Plastic surgeon Gaurav Bharti, MD, FACS, and Cytrellis Biosystems CEO Denise Dajles, D.Eng, share clinical and strategic insights into how ellacor is changing the way skin laxity and facial wrinkles are treated without surgery or thermal energy.
As patient demand shifts toward less invasive procedures with minimal downtime, plastic surgeons are exploring technologies that bridge the gap between surgical outcomes and non-surgical approaches. One device gaining traction is ellacor with Micro-Coring, the first and only FDA-cleared system that removes micro-cores of skin without the use of thermal energy or scalpels. Designed to treat moderate to severe wrinkles and improve skin laxity, ellacor offers a novel solution for patients who aren’t ready for—or no longer want—traditional surgery.
Board-certified plastic surgeon Gaurav Bharti, MD, FACS, co-founder of H/K/B Cosmetic Surgery with multiple locations across the Southeast, shares how ellacor has integrated into his surgical and non-surgical offerings. From facial rejuvenation to addressing post-weight-loss skin laxity, Bharti offers firsthand insight into where this device fits in today’s aesthetic toolkit.
To understand the company’s strategic direction and evolving indications, we also spoke with Denise Dajles, D.Eng, president and CEO of Cytrellis Biosystems. With two decades of experience in medical device innovation and commercialization, Dajles discusses how Cytrellis is positioning ellacor to meet rising patient expectations.
First up, our conversation with Bharti.
Plastic Surgery Practice: What motivated you to bring ellacor with Micro-Coring into your practice, and how has it changed your approach to treating skin laxity and wrinkles?
Gaurav Bharti, MD, FACS: The real reason that we were intrigued and brought this technology into our practice is that there is an unmet need. There are so many devices and things in our space that were designed to improve skin quality and alleviate laxity, but they all just truly under-delivered. They sometimes didn’t do anything, and were often painful for the patients as well. When we heard of this device and saw some of the emerging results, we felt it was fulfilling an unmet need. So, we brought it in, and it has thrived in our practice. It has been truly unbelievably successful and has worked so well. We are a heavy, aesthetic surgical practice, and it has worked beautifully for people who are not ready for surgery, for people who have had surgery, and for people in between. It’s been great, and we are continuing to find innovative ways to use it.
PSP: Compared to energy-based or surgical solutions, how does ellacor perform in terms of patient recovery, outcomes, and satisfaction?
Bharti: Compared to other technologies, the most amazing thing about this procedure is that we see a result with every patient. We are seeing incremental improvement every time. That is a real change because there were so many devices and treatments that we would do, and you wouldn’t really see a result, or you would wonder if there was going to be a result. With this one, we’re always getting a result. Obviously, sequential treatments lead to an even better result, but that has been the real reason why we’ve been so excited about the treatment. Also, the innovation of the new generation device has made it more predictable, and the results have taken a step up as well.
PSP: Have you noticed a shift in patient demand due to GLP-1 medications, and how are you using ellacor to address concerns like rapid weight loss–related facial laxity?
Bharti: Yes, there has definitely been a shift and increase in demand for solutions to combat skin laxity and volume loss that occur with massive weight loss, specifically GLP-1s. ellacor fits beautifully into that treatment algorithm along with other techniques, whether those techniques are surgical or volume addition. Employing these and utilizing these treatments early on has been valuable, especially once you start seeing the signs of laxity emerging. We have been using them on the face, which is the indication. But, there are other things that are being done outside of the face that have been really remarkable. I think that it is a really important tool that everybody needs to have access to, because it’s novel. Additionally, it is less traumatic than these energy platforms because there’s no energy transmitted, which is a unique aspect of this treatment.
PSP: ellacor 2.0 introduced technical refinements and faster procedure times—what has the learning curve been like, and how has it affected your clinical workflow?
Bharti: The learning curve was quick. The advances of ellacor 2.0 were extremely well received. Treatments are quicker, coring is more efficient, and results are enhanced. So, I’m happy that the company has done that. We have great expectations that Cytrellis will continue to innovate and bring us newer, more innovative handpieces and cartridges to continue giving even more unbelievable results.
PSP: From your experience, which patient demographics or clinical indications respond best to ellacor, and how do you set expectations during consultation?
Bharti: There are numerous patients who can benefit from this technology. The truth is that their demographics vary depending on what’s going on with a patient. Someone as early as their 30s can potentially benefit from this. On the other hand, patients could be much older, like in their 60s or 70s. The truth is, it depends on the patient. Each patient is unique and will have different needs for the treatment of skin laxity, as well as potential skin textural changes. ellacor works in a very effective fashion.
Setting expectations is the key, so patient selection is everything. You need to have realistic expectations, as this is not a replacement for surgery. This is not a replacement for volume enhancement, but it is a procedural adjunct that can be used alongside those. So again, patient selection is everything. If someone needs a facelift, they still need a facelift. But you can potentially “kick the can” for a couple of years if that’s what you want. Or, you can supercharge someone who’s already had a facelift. For perioral rhytids, it has been quite remarkable. People who had these deep-set wrinkles around their mouth can do an ellacor treatment and get a real change that can sometimes rival a fully ablative laser resurfacing. I think that is the real deal, and that’s exciting.
