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    What is a skin booster?

    Collagen and hyaluronic acid are the key to healthy, firm and youthful skin. Skin’s hyaluronic acid concentration decreases with age and due to environmental factors such as UV radiation and air pollution. Enzymes called matrix metalloproteases (MMPs) break collagen fibers into short pieces. At the same time, connective tissue cells (fibroblasts) produce less collagen. Collagen gives the skin firmness and elasticity.

    Hyaluronic acid offers a wide range of treatment options. For this reason, it is important to consult experienced specialists who will choose the best treatment for your skin condition and create an individual treatment plan for your desired result. On the Filler FAQ page you will find the answers to the most frequently asked questions about hyaluronic acid and its alternatives.

    Scientific studies have shown that hyaluronic acid injections stimulate connective tissue cells to produce collagen. Four weeks after a subcutaneous injection, the formation of collagen increases tenfold. The newly produced collagen has a half-life of approximately 15 years (Cui Y, et al., 2021, Plast Reconstr Surg.). Injecting small chains of hyaluronic acid into the superficial layers of the skin gives the skin more freshness, moisture, tone, and reduces skin wrinkles (Belmontesi M, et al., 2018, J Drugs Dermatol.). Hyaluronic acid is therefore often referred to as a beauty booster.

    Who is suitable for Skinbooster treatment?

    Numerous study indicate that aesthetic treatments such as Skinbooster not only improve appearance, but also have a positive impact on first impression, quality of life, self-esteem, and mood (Dayan S.H., et al., 2019, Dermatologic Surgery.).

    Skinbooster treatments can be performed on any adult. Between the ages of 30 and 40, skin moisture and skin elasticity already decrease. A Skinbooster treatment prevents the formation of skin wrinkles. The better the skin is cared for at an early age, the later and the fewer the signs of aging of the skin. From the age of 40 to 45, depending on the skin condition, higher concentrated hyaluronic acids can be used. The treatment frequency as well as the treatment regions are adapted to the individual needs. In this way, already existing wrinkles can be reduced. The skin becomes smoother, firmer, tighter and more youthful. The positive effect is reflected in the patients’ fresh appearance.

    For special occasions, for example a wedding, a holiday or a photo shoot, we recommend having the hyaluronic treatment done a few months in advance. Thus, the full effect of the treatment can unfold by then. Plus, the early application gives you enough time to repeat the procedure before the event if you want a more intense effect.

    Which parts of the body are suitable for treatment with Skinbooster?

    The effect of hyaluronic acid treatment can be detected on the entire body. Skinbooster treatment is therefore performed on the areas of the body that suffer most from harmful environmental influences such as UV radiation and air pollution. Common treated areas include:

    • On the face, skin rejuvenation and a preventative treatment can be given to the cheeks, mouth area, eyes and forehead.
    • For the lips, a Skinbooster treatment gives a natural and fresh look and a smooth texture. Hyaluronic acid improves the elasticity and moisture of the lips.
    • On the neck and décolleté a regeneration of dry and light-damaged skin is visible when hyaluron is injected.
    • On the back of the hand, skin hydration and tone improves.
    • Acne scars are significantly reduced and in some places almost invisible.

    Which products are used in a Skinbooster treatment?

    The effect of Skinbooster treatment is determined by the properties of hyaluronic acid. Short hyaluronic acid chains provide more moisture (Pavicic T, et al., 2011, J Drugs Dermatol.). Hyaluronic acids used as fillers cause a more significant increase in volume due to the longer hyaluronic acid chains and higher concentration. The concentration of hyaluronic acid in skin boosters ranges from 13.5 to 20 milligrams per milliliter. Higher concentrations and cross-linking of the hyaluronic acid chains slow down the degradation and thus prolong the effect. Certain skin boosters have sugar molecules added (mannitol or glycerol) to enhance the skin rejuvenating properties. Glycerol is a natural substance of the skin (Fluhr JW, et al, 2008, Br J Dermatol.). Glycerol is used to moisturize and support the skin’s barrier function. Mannitol is a naturally occurring sugar that slows the natural breakdown of hyaluronic acid. For thin skin, superficial injections or young people, low-concentration skin boosters are more suitable. The following high-quality and certified skin boosters are used in CenterPlast:

    • Belotero® Hydro, company Merz, concentration: 18mg/ml, additive: glycerin 21mg/ml.
    • Belotero® Revive, company Merz, concentration: 20mg/ml, additive: glycerin 17,5mg/ml
    • Juvéderm® Volite™, company Allergan, concentration: 12mg/ml
    • Juvéderm® Hydrate, Allergan company, uncrosslinked hyaluronic acid, concentration: 13.5mg/ml, additive: mannitol 9mg/ml
    • Teosyal® Puresense Redensity 1, company Teoxane, non-crosslinked hyaluronic acid, concentration: 15mg/ml
    • Restylane® Skinbooster™ Vital light, company Galderma, concentration: 12mg/ml
    • Restylane® Skinbooster™ Vital, company Galderma, concentration: 20mg/ml

    How does a Skinbooster treatment proceed?

