Dr. Desmond Fernandes

[mustardseed46]

I read this post from the doctor:

"If you don't bleed, you won't get the results and that is the part that most people aren't willing to do!" pointed out Dr Desmond Fernandes, who has written numerous papers for medical publications on various plastic surgery procedures, methods of improved penetration and skin needling for collagen stimulation. Naturally, when the blood vessel is pricked, it causes bleeding and this releases the platelet cells inside the blood that carry a mechanism to clot up blood vessels. At the same time, it carries out a lot of growth factors.

My question is how do I know who is right as to the need to bleed or not? I read on this forum that it is not necessary to achieve results. Thank you

[geijutsu12]

I agree I had the same question in mind, so far I did 2 dermarolling session one when I used only a 1.5 dermaroller where I had minimul bleeding, and the other I used a combo of a 1.5 roller and a 1.5 pen and I bled a lot, I think I'll go with the bleeding suggestion, having seen his results, I have to say that they are very dramatic.

He uses a 3mm roller to guarantee bleeding:

https://http://www.sciencedirect.com/science/article/pii/S0738081X07001903
https://http://www.sciencedirect.com/science/article/pii/S030541790900566X

[mustardseed46]

OMG!!! From looking at all that blood, I can't imagine doing that at home. Since I'm a guy with thicker skin maybe I will try the 2.0mm roller on my face.

[geijutsu12]

Yeah, it's pretty brutal, I bled nearly as much as the pictures in this paper, it's day 5 now and things are almost back to normal, I say almost because there is still some very faint reddening mainly on my cheeks, because I have extremely sensitive skin.

[cesamaddictaol]

Would it be smart then to do some suctioning directly after beedling so that we can get the benefit of the blood?

[SarahVaughter]

I have great respect for Dr. Fernandes and I am not sure whether microneedling was already widely used by the time he made the "no serious bleeding, no results" statement but current reality does not support that statement. Almost nobody rolls at home with a 3 mm dermaroller, causing so much blood as seen on the attached photo (a 3 mm roller is used), and still there are thousands of "homerollers" reporting great results and backing it up with before-and-after pictures. It may perhaps take a little longer with needles shorter than 3 mm, but in return for a little extra patience you get the peace of mind that there is a no danger for infection, which with 3 mm is starting to become a small risk factor.

Just one example concerning success with a 1 mm roller size:

https://http://forums.owndoc.com/dermarolling-microneedling/improvement-after-dermarolling/

Dr. Fernandes rolls his patients (or at least some of them) with a 3 mm dermaroller but he also promotes and uses on himself shorter sizes – such as 1 mm and others.
 
Skin thickness varies depending where on the body it is (the thinnest skin is on the eyelids, the thickest is on the foot soles) and it also varies individually but it is on average between 1 - 2 mm thick.

A dermastamp penetrates deeper than a dermarolloller of the same needle length (unless you push the roller into the skin with very much force).

A 1.5 mm dermastamp normally penetrates about as deep as a 2 mm dermaroller.

A 2 mm dermastamp will normally penetrate slightly less than a 3 mm dermaroller.

If you read the size guide in our dermarolling instructions, you will notice that I tend to recommend a combination of a dermaroller and a dermastamp (or a single needle) for scars and wrinkles – a dermaroller for an overall roll and a dermastamp to locally target individual scars and wrinkles.

In case the scars or wrinkles do not respond to microneedling, it is a good idea trying longer needles (or/and applying Tretinoin right after microneedling or/and adding the suction method etc. but rolling large areas at home with a 3 mm size dermaroller and inducing such bleeding as seen on the photo carries more risks, is painful and it is not really necessary from our experience.

I have gotten many emails from people (living in various countries) who underwent a professional dermrolling treatment by plastic surgeons and the needle length used was usually a 1.5, maximum 2 mm.

I have answered a similar question here:

https://http://forums.owndoc.com/dermarolling-microneedling/the-more-blood-the-better-when-dermarolling/

Related forum postings:

https://http://forums.owndoc.com/dermarolling-microneedling/do-we-need-to-get-that-bloody-to-get-results/

BTW a dermaroller was already patented in 1975 by Dr.Pistor:

https://http://www.owndoc.com/pdf/dermaroller-patent.pdf

[~dreamer~]

Sarah, would I be able to suction my scars ON the same day which I dermaroll/stamp?

I remember in my thread you gave advice about suctioning scars on the 2nd or 3rd day, but I experimented and the earliest I suctioned my scars was 24hours after I dermarolled, and my skin was fine (apart from expected bruising).

Would suctioning on the day be fine too? Or have you read in medical literature that this is detrimental to healing skin.

[mustardseed46]

Thanks Sarah, that was very informative. I did find the following link from the doctor also very useful in my confusion. I do have to question the part where he say's it takes 40 minutes to roll the face with a 1.0mm and that the patient comes back every week or two for six sessions using a 1.0mm roller.

https://http://www.dermaconcepts.com/documents/0000/0103/Articles_-_Environ_-_Micro_Needling.pdf

[SarahVaughter]

@Dreamer:

You will find the answer in the first forum posting of this thread:

https://http://forums.owndoc.com/dermarolling-microneedling/subcision-suction-method-for-acne-scars

Suctioning right after needling/stamping would be OK too but you may get more bruises.

If subcision was done (do not do this yourself), suctioning the same day is not a good idea.