While Bharti offers a firsthand look at how ellacor performs in clinical practice, the device’s evolution has also been shaped by ongoing feedback from the field. That input has informed new design features, improved outcomes, and shorter recovery times with the launch of ellacor 2.0. To understand how those changes came about—and what’s next—we now turn to Dajles for a discussion of Cytrellis Biosystems development priorities, expanded indications for ellacor, and where ellacor fits in the shifting landscape of aesthetic medicine.
PSP: Since ellacor launched in 2022, what clinical or market feedback most influenced the development of ellacor 2.0?
Denise Dajles, D.Eng: Our top priority was ensuring consistent outcomes and the best experience for both providers and patients. We gathered feedback from over 250 accounts to learn what was working and best practices. Additionally, we sought input from providers on streamlining the procedure to ensure we could make it faster, easier, and more comfortable for the patient, leading to the most consistent and optimal outcomes with minimal downtime.
PSP: How do you see ellacor positioned in a landscape increasingly shaped by non-invasive solutions and patient demand for minimal downtime?
Dajles: ellacor is the next level beyond traditional minimally invasive procedures. This is a non-surgical procedure that yields results comparable to those of a surgical outcome. So, it is a procedure that takes you a step further from your typical lasers or microneedling by truly removing the skin. Other treatments target only some tightening by creating a thermal injury and stimulating collagen production through the healing of that thermal injury. ellacor is different. Analysis shows ellacor increases the expression of collagen-producing genes by up to 340%, improving collagen content in the skin. So, we achieve a tightening and rejuvenated look like other procedures, but we also remove the skin, which other procedures don’t do. With roughly 3 to 7 days of downtime, you can not only get a tighter look, but you can also effectively remove that extra skin that you previously had no option to remove without surgery.
PSP: With the growing popularity of GLP-1 drugs, how is Cytrellis responding to the evolving aesthetic needs, particularly around skin laxity without added volume?
Dajles: Aging through the natural aging process, as well as weight loss, causes skin laxity. However, it is multifactorial. You experience the loss of fat, muscle, and the extra skin that starts to sag, among other changes. So, it isn’t a one-size-fits-all approach. However, ellacor plays a key role in meeting the needs of that population by removing the extra, sagging skin that is often left behind. It serves as a great starting point that other procedures can complement. Once the skin is removed, you may choose to fill the volume you have lost with several options like fat grafting, fillers, or other solutions to replenish that lost volume. However, ellacor is the only non-surgical option to remove sagging skin that not only needs to be tightened but also removed.
PSP: You are pursuing expanded indications for ellacor, including full-body use. What are the clinical or regulatory hurdles you’re most focused on navigating right now?
Dajles: Our next indication is full skin resurfacing, which will allow for broader use of ellacor in various areas of the body. We have completed the clinical work that’s required for that indication. Additionally, as we look into what the future holds, we are exploring what practices are already doing off-label with ellacor that are yielding some really good results. Then, we will work with the agencies to get those additional indications. For example, we have an interest in a scarring indication. We know ellacor provides excellent results, not only with acne scars, but also with burn patient scars and some surgical scars. That’s an area we will be exploring in the future. Stretch marks and darker skin tones are other areas where we are seeing great results. We are collecting the clinical data and the required package to apply for the expansion of our indication.
PSP: As a CEO leading a medical aesthetics company, what trends are you watching most closely in terms of future device development and patient demand?
Dajles: We are seeing a few trends that we are tracking because, for us, it’s about providing patients with the options to look and feel their best and feel confident and empowered.
We are seeing a massive anti-aging trend. While we have observed it for some time in older patients, the trend is also evident in younger patients. As younger patients become increasingly interested in entering the anti-aging space, we want to emphasize the longevity and effectiveness of our treatment as a response to this growing trend. We want to emphasize that ellacor can age with you.
Another trend is the desire to look natural. Many people do not want to look like they have had work done. So, keeping skin looking natural, fresh, and rejuvenated as time passes is important to us. In addition to removing the skin, we have data that indicates a patient’s collagen can triple after only two ellacor treatments. This means that ellacor is not only removing sagging skin, but also renewing the skin in the area.
As a woman in this space, I prioritize choices. I want to give patients options to feel their best, but naturally. It’s about gaining confidence while maintaining your original self. So, we are working on how we can maximize the opportunities that ellacor brings to being your best self while looking like your natural self.
Another priority for us is being multimodal. We recognize that different technologies offer varying capabilities, so we are developing a multimodal option that targets different areas of the anatomy. We are the only system that can go all the way to the skin-fat junction. So, we can go deeper and provide truly long-lasting results. PSP
Opening Photo: ID 149664725 © Prostockstudio | Dreamstime.com; Bharti portrait: Gaurav Bharti, MD, FACS; Dajles headshot and product images: Cytrellis Biosystems.