    At the beginning of every treatment are the questions: Which treatment is the most effective, safest and cheapest for you? If your goals are best met with a Skinbooster treatment, a treatment plan will include these hyaluronic injections. As a rule, we can meet the frequently expressed wish for treatment immediately after the consultation. For this purpose, we store the high-quality ready-to-use syringes of the various hyaluronic acid filler manufacturers with different concentrations in a safe environment. In agreement with you, the most suitable one will be chosen, according to the treatment plan discussed together.

    In order to be able to better assess the effect of the injections, the skin appearance before and after the treatment is precisely documented. The application of a local anaesthetic cream ensures that the treatment is very painless. Cooling the skin additionally reduces the perception of pain and prevents the formation of bruises. Taking pain medication is possible but rarely necessary. The hyaluronic acid injection is performed under strict hygienic measures after careful disinfection of the skin with an alcohol solution. The skin booster is injected into the planned regions at intervals of about one centimetre using extremely fine cannulas. The hyaluronic acid gel is injected systematically according to the treatment plan in the specified order and amount of hyaluronic acid. As a rule, 0.02 ml of the dermal filling substance is injected at intervals of one centimetre. In the case of deeper wrinkles, such as those found in mature skin, the wrinkle injections are performed at shorter intervals. The skin elasticity and thickness as well as the texture are decisive for the required amount of Skinbooster. As a guideline, about one milliliter per side is needed for the treatment of the cheeks and jawline, half a milliliter for the mouth area, two milliliters for the décolleté and half a milliliter per side for the back of the hands.

    It is possible and also recommended to combine the treatment with the injection of a neuromodulator substance. The effect can also be enhanced by a supplementary treatment with platelet derived concentrate. Furthermore, the skin pigmentation can be significantly improved by a microneedling treatment if desired. A volume build-up for skin rejuvenation of certain parts of the face is also called Liquid Lift or Liquid Lifting.

    For optimal results, the Skinbooster treatment should be repeated three times at intervals of four weeks. If the desired goal has been achieved, a repetition every six to twelve months is sufficient. We strongly advise you not to attempt an application with hyaluronic acid pre-filled syringes on your own. Skinbooster therapy should always be performed by highly qualified medical professionals to be done under the safest circumstances. This is how you achieve the desired result: a natural and healthy skin appearance.

    What are the risks of Skinbooster treatment?

    After an injection treatment, minor swelling and slight redness is unavoidable for sensitive skin. For prevention, we recommend cooling the skin before and after treatment. In most patients, the mild side effects have subsided by the next day. Make-up can be applied as usual from the following day. Uncross-linked and low-concentration hyaluronic acid is injected into the superficial layers of the skin. In these cases, slight irregularities must be expected after the treatment. With a light massage, small nodules usually recede by the third day. Inflammation or allergic reactions are extremely unlikely. Injury to small blood vessels can never be completely ruled out with injections. Nevertheless, bruises are rare. The risk of vascular occlusion is estimated to be less than 1:10,000 during Skinbooster treatment. CenterPlast doctors always take all possible precautions to avoid any risks. With extensive training, years of experience and modern technical equipment, CenterPlast doctors are well prepared for any emergency.

    Collagen formation with Sculptra®

    The active ingredient of Sculptra® (Galderma company) poly L-lactic acid (PLLA) consists of long lactic acid chains. In the body, lactic acid is formed in the muscle when sugar is broken down. Lactic acid chains as well as the other ingredients of Sculptra®, carboxymethylcellulose and mannitol are harmless to health. PLLA is made from corn and is broken down in the body to water and carbon dioxide. In 1932, polylactic acid was first described by Carothers (Carothers, W.H., et al., 1932, J Am Chemical Society). Since 1972, PLLA has been used worldwide and frequently in absorbable sutures (Vicryl®, Ethicon Company). PLLA is also a major component of absorbable sutures for suture lifts (Silhouette Soft®, Silhouette InstaLift® from Sinclaire Company). PLLA has been approved for skin rejuvenation in Europe since 1999 and in the USA since 2009. Injection of PLLA microparticles stimulates connective tissue cells (fibroblasts) to produce collagen. The proven effects of PLLA are:

    • Increase in skin elasticity
    • Increase in skin hydration
    • Reduction of skin redness
    • Reduction of pigmentation spots
    • Reduction of pore size
    • Reduction of skin wrinkles (Bohnert K, et al., 2019, Dermatol Surg.).

