Lakes Dermatology/The Spa is the first office in Las Vegas to offer treatments by Invasix.
Dr. Rueckl has worked previously with the creators of Invasix who were with another laser company prior. Branching off and starting a new company, these developers saw places in the aesthetic market that needed advancements in technology, so they worked to created the Invasix platform to fill some of the holes in this field. They specifically asked Dr. Rueckl and his technicians to use this new technology, knowing we would be able to use it on a good caliber of patients. The Fractora technology is FDA-approved and the most versatile bipolar radio frequency treatment on the market. Fractora provides dramatic skin, acne scarring, and wrinkle improvement by fractionally ablating the skin and restructuring deeper tissue.
What is Fractora and what does it do?
Fractora is the most advanced fractional radio frequency (RF) treatment providing anti-aging improvements on skin tone and texture for a more radiant 
appearance through ablation and skin resurfacing. Ablative treatments do remove some skin, so they have more downtime than other non-ablative technologies like IPL and FotoFacial. For more information on the Fractora technology and a gallery of before/after photos, please visit www.invasix.com.
Fractora delivers radio frequency energy to the skin through an array of pins producing localized heat and small micro-lesion dots in the treatment area. The gentle heat generated by the Fractora pins in the sub-dermal tissue promotes collagen restructuring for skin rejuvenation and an improved appearance in the skin. The methodical scattering of micro-lesions allows the skin to heal faster than if the entire area was ablated. What this means is that the majority of repair is being done under the skin, maximizing your results, but the damage to the surface is more minimal, allowing you to heal faster and better than with traditional resurfacing machines like Fraxel and CO2 technologies. While our offices also still continue to offer Matrix RF treatments, Fractora is a more intense treatment, allowing us to treat deeper lines and scarring than with Matrix RF.
Because of Fractora’s unique system, the treatment can be done by either Dr. Rueckl, on very high settings, or our technicians at The Spa, on lower 
treatment settings. This dual-function allows patients to receive more intense results with a bit more downtime, or a series of treatments with much lower downtime, but more treatments needed for maximum results.
The Invasix machine has separate attachments for each modality of treatment being performed. The same handpiece is used for Fractora whether Dr. Rueckl or the technicians do the treatments, but different settings are used, as well as different treatment tips.
What areas are treated with Fractora?
Because the RF depth is variable, and different treatments tips (both is size and depth) can be used, treatments can be customized per-person more than any other fractional treatment on the market. 
Fractora can be used in areas that demonstrate fine or deep wrinkles, scars, or excessively discolored red and brown skin tone (many scattered red vessels). The most common areas of treatment are the lower eyelid, upper eyelid, smile lines, cheeks, mouth, and neck. While the full face and neck are often treated, it is also possible to treat smaller areas like cheeks and nose, where many people have localized acne scarring. Fractora treatments have also been done successfully on stetchmarks on the body.
Fractora can also be combined with other treatments including Firm (sometimes even used pre-treatment on the same day as Fractora), FotoFacial, Venus Freeze, and additional procedures done by Dr. Rueckl, to enhance the effects of the Fractora, if desired.
What is a Fractora treatment like?
The Fractora treatment will differ slightly depending upon whether you elect to have it done more aggressively by Dr. Rueckl, or more superficially by the technicians at The Spa. Before you begin Fractora treatments, you will discuss the procedure with Dr. Rueckl or one of the certified technicians, sign a consent, and take pre-treatment photos. Regardless of who is doing the treatment, prior to your treatment a topical numbing cream will be applied to the area being treated to reduce any associated discomfort. Many offices charge extra for topical anesthetics but we have always believed that your comfort should come first, so we include this at no charge for any procedures in our offices. The topical cream will be kept on longer than with other laser treatments, for about 30 minutes. If you are electing to have the procedure done at higher energies by Dr. Rueckl, he will numb you with lidocaine with epinephrine injections for your further comfort after the numbing gel.
Your technician or Dr. Rueckl will then look at your area(s) to be treated and may mark your skin if needed with a skin marker. The operator will then choose the appropriate Fractora tip to garner the best results for your specific skin issues. Unlike with other laser treatments, there is no conductive gel applied for Fractora treatments. This tip is applied directly onto the skin. However, a cold air chiller will be used at the same time as the Fractora passes are done. This allows the RF to travel deeper into the skin, as well as makes you more comfortable. The treatment tip will be applied to the skin and a pulse of RF will pulse into the skin and target the appropriate areas. Multiple passes will be done to each area for the best results. Many offices simply do a single pass with their machines, but our operators have been trained to do multiple passes and pulses. This allows the skin to achieve better results, faster. A Fractora treatment will last between 45-120 minutes depending on whether Dr. Rueckl does the treatment (more time is required due to injections), as well as the size of the area(s) being treated. Regardless of who does your Fractora treatment, there should not be a significant amount of pain, but some areas may feel warm or even hot. This is the energy going in, which is a desired outcome. More sensitive and thin-skinned areas may also be a bit more sensitive (like the jawline or forehead) but your operator will adjust accordingly. Never should you feel so much pain that the procedure is intolerable.
After your treatment your operator will go over post-treatment protocols, as well as cover your treated area with Aquaphor. You will look red, swollen, and shiny when you leave.
What kind of results can I expect from a Fractora treatment?
When you leave, there will be redness and swelling of the treated zone. The redness and swelling will be more significant for treatments done by Dr. Rueckl, and you may have some additional bruising at the injection points too. You should follow the post-care instructions given to you, and keep the area very moist with Aquaphor, as advised. The swelling and redness will subside over the coming days, but you should expect that it can persist for up to a week (or more if you are prone to swelling), particularly on the higher settings. You should be able to put on makeup and cover most redness after a few days, but again this depends on your body’s healing.
You should have realistic expectations and remember that multiple sessions may be necessary. Fractora results will continue to develop over the coming months, as new collagen is created. Each session will further ablate and resurface the skin, resulting in a reduction of wrinkles, skin laxity, textural irregularities, and scarring. Follow-up treatments may be needed in the future to maintain results and are offered at a discounted rate after the initial treatment package is completed. Remember that with Fractora we are changing your skin and your collagen, so while results can take a month or so to start appearing, they will continue to build over time, and the results won’t just disappear overnight after a year or so. Your skin will be refreshed and renewed, and then will start to age again naturally, which is why many patients will elect maintenance treatments in the coming years.
If you are having the treatments done by the technicians, you will have a treatment every 3-4 weeks, for 3 treatments. If you are having a treatment by Dr. Rueckl and wish to have more than one done at the higher parameters, you will wait longer between treatments.
Fractora for Giuliana Rancic with Dr. Raj Kanodia from InMode Aesthetic Solutions on Vimeo.
How much does a Fractora treatment cost?
Fractora treatment prices are customized per-person and need to be quoted in the office by Dr. Rueckl or a technician. Prices will range from $750-$2500 depending on the size of the area and who is doing it.
Our prices are based upon our technicians’ and Dr. Rueckl’s high level of experience, the care you receive, our value-added benefits, the direct supervision of a Board-certified dermatologist, and the consumable costs for our treatments.
