Dr. Steve Weiner: “FINALLY…A Radiofrequency (RF) Skin Tightening Device that Makes Sense. Infini by Lutronic.” Includes an overview of the RF skin tightening industry.

Before and after one treatment with the Infini.  After is 8 weeks after the treatment.

Before and after one treatment with the Infini. After is 8 weeks after the treatment.

Infini treatment of the forehead

Infini treatment of forehead lines. After (right) is 8 weeks after one treatment.

Infini RF skin tightening of face

Infini RF treatment of face and neck. After (right) is 6 weeks after 1 treatment. Show improvement in jowls, jawline, upper eyelids, and cheeks wrinkles.

Infini treatment for neck and lower face wrinkles.

Infini treatment for neck and lower face wrinkles.

15 hours after Infini Treatment

15 hours after having the Infini Treatment, ready for work

3 hours after Infini Treatment, she had already gone to yoga

3 hours after Infini Treatment, she had already gone to yoga


Dr. Weiner’s White Paper on Infini (more medical terms and more detailed than blog)

Dr. Weiner explains why Coagulation is so important in tightening skin

Radiofrequency use in medical treatments has over a 70 year history.  It has been used for multiple applications but the most exciting innovations recently have been in skin tightening.  Thermage in 2002 was the first to market a device which was FDA approved to tighten skin and improve wrinkles.  Since then, there have been a least a dozen devices come to market with similar technology including:  Exilis, Venus Freeze, Pelleve, Viora Reaction, 3Deep RF, Accent XL, eMatrix, eTwo, TriPolar RF, ReFirme, Sublime, Fractora, Evolastin, and most recently Infini.  The “knock” on most of these devices has been:

  • The results are variable – most patients get minimal or no results
  • Multiple treatments (6 or more) are often needed with touch ups with some of the devices

This blog will help the reader understand how RF devices tighten skin, the problem with most RF devices (why they mostly don’t work), and why the Infini by Lutronic is a game changer in this group. Research has shown that heating the dermis to a certain temperature will cause collagen stimulation and contraction.  By heating to 40-45 degrees Celsius, enough heat is created to cause the body to try to repair the area by laying down new collagen.  Higher temperatures, in the 65 degree range, will denature collagen and cause contraction.  Obviously this requires more energy but this equates to more visible results.  Here’s the problem with all cutaneous devices (Exilis, Venus Freeze, Pelleve, Viora Reaction, 3Deep RF, Accent XL, eMatrix, eTwo, TriPolar RF, ReFirme, Sublime):  It is very difficult to heat the dermis to a temperature that is effective and still maintain safe temperatures for the skin surface.  If the surface were to reach the 40-45 degree area, it would burn.  So, these device’s solution has been to try to cool the surface while pumping in energy to the deeper layers.  This becomes a very difficult and unpredictable task.  The devices rely on the tissues to carry the energy to the right level.  Differences in skin thickness, hydration and the composition of collagen and fat can lead to placement of the energy at unknown or variable depths.  If the energy is placed too deep, you can get fat necrosis, as what was occurring with the early Thermage device, and if placed too superficial, the skin can burn or get hyperpigmentation.  Also, if you don’t actually reach the critical temperatures, you will get no stimulation of collagen.  Multiple treatments are the norm for several of these devices because getting collagen stimulation is very difficult with the one treatment.  The bottom line is that


Skin surface is cooled and RF energy is pumped through the skin surface to heat dermis is UNPREDICTABLE manner

During Thermage, the skin surface is cooled and then RF energy is pumped through the skin surface to heat the dermis in an UNPREDICTABLE manner

Infini vs Other RF Devices

Infini vs Other RF Devices

Ever since Fraxel was approved in 2005, the concept of treating areas fractionally has been the desired treatment modality for most devices.  By treating only a fraction of the tissue, you can have more safety, more comfort, yet still get fairly similar results than treating the entire area.  This concept has been borne out mainly with lasers in the arena of fractional laser resurfacing.  Now comes another “knock” for the majority of RF devices:  Almost all of the devices use a bulk heating method and not a fractional heating, so the risk, downtime, and discomfort are high.  By keeping surrounding tissues untreated (fractionally) as with the Infini, you get faster healing, less pain, and much less risk. So how can we get more predictability with RF?  Penetrate the skin to the level you would like to heat with microneedles and bypass the superficial layer that must stay cool and untreated.  You can heat the deeper tissues to a much higher level with this technique, leading to greater collagen remodeling, collagen contraction, and stimulation.  As a secondary benefit, the actual penetration with microneedles has been shown to mechanically stimulate fibroblasts to produce collagen.

