Bioremodelling Injectable Treatment

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Requires two sessions 4 weeks apart:

Cost:
$1200 (for 2 sessions) or $650 per session

Profhilo is one of the most talked-about injectable treatments in Europe. Named the “anti-wrinkle treatment of 2019”, Profhilo is a new treatment for rejuvenating skin hydration, elasticity, and quality. Like skin boosters and many other dermal fillers, the main ingredient is Hyaluronic Acid (HA). However, Profhilo has many exciting differences compared to other HA fillers such as Restylane and Juvederm. Profhilo is a new concept of anti-aging skin treatment developed by IBSA, a pharmaceutical company headquartered in Switzerland. It introduces a new category called ‘bio-remodeling’ into the broad spectrum of injectable fillers.

Profhilo can reverse signs of aging through elastin and collagen stimulation, promotion of wound healing, and recruitment of stem cells in fat tissue.

Due to its extensive spreadability (about 2cm radius), only ten injection points are required for the cheeks and lower face and a further 10 for the neck.

Volumizing filler injections, on the other hand, are more targeted. They are either introduced via direct injection or via a long blunt needle called a cannula into the area which needs the filler.

Effects of Profhilo Compared to Other Fillers

With traditional filler treatments such as Restylane and Juvederm, the inject gel stays in place and volumizes the area we want it. However, instead of filling the face in specific areas, Profhilo stimulates collagen and elastin production in the face. Profhilo works in the epidermis, dermis, and superficial fat compartments to restore aged tissue without volumization. The process is active rather than passive like in other skin booster treatments – it is a regenerative anti-aging treatment that reverses the aging process through bio remodeling of the skin.

Once injected, Profhilo quickly improves skin hydration and fine lines as hyaluronic acid is replaced in the skin. This effect is similar to skin boosters. Later on, skin tightening and improvements in elasticity are also seen and will continue for up to 12 weeks after the treatment. This is unique to profhilo and not other HA filler treatments.

What Profhilo cannot do

While Profilo offers a different way to treat aging skin, it is essential to note that it should not be considered a replacement or alternative to traditional dermal fillers. If the volume is needed, HA fillers are still required. Examples include filling up the depression under the eyes, cheeks, or temple and augmenting the nose or chin to better projection the mid-face area.

Because of this, Profhilo works beautifully and synergistically with traditional HA fillers. We first use fillers to replace volume, then follow up with two treatments of Profhilo (either in the same or a separate session) to improve skin texture and tighten skin. This way, we complete solving several problems associated with skin aging.

Profhilo – NOT a Skinbooster nor a Filler

Hyaluronic acid is a polysaccharide naturally present in the human body. Its primary function is to maintain tissue hydration. Hyaluronic acid’s moisture-binding characteristic is crucial in allowing the skin to hold onto water and retain moisture. The amount of hyaluronic acid in our skin declines as we age, explaining why older people generally have thinner, more crepey skin.

Skinboosters uses the principle of replacing lost hyaluronic acid in our skin to restore hydration and elasticity. The treatment involves tiny injections of a low viscosity HA filler, such as Restylane Vital or Vital Light, into the mid-layers of the skin.

On the other hand, dermal fillers such as Restylane, Juvederm are also made of hyaluronic acid. To ensure they are firmer and last longer, the HA molecules are modified by adding cross-linking agents – the most common being 1,4-Butanediol diglycidyl ether (BDDE).

Profhilo, although also made up of hyaluronic acid, is a very different treatment from either skin boosters or dermal fillers. It is used to improve the skin rather than add volume. However, the treatment process, effects, and technology differ significantly from traditional skin booster treatments. The heart of the therapy is a unique hyaluronic acid molecule called the Hybrid Cooperative Complex (HCC).

The patented NAHYCO process produces a new type of hyaluronic acid molecule – the Hybrid Cooperative Complex, found in Profhilo.

Profhilo – Hybrid Cooperative Complexes With Unique Actions

Profhilo contains the highest concentration of hyaluronic acid available today – 32mg/ml. (in comparison, both Juvederm Voluma and Restylane are comprised of 20mg/ml HA). The HA in Profilo is non both high molecular weight (H-HA) and low molecular weight (L-HA), and non-cross-linked. Through a proprietary process (NAHYCO® Hybrid Technology), the L-HA and H-HA chains in Profhilo interact to form a Hybrid Cooperative Complex (HCC) with unique rheological properties.

A very different type of hyaluronic acid molecule is created, which unique physical properties:

HIGH HA CONCENTRATION – Profhilo contains 32mg./ml of L-HA and 32mg/ml of H-HA, totaling 64mg in 2ml

EXTENSIVE SPREADABILITY – It has a Tan Delta (ratio bet viscous and elastic modulus) of 1.36, which enables it to spread all over the face once injected

Low viscosity: Profhilo has a low G value of 39. Hence it cannot be used to lift like other fillers.

