Aging is an environment-modulated process, that is genetically predisposed, comprising of biological and cellular processes leading to the decline in intrinsic physiological activity of the cells. Aging in the skin is characterized by thinning of epidermis, reduced dermal cellularity, loss of subcutaneous tissue, thicker and fragmented elastin fibers, decreased epidermal turnover and increased bone resorption.
Collagen is a major structural protein in the extracellular matrix that provides the skin its integral structure and strength. After the age of 30, a reduction in the total collagen and increase in enzymatic collagen fragmentation leads to the formation of wrinkles.
Neo-collagenesis is a process of formation of new collagen in response to inflammation through the process of wound-repair. The process of collagen remodeling leads to an increase in procollagen and matrix metalloproteinases which helps minimizing facial lines and wrinkles. 1,2
Over the past decade, the popularity of anti-aging medicine has soared, with the introduction of countless treatments and products intended to achieve facial rejuvenation. Among several, only a few approved soft tissue fillers are able to provoke neo-collagenesis. Newer studies have established that the use of combined Hyaluronic Acid (HA) chains of different lengths and molecular weights, synergistically, improves tissue regeneration and repair.
PROFHILO
Profhilo is a revolutionary product, acknowledged as a bio-remodeler in the industry. Being rich in HA content, it is known to stimulate collagen receptors and induce long-lasting neo-collagenesis. Profhilo uses bio-compatible, stabilized, thermally cross-linked HA, designed to remodel multilayer skin tissue. Profhilo uses a highly innovative NAHYCO technology resulting in stabilised hybrid co-operative complexes of high molecular weight-HA and low molecular weight-HA. The benefits of these complexes help protect HA from enzymatic degradation which makes it ideal for long-lasting treatment of skin laxity.3
What to expect: As a physician, injecting Profhilo is a very simple procedure. Under topical anesthetic cream, using the bolus technique, slowly inject the product into the deep dermis. A standardized technique is recommended that involves using five injection points on each side of the face. Two treatment sessions, 1 month apart, gives substantial longer lasting results. Overall skin laxity is improved and a hydrated plump skin is expected. Patients must avoid cardio exercises, steam, and strenuous activity for 24-48 hours after the procedure.
Advantages:
- High biocompatibility
- Low inflammatory response
- Remodels skin tissue
- Improves skin hydration and quality
- BDDE free
- Skin lifting and volumetric effect
- Increased production of endogenous HA
- Good patient compliance
ELLANSÉ
Ellansé is a patented, hybrid dermal filler with a unique combination of 30% Polycaprolactone (PCL) microspheres smoothly dispersed in 70% Carboxymethyl Cellulose (CMC) gel carrier base. This dual action filler restores facial volume and stimulates neo-collagenesis over a course of few months. The longevity of Ellansé depends on the number of molecules in the microspheres. The CMC is rapidly reabsorbed and gives immediate lifting whereas the PCL microspheres triggers collagen production. This process of bio stimulation is long lasting, between 1-4 years, depending on the product used (Ellansé S, M, L, and E). For until now, only Ellansé S & Ellansé M are approved by the regulatory board.4
What to expect: Injecting Ellansé is a quick lunch hour procedure. It is administered under topical anesthetic cream with minimal to no discomfort to patients. Depending on the area treated, different injection techniques can be used. Instant smooth skin and reduction in fine lines and wrinkles is expected. Patients must avoid cardio exercises, steam, and strenuous activity for 24-48 hours after the procedure.
Advantages:
- Longer lasting than HA filler
- No delayed hypersensitivity reactions
- Does not migrate
- More cost effective than HA filler
NEAUVIA STIMULATE
Neauvia Stimulate is a scaffolding filler used to treat volume loss especially in older patients requiring intense restoration. It is a unique combination of Hyaluronic Acid and Calcium hydroxyapatite (CaHA) that has advanced tissue integration for more natural looking results. Its distinct engineering provides a medium to high extrusion force which in turn promotes skin homeostasis and neo-collagenesis. 5
What to expect: Under topical anesthetic cream, depending on the area treated, Neauvia Stimulate can be gently injected in bolus or with a cannula. An immediate lifting of the mid face is expected along with collagen remodelling over a few months. The results last over 12 months in most patients. Patients must avoid cardio exercises, steam, and strenuous activity for 24-48 hours after the procedure.
Advantages:
- Intense volume enhancement
- Longer Lasting
- Great tissue integration
- Natural results
- Firm Product
- Reversible
References:
- Carruthers JD, Carruthers JA, Humphrey S. Fillers and neocollagenesis. Dermatol Surg. 2014 Dec;40 Suppl 12:S134-6. doi: 10.1097/DSS.0000000000000227. PMID: 25417563.
- Farage MA, Miller KW, Elsner P, Maibach HI. Characteristics of the Aging Skin. Adv Wound Care (New Rochelle). 2013;2(1):5-10. doi:10.1089/wound.2011.0356
- https://ha-derma.co.uk/products/profhilo/
- https://www.sinclair.com/
- https://www.neauvia.com/product/stimulate/