Originally a roller with many needles was used by a plastic surgeon from South Africa to cause thousands of tiny punctures of varying depths to stimulate collagen in the skin. This in turn was refine using an erbium laser to create these tiny punctures and burned holes in the skin at various depths while leaving the surface intact. This was based on the fact that erbium was a water seeking laser and the skin with its dead cells had very little water content. The rest of Fraxel® history is still been written. Now with the introduction of a band that uses multiple needles in a vertical in and out direction to cause the same punctures as the roller but at 90 degrees causing less injury to the superficial layers but equal stimulation of collagen in the deeper layers of the skin. Because the superficial Berrier is broken, however, tissue stimulating substances such as autologous platelet gel, vitamin C, collagen stimulants can be applied topically and actually pushed through with the needles. The her early results mimic those of the Fraxel® series and especially useful in fine lines in the perioral area and the periocular area as well as scar revisions for which needling has been known to work for years. One of the nice things about the Dermapen is that the needle depth is adjustable and does can be used by aesthetician up to 1 mm and by physicians, physicians assistants, and nurse practitioners on the 1 mm to 2.5 mm setting. Dr Pena, a plastic surgeon in Naples, Florida is exited to offer this both in the operating room and in his La Piel Spa just in time for Christmas.