NO BDDE or other cross-linking agents

LOW INFLAMMATORY RESPONSE – Due to its high cohesivity and excellent integration into our skin after being injected

GEL DURATION LONGER THAN OTHER non-cross-linked HA FILLERS – Profhilo survives in the skin for 30-45 days, the same duration as other low cross-linked hyaluronic acid fillers, before being degraded naturally by hyaluronidase in the skin. In contrast, other non-cross-linked HA fillers last only a day.

As a hyaluronic acid treatment, Profhilo hydrates the skin when injected, just like other skin-boosting treatments. However, the Hybrid Cooperative Complexes (HCC) go a step further. What is very exciting is that Profhilo also stimulates collagen and elastin in the skin, which explains its tightening and rejuvenating effects.

Profhilo has been shown to:

SUPPORT KERATINOCYTE VIABILITY AND PROMOTE WOUND HEALING in vitro.

STIMULATE SKIN CELLS (KERATINOCYTES AND FIBROBLASTS) TO PRODUCE COLLAGEN AND ELASTIN As a hybrid complex, Profhilo stimulates collagen and elastin up to 12 times more than L-HA or H-HA alone.

RECRUIT STEM SELLS IN ADIPOCYTES AND IMPROVES FAT TISSUE RENEWAL.

Keratinocytes-fibroblasts immunofluorescence pictures showing increased collagen production with Profhilo. Green: type I collagen, red: Cytoskeleton (Phalloidin). Diagram from Enis AGOLLI’s review paper.

Because the H-HA and L-HA are released slowed into the skin, they do not trigger an inflammatory response, making it biocompatible and low in inflammation. This is in contrast to other stimulators in the market, such as Ellanse and Sculptra, which work by inducing a low-grade inflammatory response in the body to stimulate new collagen.

In short, Profhilo works in the epidermis, dermis, and superficial fat compartments to restore aged tissue without volumization. The process is active rather than passive like in other skin booster treatments – it is a regenerative anti-aging treatment that reverses the aging process through bio remodeling of the skin.

Profhilo has been shown to support adipocyte (fat) stem cells and induce them to differentiate better.

Once injected, Profhilo quickly improves skin hydration and fine lines as hyaluronic acid is replaced in the skin. Later on, skin tightening and improvements in elasticity are also seen. Patients often have bouncier and more youthful-looking skin. The full effects of Profhilo take up to 12 weeks after the first treatment, as the bio remodeling process takes time to complete.

Remember, Profhilo is the treatment for improving the skin. There are definite, visible results backed by science, but it is NOT MAGIC. It will not be able to lift very saggy skin or replace a surgical facelift. If you have severe skin texture problems, you will require more sessions to see results.

Profhilo can be used to treat both the face and the body. However, it is particularly indicated for the treatment of the cheeks, jowls, and neck, where injection protocols have been studied and shown to be very successful.

Doctors have used Profhilo to treat practically anywhere on the body, including the following:

  • Forehead and Eye area
  • Cheeks, Lower face, chin
  • Neck and Décolletage
  • Arms, Hands
  • Knees
  • Chest and Abdomen
  • Depressed acne scars
  • Safe and (Almost) Painless Treatment Process With BAP Technique

The Bio Aesthetic Points or BAP Technique chooses five anatomically receptive areas of the face without large vessels and nerve branches, minimizing risks while maximizing product diffusion in the malar and submalar regions. Using only 5 points to administer Profhilo is possible as the formation of hybrid cooperative complexes significantly reduces viscosity while at the same time maintaining manageability and diffusibility in the tissue.

Treatment of the neck involves a total of 10 injection points. Standardized protocols for other areas, such as the forehead and the arms, are still being formulated.

The BAP technique has been shown in several clinical studies[6] to be efficacious, thus eliminating the need for the traditional injection techniques of skin boosters and other mesotherapy treatments of the skin, which can result in more patient discomfort, and downside effects are very mild (e.g., swelling and occasional bruising) and temporary. The raised bumps from the injection points quickly fade away over a few hours as the product soon diffuses all over the skin.

The Bio-Aesthetic Point (BAP) technique only needs minimal injections to achieve maximal results.

An initial cycle of 2 treatment sessions, one month apart for Profhilo. A third session may be needed to obtain optimal results in people with severe skin laxity.

After the initial treatments, the company recommends that the treatment regime is repeated after 6months. However, experts have differing opinions on how long the treatment lasts – and more studies are needed to determine that. The longevity of the treatment will depend on several factors, such as the patient’s skin, genetics, lifestyle, and environmental factors. Some doctors report that the skin quality improvements from Profhilo continue to show even after a year in some of their patients!

Profhilo is suitable for anyone with mild to moderate skin aging who wishes to improve their skin texture, hydration, and tighten skin. It works best when the signs of aging are just beginning to show – in a patient with some mild skin laxity and mild fine lines.

Profhilo is very suitable for men as it works well on thicker male skin and does not have feminine masculine features (unlike fillers and Botox when done poorly).

The short answer is yes! Profhilo can be safely combined with energy-based devices such as Ulthera and Picosure laser for synergistic effects. It works best when combined with fillers – the fillers will replace lost volume, while Profhilo finishes the job but restores youthfulness to the skin.

Profhilo is finally in the United States after a long wait, and I cannot wait to see the results on my patients!