxity, deeper scarring and significant skin quality decline. Pricing is confirmed on the Fractora treatment page.

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What Fractora is

Fractora is a fractional RF microneedling device. Each of those three words describes a distinct aspect of how it works, and understanding them together explains why Fractora occupies a different clinical category from standard microneedling.

Microneedling: fine needles penetrate the skin to a set depth, creating micro-injuries that trigger the wound-healing cascade and collagen induction. This is the mechanical component, shared with the SkinPen device we use for standard microneedling at The London Road Clinic.

Radiofrequency: at the tip of each needle, RF energy is delivered into the dermis. This creates a zone of controlled thermal injury: the tissue is heated precisely enough to trigger a strong reparative response, including collagen contraction and new collagen synthesis, without damaging the surrounding tissue. This is the thermal component, unique to RF microneedling devices.

Fractional: the needles are arranged in a matrix pattern, so the energy is delivered in precise grid points rather than uniformly across the whole treatment area. The tissue between those points is left intact and acts as a reservoir for healing. This is what makes the treatment both effective and recoverable: the result is meaningful, but the surrounding untreated tissue supports a faster repair than if the whole surface were treated simultaneously.

The combination of mechanical and thermal injury produces a stronger collagen remodelling stimulus than mechanical injury alone, which is why Fractora is indicated for concerns where standard microneedling would produce more limited results.

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How the RF energy works

The needles used in Fractora are insulated along most of their length, with only the tips uninsulated. This is clinically important: it means the RF energy is delivered at the tip depth, in the dermis, rather than throughout the needle track. The epidermis above the needle is largely protected, which reduces the risk of post-inflammatory pigmentation and makes the treatment appropriate across a wider range of skin types than older, non-insulated RF devices.

Once the RF energy is delivered, three things happen in the dermis simultaneously:

1. Immediate collagen contraction. Heat causes the existing collagen fibres in the treatment zone to contract and tighten. This produces some visible tightening effect from the first session.
2. Inflammatory repair response. The controlled injury recruits growth factors and fibroblasts to the treatment site, initiating the same wound-healing cascade as standard microneedling but with greater intensity.
3. Remodelling over weeks to months. New collagen and elastin are produced as the repair progresses. The full structural benefit of this process develops over three to six months after each session.

Understanding how collagen and elastin function in skin structure helps contextualise why this remodelling process produces lasting change in skin quality and firmness.

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What Fractora can address

Skin laxity

This is Fractora’s primary clinical strength. The thermal component of RF microneedling contracts and remodels collagen in the dermis, improving laxity in the lower face, jaw line and neck more effectively than mechanical microneedling alone. For patients with early to moderate skin laxity who want a non-surgical option, Fractora produces meaningful improvement. The full landscape of laxity treatment options is in the skin laxity guide.

For advanced structural laxity with skin redundancy, the honest position is that Fractora has limits. Non-surgical treatments address skin quality and moderate laxity; significant anatomical change requires surgical assessment. This is stated clearly at consultation.

Acne scarring

Fractora’s combination of mechanical and thermal injury produces more aggressive scar remodelling than standard microneedling. It is particularly suited to patients with moderate to severe acne scarring, where the depth and density of the scarring benefit from the stronger thermal stimulus. The clinical detail on scar types and their responses is in the acne scarring guide.

Skin texture and quality

For patients with significant skin quality decline, rough texture, enlarged pores, or a combination of concerns that standard microneedling has only partially addressed, Fractora offers a step up in treatment intensity. The same concerns that microneedling treats can be addressed more aggressively with Fractora, in fewer sessions, with proportionally more recovery.

Fine lines and perioral area

The perioral area (around the mouth) is one of the harder regions to treat with energy-based devices because of proximity to the lip border. Fractora’s precise depth and energy delivery make it one of the more appropriate options for this anatomy, addressing the fine lines and crepey texture that develop here and that most injectables and surface treatments address only partially.

Neck and décolletage

Fractora is used at The London Road Clinic for neck treatment in patients with laxity and texture concerns. The neck presents thinner, less sebaceous skin than the face; treatment parameters are adjusted accordingly.

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How Fractora compares to microneedling and Forma

Patients frequently ask how Fractora relates to the other skin quality and tightening treatments available at The London Road Clinic. The microneedling patient guide includes a comparison table covering the key differences between SkinPen and Fractora. The summary relevant to clinical decision-making:

Fractora versus standard microneedling: Fractora adds a thermal injury component to the mechanical injury of microneedling. The result is stronger collagen remodelling, better suited to laxity and deeper scarring, but with more downtime (three to seven days rather than one to two). Standard microneedling is the better option for patients who want consistent skin quality improvement with minimal disruption to their schedule.

Fractora versus Forma: Forma is a surface RF treatment, also manufactured by InMode, that heats the dermis from outside the skin without needles. It is a gentler treatment: minimal downtime, comfortable, suitable as a maintenance protocol or for patients in the early stages of skin laxity. Fractora penetrates and delivers energy at depth; it is the more intensive of the two and suited to more significant concerns. The two treatments are complementary and often used in sequence within a programme: Forma for maintenance and gradual improvement, Fractora for the more intensive intervals.

