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Sculptra, PRF And Exosomes: The Rise Of Regenerative Injectables

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Brunette woman receiving under eye filler injection at med spa

 

Since 2019, flashing a new injectable treatment has become as common as flaunting a new handbag. “Since about that time, it’s been considered more of a skin maintenance treatment just the same way we take care of our nails and hair,” Los Angeles-based Dr. Sherly Soleiman has said. “It’s no longer considered taboo.”

Since the astronomical rise of Botox and minimally invasive hyaluronic acid filler treatments, there’s been discourse surrounding over-injecting, migration and reversing or dissolving previous work.

“Once you've gone out of balance, people look at you like, Well, what else have you done?” Motykie Med Spa founder Dr. Gary Motykie says. “It totally throws everything off. Like with any any sort of surgery or any type of filler, anybody who's overdoing any of it can end up looking weird. But people kind of almost get used to the way they're looking. Then they get a little more and a little more. The West Hollywood, CA-based doctor doesn’t always look to the patient, however. “I think it’s a little on the provider as well, to tell the client they’re in a good spot,” he says. “But then there are some patients that if you do that, they just go somewhere else. I've had that done, where the patients, I tell them no, and they go somewhere else, they get overdone, they come back, and they want it out. That said, injectables are only growing in popularity. 

 

The New Wave of Injectables

“Social media has made every day a photo opportunity,” explains board-certified celebrity dermatologist, Dr. Ava Shamban. “The Instagram generation is all about instant gratification. This is combined with the acceptance of treatments and procedures, and the pressure for some kind of 'perfection' we didn’t have a decade ago. This all leads to new ideals and 'standards' in the world of beauty that are certainly not always for the best. If not filler, filters have changed the idea of beauty.”  

 

As patients have realized they can alter their features to perfection with little to no downtime, society has developed beauty standards “built on a trend or a fix, rather than an approach of building on a signature feature and what is beautiful about any individual face,” Dr. Shamban, founder of Ava MD DermatologySkin Five Medical Spas and Althaea Skin, says.

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However, with changing trends and greater informational resources, the industry is seeing a shift. The trend is moving from predominantly rejuvenating superficial dermal filler treatments, to regenerative injectables that stimulate greater production of what’s already in the body. They don’t typically offer immediate results, but the results are longer lasting. They’re like an investment to the skin and body.

“You're not just rejuvenating, but you're causing a regeneration action, which is why it lasts longer,” Dr. Motykie explains. “You're regenerating collagen, you're regenerating growth factors, you're making the skin healthier. You're building up over time and turning the clock back and really rebuilding some of the things you've lost or that you never had. So that's really, I think, the future of these things. Everybody's worried about what's on the surface, right? Fixing this or that. But a lot of what's on the surface is coming from what's inside.”

 

Sculptra

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Woman gets Sculptra injected 

Among leaders in the regenerative injectable category is Sculptra. Often considered another form of filler, Dr. Motykie explains that “Sculptra is not, in fact, the filler itself. What it's doing is stimulating your body to produce its own collagen, and then it replaces the Sculptra filler. It's different than, say, hyaluronic acid.”

Sculptra, a polymer also known as poly-l-lactic acid (PLLA), is mixed with water and injected. This leaves a patient “immediately looking really full because there’s all the water in there,” the doctor explains. “So when you walk out, it looks really full. Then the water absorbs and the Sculptra is left behind. It acts as more of an irritant, causing not an inflammatory reaction, but a fibrotic one. Your body slowly forms its own collagen around it. It acts as your own natural filler over time.”

According to a report by Grand View Research, the global poly-l-lactic acid filler market size was valued at $393.8 million in 2023, and is projected to grow at a compound annual growth rate (CAGR) of 10.1% from 2024 to 2030.

Sculptra is having its Hollywood moment now, but it’s actually been around since the early 2000s.

“Its original approval was for AIDS patients, who experienced volume loss in their faces from the antivirals for medications,” Dr. Motykie says. “That's usually the way it goes. It's used for something else and then they approve it.”

Now, he says, expect to hear about it more through associations with Ozempic Face. “Because they've lost all the weight and their fat, Sculptra would be a great option for them to put volume back in their face after they’ve lost it,” the doctor shares.

In addition to the formula itself, there are other distinctions that set Scupltra apart from traditional hyaluronic acid fillers.

“Scupltra is appropriate for cheeks, jawlines, temple hollowing, and overall facial structure where patients may experience bony-loss,” Skin Charm owner and board-certified aesthetics nurse injector, Annie Bruno says. “But when it comes to lips, for example, hyaluronic acid filler is the only appropriate filler type. HA filler can be customized into shape, and it can be dissolved. Sculptra can’t be reversed once it’s injected.”

She also points out that unlike HA filler, which offers immediate results, “Sculptra is a biostimulator, which can require a series of treatments (typically three to six), in order to see results over time.”