Precise fractional controlled thermal injury of the Infini

Precise fractional controlled thermal injury of the Infini, vs monopolar and bipolar RF, vs ablative laser

There currently are many popular treatments based solely on microneedling (Vampire Microneedling).  By creating an opening in the skin with the needles, topical therapeutics can be applied at the conclusion of the treatment which will get to levels much deeper than when typically applied to the surface of the skin.  These can include:  growth factors (rejuvenation), Vitamin C (for collagen), hydroquinones (for pigment), Retin A (rejuvenation and acne).  Going deeper into the skin allows for some treatment opportunities which haven’t been/or poorly been addressed in the past with RF devices:  Acne treatment (attacking the sebaceous glands), acne or other scarring (particularly darker skin types), and sweating (attacking the sweat glands). There are 3 devices on the market which use this microneedling concept:

  1. Evolastin
  2. Fractora
  3. Infini

Evolastin:  Uses 32g needles in depths which are between 1-2mm.  The needles enter the skin in a tangential manner, so the exact depth is hard to predict.  The energy transmits between paired needles, so the heating in fractional and localized.  The major problem is that the patient requires tumescent anesthesia (infiltrating lidocaine mixed with saline) into the area being treated.  This adds additional time, discomfort, and risk.  Another concern is that this solution actually changes the tissue characteristics, so the treatment becomes less predictable – maybe more or less effective in different areas or maybe safety concerns in certain areas.

Evolastin has tangential needle placement and large caliber needles

Evolastin has tangential needle placement and large caliber needles

Fractora:  Uses needles which have a fixed depth of 1mm.  The energy is transmitted through the needles and circles back to the electrode sitting of the surface of the skin.  The surface probe has a sensor to monitor the skin temperature so as to maintain it within safe parameters.  This is truly NOT fractional because the energy is dispersed in the areas between the needle tips and the skin surface.  Here we go again with unpredictable traveling of the energy through the tissues and bulk heating.  Concerns for safety and discomfort come to mind.

Fractora electrodes are not insulated and treatment is not fractional.

Fractora electrodes are not insulated and treatment is not fractional.

Infini:  Uses needles which are 200 microns (small).  Has variable depth of penetration from 0.5mm to 3.5mm so in the same treatment, several different levels of the dermis can be treated PREDICTABLY.  Also, some parts of the face have different thicknesses of dermis, so the variable depth allows for treatment of the entire face.  A depth of 3.5mm is much deeper than the other 2 needle devices.  The energy is transmitted between the needles which results in true fractional RF ablation in the dermal tissue.  The energy only travels a very small distance so the discomfort is minimized.  (The more distance the energy travels through tissue, the more pain is felt.)  The surface tissue is safe because the needles are at a level that won’t transmit energy to the epidermis.  The treatment time is fairly quick:  full face treatments take about 30 minutes, as do the neck procedures.  For optimal results, it can take 2-3 treatments and full results take the standard 4-6 months to fully achieve (when the collagen remodeling is complete.)

Infini showing the microneedles causing a small precise fractional dermal injury at multiple levels

Infini showing the microneedles causing a small precise fractional dermal injury at multiple levelsinfini_5

The wide spectrum of indications of the Infini are:

  • Improving superficial fine lines and wrinkles of the face, eyes, neck
  • Improving the elasticity of aged and solar damage “thin” skin
  • Treating scars of all types but particularly acne scars.  It has a great advantage over laser for darker skin types.  Infini might turn out to be the “go to” device for scars over the Fraxel Dual 1550 because of deeper treatment levels (3.5mm vs 1.8mm of the Fraxel) and without the pigmentation risks.
  • Tightening loose skin on all parts of the body including:  arms, chest, knees, abdomen.  There are no limitations as to where the skin can treated on the body.
  • Potentially a treatment for acne and hyperhidrosis
  • No exclusion of patients based on skin type with no risk of hyperpigmentation.
  • Downtime is limited to only about 2 days of sunburn like sensation and slight redness

When comparing to the Ulthera, the differences are:

  • Ulthera is more for lifting than for the superficial lines and wrinkles
  • Ulthera is only used on the face and neck at the present time
  • Ulthera is still being evaluated for acne scars
  • Ulthera can be used in conjunction with Infini for even greater tightening and lifting then just Infini or Ulthera alone
  • Ulthera results in 15,000 coagulation points with a treatment, Infini is over 50,000
  • Ulthera depths are below the dermis for the most part where tissue tightening is not very effective.