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The treatment: what to expect

Consultation

A consultation with our team is the starting point. The appropriate energy settings, tip configuration, and number of sessions are determined based on clinical assessment of the concern, skin type, and Fitzpatrick classification. Fitzpatrick skin type is assessed carefully before Fractora: while the insulated needle design reduces epidermal heating compared to older RF devices, skin type assessment is standard and essential.

Read more about what to expect at a consultation at The London Road Clinic.

The appointment

A Fractora appointment takes approximately 60 to 90 minutes, including 30 to 45 minutes for topical anaesthetic cream. Adequate anaesthesia is standard before Fractora; the treatment without it would be significantly uncomfortable.

Once the skin is numbed, the Fractora handpiece is applied systematically across the treatment area. Patients typically describe a sensation of warmth and pressure rather than sharp pain during the procedure. The skin appears red and may show pinpoint marks at needle sites immediately after treatment.

Recovery

Recovery from Fractora is more involved than standard microneedling and should be planned for accordingly.

Timeframe	What to expect
Hours 1–6	Significant redness, warmth, swelling. The skin feels sensitive and tight.
Days 1–2	Redness persists. Swelling may peak at 24–48 hours, particularly around the eyes if the periorbital area has been treated.
Days 3–4	Redness begins to settle. Bronzed or dark appearance to the skin as microscopic crusts form at needle sites.
Days 4–7	Crusts shed naturally. Do not pick or rub. Skin beneath is pink and sensitive.
Week 2	Most patients look presentable. Residual pinkness may remain in some areas.
Weeks 4–8	Visible improvement in texture and laxity as remodelling progresses.
Months 2–4	Full remodelling benefit of each session develops.

During recovery:

• No strenuous exercise, saunas or steam rooms until redness has fully resolved.
• No active skincare (retinoids, acids, vitamin C) until skin has completely settled.
• Apply only clinic-recommended post-procedure products.
• SPF 50 applied every morning without exception. See the sun damage and SPF guide. UV exposure during the remodelling phase counteracts the result and significantly increases PIH risk.
• Do not pick, pull or force the shedding of the microcrusts at needle sites.

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Results: timeline and realistic expectations

What Fractora typically produces:

• Improved skin firmness and reduced laxity in the lower face, jaw line and neck, particularly where laxity is mild to moderate.
• Reduction in acne scar depth and improved skin texture in patients with moderate to severe scarring.
• Improved skin quality overall: reduced pore size, smoother texture, improved tone.
• Tightening of fine lines and perioral texture.

What Fractora does not produce:

• The result of a surgical procedure. Fractora addresses skin quality and moderate laxity; it cannot lift or restructure anatomy in the way a surgical facelift does.
• An immediate result visible at day one. The remodelling process takes months to complete.
• Permanent results without maintenance. Annual maintenance sessions are typically recommended once the primary course outcome is established.

A course of three to four sessions, four to six weeks apart, is standard. Results continue to develop for three to six months after the final session.

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Suitability

Generally suitable:

• Adults with early to moderate skin laxity in the lower face, jaw line or neck.
• Patients with moderate to severe acne scarring where standard microneedling has produced limited improvement.
• Patients seeking a more intensive single-treatment-per-interval approach with a planned recovery period.
• Fitzpatrick types I to IV with appropriate parameter adjustment. Fitzpatrick types V and VI require careful assessment and conservative parameters.

Not suitable or requires careful assessment:

Contraindication	Why
Pacemaker or implantable cardiac device	RF energy is contraindicated with pacemakers. Absolute contraindication.
Metal implants in the treatment area	RF energy near metal implants carries risk. Disclose at consultation.
Pregnancy and breastfeeding	Standard contraindication for all energy-based treatments.
Active skin infection, inflammation or open wounds in the treatment area	Treatment contraindicated until resolved.
History of keloid or hypertrophic scarring	The wound-healing response may produce excessive scar tissue in predisposed patients.
Isotretinoin (Roaccutane) within the past 12 months	Altered healing response; discuss timing at consultation.
Patients under 18	All cosmetic treatments at The London Road Clinic are for adults only, in line with UK age-restriction legislation introduced in October 2021.

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How Fractora fits with other treatments

Fractora and Forma: often used in combination within a programme. Forma provides ongoing maintenance RF tightening between more intensive Fractora sessions. The two treatments address the same tissue layer through different intensities and are clinically complementary.

Fractora and Profhilo: Fractora addresses structural collagen and laxity; Profhilo addresses skin quality and hydration. Combining them in a planned programme is logical where both components of the skin’s condition need addressing. They are not given on the same day; sequencing is agreed at consultation.

Fractora and chemical peels: for patients with acne scarring alongside post-inflammatory pigmentation, alternating Fractora sessions with appropriate chemical peels addresses the structural scarring and the pigmentation component respectively. See the chemical peels patient guide.

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