 

PRF

Another treatment doctors are performing more frequently is PRF (platelet-rich fibrin). This is becoming more encouraged under the eyes specifically, while traditional hyaluronic acid filler is often warned against. That said, it’s important to note that PRF isn’t designed to give you the same outcome as traditional filler. And neither filler nor PRF are recommended if a patient has actual bags under their eyes (versus hollows, dark circles, crows feet or other issues).

“PRF is a biotechnology that concentrates a patient's platelets to promote skin rejuvenation by boosting collagen and elastin production,” explains Grace Jensen, an aesthetics nurse practitioner at JECT in West Hollywood. “It can be used as a standalone treatment to areas such as the under eyes for dark circles and crepey tissue or scalp for hair rejuvenation. It can also be used in conjunction with treatments like microneedling to improve the skin appearance of the entire face and neck.”

While both can be injected under the eye, “PRF is an autologous product, meaning it comes from an individual’s own body,” Jensen goes on to say. “After drawing a blood sample, collagen-stimulating growth factors are processed and concentrated in-office immediately prior to treatment. The infusion remains in the treated area for days following treatment, allowing platelets and growth factors to gradually improve skin texture.”

Jensen typically opts for alternatives to HA under eye filler off the bat, but if a patient still experiences hollowing following PRF, for example, she isn’t opposed to another injectable treatment.

“Following PRF, filler can be a great option to build upon your results,” she says. “PRF is an excellent option to prepare the periorbital tissue for filler, as it strengthens the skin, reduces hyperpigmentation and decreases the appearance of fine lines. By treating the under eye with both PRP and dermal filler, you can transform your mid-face.”

 

Radiofrequency Microneedling and Exosomes

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Woman during radiofrequency microneedling lifting treatment in a medical aesthetic

Radiofrequency microneedling (RFMN) is another popular injectable treatment that’s seen a recent rise. Unlike the aforementioned injectables, this type is focused on inflicting skin-stimulating micro-injuries by way of tiny needle pokes, versus injecting the skin with a substance. It’s an intensified and higher performing form of traditional microneedling, which uses a device with fine needles that puncture the skin. Morpheus8 and Vivace are two leading technologies for radiofrequency microneedling. Kim Kardashian and Jessica Simpson have both opened up about trying it.

According to Beauty Villa Vergara founder, Dr. Mariana Vergara—who specializes in using Candela MatrixPro RF microneedling technology —“these injuries stimulate the body's natural healing process, increasing elastin and collagen production,” she says. “RF microneedling combines the fine needles, plus the RF energy that’s delivered into the skin. Radiofrequency energy penetrates to deeper layers of the skin, with further heating and tightening.”

The celebrity aesthetics doctor adds that this treatment is for someone looking to improve skin texture, reduce signs of aging, scars, stretch marks, lift the skin and rejuvenate the skin overall.

Often going hand-in-hand with microneedling are the topic du jour—exosomes—with a trend known specifically as exosomes microneedling. Once the needle penetrates the skin, applying a clear application of exosomes can promote the production of new collagen and elastin, giving the skin greater elasticity and firmness.

But wait, what actually are exosomes?

“They’re tiny little ‘packages’ released from all cell​ types that contain a hodgepodge of DNA, RNA, mRNA, growth factors, peptides and lipids,” Dr. Shamban explains. “The actual contents depend on their cell of origin. We secrete these potent vesicles filled with essential materials to direct communication within a cell. They can modulate, restore or regenerate the physiological function of a damaged cell.”

For example, “In normal cellular metabolism, they function as a way for the cells to communicate with each other to initiate stimulation of tissue healing or activate the immune system,” she goes on to say. “In dermatology specifically, they can be used for addressing eczema, wound healing or reducing scar incidence. For aesthetics, they’re used to 'fix' defects of cellular cells with cellular turnover, repair and regeneration. They have a variety of additional uses including enhancing healing and stimulating hair growth.”

It’s also important to note that they aren’t FDA-approved, which is why they’re not as commonly discussed outside of medical or skincare fields.

“We’re still in the early stages of exosomes for aesthetic regeneration, but the future is promising,” Dr. Shamban says. “More clinical research is needed. However, they’re widely used in skincare, and topically following laser procedures and used for hair restoration. Post procedure, pure lab derived exosomes can be potent, stable and have very little risk of rejection or infection.”

With exosomes on the rise, high-end, science-backed brands like Plated Skin Science and Elevai Skincare have offered access to the masses. The brands offer exosome-infused serums that work at a cellular level to support the skin’s natural repair mechanisms and help improve the appearance of fine lines and wrinkles. Plated also offers hair serums clinically proven to make the strands look fuller, thicker and stronger.

As for what could be next? We know this much: The younger generations won’t experience aging the way their parents and grandparents have.

“Gen-Z and Gen Alpha will have options today that didn’t necessarily exist even a decade ago,” Dr. Shamban says. “Or the technologies have advanced so quickly that there’s a range of tools in the kit to address even the earliest signs of aging. A young patient can get in front of changes and rejuvenate every step of the way, literally changing the trajectory of how they age. Done right, a patient can push back the drooping point and look 'ageless' for decades.”

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