To summarize, RF skin tightening has over a 10 year history which has been fraught with several different technical hurdles:  unpredictable results, discomfort, and safety concerns.  Using microneedling RF, we can get the energy down to the level needed with more accuracy and more safety.  Infini seems to have the right combination of the transmission of energy through their needle tips as well as having variable depths to be the ideal RF Skin Tightener at the present time.  It also has a broad list of indications including acne scars, skin tightening on the body, and improving the fine lines and wrinkles of facial skin.

Dr. Steve Weiner is a Facial Plastic Surgeon who “laid down his scalpel” in 2005 and concentrates solely on non invasive and minimally invasive cosmetic procedures at The Aesthetic Clinique.  He is one of the first 15 adopters of the Infini in the United States.  His website is http://www.theclinique.net .  Call for a consultation:  850.622.1214

This link is from a European round table discussion about Lutronic Infini and Spectra (both at The Aesthetic Clinique).  Infini discussion starts on page 7.  http://digital.miinews.com/publication/?i=174629

Blog: https://stevenfweinermd.wordpress.com/

YouTube: http://www.youtube.com/user/StevenFWeinerFacial


  1. The before and afters at lutronic.com look amazing. Is it possible to use the Infini for the breast area- for lift?

    • Ulthera is probably a better choice

      • Thank you 🙂

  2. Kim maddern

    Can you use infini for the under eye area? if so how close to the eye can you go? Do you need to use corneal shields?

    • The under eye area is a great place to do the Infini. I pull the lid down and treat most of the lid. I only treat skin that has underlying bone and don’t use corneal shields. Because of the mechanism of action, whereby the handpiece presses down repeatedly on the skin, I don’t feel comfortable treating the skin overlying the globe itself.

  3. jo

    Hi, I had a cut on my face 3 weeks ago that left a depressed scar. The scar is about 1 cm, the edges feel a little hard and there is some redness left on it. How soon can I do the Infini RF?
    Please advise. Thank you very much.

  4. Diane Steinhilber

    Can Infini RF be done on the neck if one has benign thyroid nodules and currently no thyroid disease? Thanks.

    • Yes. No problem at all, even with thyroid disease.

    • Sam

      Doctor: Do you know if the Infini procedure might help with festoons sitting on the cheek bone below the eye? Any ideas on how to get rid of or minimize festoons?

      • Festoons are tough. We are working on protocols for them with Infini but haven’t made headway yet. No other treatments seem to be good at the present either.

  5. afs

    I had three scarlet rf I see very little improvement, my skin is asian wheatish. Now the Dr. says , I should get revlite. I am confused. should i get revlite or continue scarlet rf? I don’t have infini option.

    • I can’t help you without face to face evaluation. Scarlet RF is inferior to Infini, the needles are not insulated.

      • Daria

        Hi, is Infini good for hands for thin wrinkled skin?

      • It needs to be done in combination with fillers.

  6. corrri@gmx.de

    I have some radiesse filler in the jawline. Can I also do an infiny treatment or is it a contraindication?

  7. Roya

    where is your office and how much each session will cost me ?

  8. Mary

    Hello, I had Infini done on my breasts for stretch marks 4 days ago. The area is still very red and irritated and there are still little red needle holes. Everything I have read online states that this treatment has a very fast recover time (2 days), so I’m nervous. I just hope that the treatment does not leave scars. Have you ever seen scars as a result of Infini? Do you see a longer recover time for patients with fair skin and in different areas of the body (will the breasts take longer to heal?) I am hopeful that my expectations were just not set appropriately by my doctor (had he said 2 weeks recover then I would not be so concerned at this time but he told me 2 days). Thanks.

    • Off the face treatments take longer to recover. Redness can last up to a week I would say. Never have seen scarring. No worries.

  9. kay

    Have you used this treatment on afro/black skin care? Would this be effective on old stretch marks?

    • Dark/Black skin is no problem. Stretch marks – some improve, some don’t.

  10. Mary

    Hello, me again. It’s been two weeks today and I still have redness all over and I can see little raised marks of where the needles went in. I’m am starting to really worry that the marks will never go away. It looks so much worse than before I had the treatment. I’m guessing you have not seen a recovery take this long, but just thought I would see if you have ever seen anything like this or have any advice. Thanks.

    • I’ve never seen any long term issues. Faster improvement can be found if vbeam or Excel V is now used.

  11. Kelley Loftis

    What is the cost of a lower face and neck procedure with lutronic infini ?

    • Our lower face charge is $1200 and neck is $950

  12. cat

    i have some superficial acne scaring and have had 4 treatments with etwo – with minium results – I have followed treatment with meso needling (using dermapen) and have seen great improvements in my overall skin . I have small amount of pigmentation and wish to further improve my skin texture and scaring but having trouble deciding betweek infini or revlite – can you assist me in my decision? I am worried about post pigmentation as i am fair olive complexion and have quiet reactive skin (meaning i am sensitive skin type, prone to redness/scar easily; acne -prone- congested skin in t-zone, and have basically combination skin )

  13. Natalie

    Hi, you seem to be quite the expert on this procedure and I would really appreciate your opinion. I had one INFINI treatment 48h ago and I am still experiencing significant swelling. I am particularly concerned about the swelling right under my eye.
    My dermatologist recommended icing and Biogel but I read on your website that icing would counter the benefits of the procedure. Any advice?
    Beside the swelling I am also very read and I am showing yellow crusts everywhere. Is this normal? I feel like my dermatologist was not very gentle…
    I can send pictures if you have time to look.
    Again, I would really appreciate your second opinion as I am very concerned.

    • I would see you doctor in person. Yellow crusts and swelling in not normal. Concerned about possible infection.

  14. Natalie

    Thanks for your quick reply!
    I did go back to see her a few hours ago but she assured me it was normal, to keep being patient and wait a week.
    Should I go see my primary doctor at this point?

  15. cat

    i have had 4 treatments with etwo (RF Treatments) I also have had 6 dermapen treatments and 2 subscissions – and noticed great improvements. I am considering this Infini treatment or Revlite or PRP after 6 month rest period – Mainly to improve scars better ( 1 box scar and 1 slightly raised scar) skin texture ( pores and milia) and skin colour ( a few hyperpigmented spots chin ; a few vasular on nose and a few dark spots around cheek area)

    a few physicians have given me different recommendations – one said etwo, another fraxel (1927) or fraxel 1540, Alma XL Harmony, PRP, Revlite and then Infini. what treatment do you think would be the best benefit?

    • For scars-Infini is better than all listed. Pigment is Qswitched Laser (revlite) or Fraxel 1927. For vascular, Excel V or VBeam. All can be done on same day. Deeper scars can be filled with Bellafill. PRP I do but only in combo therapy usually.

  16. I had Infiniti lutonic treatment 48 hours ago and my whole face has broken out with small white pust pimples is this normal?

    • It happens Topical clinda mucin or oral Minocin helps. If you are acne prone this happens. I put a coating of clinda gel after each case and it’s no longer a problem. Also if procedure was not done sterile, this can happen.

  17. Samantha

    Hi Dr. I had a co2 laser done 3 times on a scar and it left some hypopimentation, what procedure would you recommend that could make this less noticeable? Also I’m doing some microneedling w/prp treatments.

    • Hypopigmentation is tough to treat. Consider adding Latisse on top of microneedling. There have been reports this works to bring back pigment.

  18. Peter

    Hello Doctor, I have an option of doing 3 intracel treatments or 3 infini RF treatments. Which would you recommend? What device brings more superior results? Thank you!!

    • Intracel looks similar to Infini. It is not approved in the US so I don’t have experience with it.

  19. Sarah

    Thanks Dr. Weiner for all the great info!! I really want to try the Infini laser, however I had a few rounds of Silikon 1000 micro droplets injected into my scars a few years ago. Have you used this laser on someone that has had this done? Or have you heard of anyone having this done without a problem? I have had many micro laser peels with the Sciton laser over my Silikon with no reaction, but the Infini is obviously much deeper, I wonder if it would be ok?

    • I probably wouldn’t do it. Risk is to cause a reaction to the silicon and possible granulomas. Too much risk for me.

  20. John

    Hello Doctor, thank you for the great information. I have a couple of questions which I hope you answer:
    How long after an intense Infini treatment can I go back to using tretinoin?
    Also, is it normal to have deeper scars turn into very shallow boxcar scars a couple of months after an Infini treatment?

    • Go back on Retin A immediately. Scars which are deep will gradually become more shallow.

  21. Sandra Snabl

    Is Infini the best treatment for a linear not keloid facial scar?

  22. Elisa

    Hi Doctor
    I read in one of your other posts you were testing Infini on knees and other body parts, did you have any conclusions on this?
    I’m researching a number of crepey knee treatments at the moment, from what I’ve read thermage seems inconsistent, elixis has some good but also some appalling reviews, ultherapy has inconsistent reviews too and those that I’ve found are more for fat loss. Thermi RF seems positive but isn’t yet available in Australia, and what you’re saying about Infini seems positive too. Any thoughts?
    Thanks very much!

    • It works in some. I’ve seen volume added (Sculptra) in some videos too. Don’t think there is downside. Must limit expectations.

      • Elisa

        Another thing for me to research, thanks 🙂

  23. Aicha

    Hi Dr, very interesting comment you made about scarlet not having insulated needles. How so are insulated needles more beneficial? I don’t think infini is an option where I am at the moment, however there is a dermatologist offering something very similar called “vivace’. It also entails microneedling with rf. How would you rate it in contrast to infini, specifically for acne scars? And would the needles be insulated? Looking forward to your response!

    • Vivace is a very cheap imitation of Infini. It has insulated needles. I have looked at it with a critical eye. The needles are motor driven, which is slow and not as reliable. Even though wattage is high (max), I believe the joules the Infini gives is much higher. There is more redness, more discomfort, and fewer treatments needed with the Infini. Vivace says 6 treatments. MOST IMPORTANTLY, INFINI HAS MULTIPLE BEFORE AND AFTER PHOTOS WITH ACNE SCARS. I HAVEN’T SEEN ANY (FROM THE STATES) OF VIVACE ACNE SCAR PHOTOS. ALTHOUGH KIA CAN MAKE A CAR THAT LOOKS LIKE MERCEDES, ITS NOT THE SAME. I believe the Infini will give better results. The whole point of article centers around insulated needles and their benefits. Uninsulated will cause potential for pigment and scarring issues and the only way around that is to minimize the energy, thus reducing efficacy.

  24. Noel


    How does Infini compare with EndyMed Intensif? What is the different between the two? Thank you for this thread…very informative!

    • There is misleading content about Intensif on the web. The Intensif has noninsulated needles which means that there are risks of pigmentation issues (particularly in darker skin), more wound care, and scarring risks. Intensif is not more robust. It can’t be. If it were, it would cause too much epidermal damage. The energy from Infini is placed deeply, so more energy can be placed. The Infini’s energy capability is actually greater than the skin can tolerate. So it is not the Infini’s power that is the limiting factor. The Intensif is riding on the coattails of the Infini. I haven’t seen many before or afters from Intensif. The Infini has many highly respected docs using it. The leaders in the field.

  25. E

    Hi Dr, any more info about whether Intracel is similar to Infini? I live in Europe and I can’t find Infini anywhere.. Intracel seems much more popular. Would very much appreciate your opinion.


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  4. Ultherapy – Non Invasive skin tightening with no rivals | stevenfweinermd
  5. Rejuvenation of the Eyes – Completely Nonsurgically | stevenfweinermd
  6. Fraxel Dual Question Answered by Dr. Steven Weiner, Destin, Florida. | stevenfweinermd
  7. Acne Scar questions answered by Dr. Steve Weiner, Facial Plastic Surgeon | stevenfweinermd
  8. Coagulation is Necessary For Maximum Skin Tightening, Science and Experience Prove This – INFINI | stevenfweinermd
  9. Off Label Use of the Infini – A Plethora of Potential Treatment Options – Scars, Sweat, Cellulite, Acne, Fat, Breast Lift, Knees, Tattoos | stevenfweinermd
  10. Fractional Coagulation is in, Bulk Heating is out for Skin Tightening | stevenfweinermd
  11. Amazing Things That Can Be Done (By the Experts) With Dermal Fillers | stevenfweinermd
  12. Dr. Steven Weiner of The Aesthetic Clinique, Shows That Excessive Sweating, Hyperhidrosis, Can Be Treated With The Infini Radiofrequency, a First for The United States | NewsTribune.Asia
  13. INFINI before and after
  14. Most Frequently Asked Questions about Infini, RF Skin Tightening from Lutronic | stevenfweinermd
  15. State of the Art in Acne Scar Treatment – 2015 | stevenfweinermd
  16. Comparing Infini to Ulthera and Why Infini’s Technology is Superior for Laxity, Wrinkles, and Acne Scars | stevenfweinermd
  17. The Top 5 Procedures for a Youthful Appearance | stevenfweinermd

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