    The effect of PLLA can be demonstrated on nasolabial folds for over 3 years, making it more durable than resorbable fillers (Salles A.G., et al., 2008, Aesthetic Plast Surg.). PLLA microparticles are 40 to 63 microns in diameter and are dissolved with sterile water. The small diameter of the particles, proper dilution, and expert injecting are critical for safe and good results. Mild temporary side effects such as redness and swelling occur in 3.4 percent of patients. The risk of developing palpable nodules is 0.4 to 4.7 percent (Palm M, et al., 2021, J Drugs Dermatol.; Schierle CF, et al., 2011, Aesthet Surg J.). With cortisone injections, the nodules may regress. Therefore, place yourself in the hands of qualified and experienced specialists.

    Collagen formation with Radiesse®

    Radiesse® is a tissue filler made of calcium hydroxylapatite and carboxymethylcellulose, which has been approved in Europe since 2003 and in the USA since 2006 (Merz company). Calcium hydroxylapatite is a natural component of bone and carboxymethylcellulose is a thickener and binder that is also found in many foods. Radiesse® is suitable for the treatment of deep wrinkles and cheek augmentation. The calcium hydroxylapatite microparticles have a diameter of 25 to 45 micrometers and stimulate the body’s own collagen production. The correction of wrinkles and volume deficiencies of Radiesse® lasts approximately 18 months. Radiesse® is not suitable for superficial treatment of the skin or treatment of the mouth area. The most common side effects of Radiesse® treatment are the formation of palpable nodules in approximately 3 percent of cases (Kadouch J.A., 2017, J Cosmet Dermatol.). We recommend that you seek treatment only from qualified physicians.

    How long does a Skinbooster treatment last

    After three applications at four-week intervals, 77 percent of patients are satisfied with the results after six months (Lee BM, et al., 2015. Arch Plast Surg.). The newly formed collagen remains in the skin for decades. Therefore, benefits can be expected over a longer period of time (Cui Y, et al., 2021, Plast Reconstr Surg.). Since the skin appearance is influenced by many circumstances, the sustainability of a Skinbooster treatment is not exactly predictable. For example, environmental factors, cigarette smoking and body weight fluctuations have a detrimental effect on results. Good skin care with UV protection and the combination with other procedures, on the other hand, ensure particularly lasting results. The combination of skin boosters with the application of a neuromodulator substance results in higher skin hydration, elasticity and finer skin texture than hyaluronic acid treatment alone [1]. The combination of a hyaluronic acid injection with platelet derived concentrate treatment also produces noticeably better results than the respective treatment alone (Hersant B, et al., 2021, Aesthet Surg J.).

    Skinbooster for acne scars

    Acne scars can cause significant distress. Hyaluronic acid treatment can significantly improve the appearance of acne scars (Dierickx C., et al., 2018, Dermatol Surg.). Sunken (atrophic) scars are caused by severe inflammation and injury to deep layers of the skin. Acne scars are divided into three types:

    • Boxcar scars: U-shaped, 1.5 to 4 millimeters in diameter.
    • Rolling scars: M-shaped, diameter greater than four millimeters.
    • Ice-pick scars: V-shaped, diameter less than two millimeters, the most common type of acne scars.

    The results and longevity of hyaluronic acid treatment depend not only on the hyaluronic acid and the injection technique, but also on the type of scar. The best results with hyaluronic acid treatment are achieved with soft atrophic U-shaped or M-shaped scars. Two milliliters of hyaluronic acid are usually needed per half of the face for one treatment. For best results, treatment should be repeated three times at four-week intervals. Studies show that combining hyaluronic acid injections with microneedling treatment removes scars even more effectively (Amer A, et al., 2020, Dermatol Ther.).

    Skinbooster versus Microneedling

    The effectiveness of the microneedling treatment depends, among other things, on the penetration depth of the fine needles. CenterPlast uses the most effective form of needling with 2 to 3 millimeter long needles (surgical needling). Needling can be performed with a pen-shaped device (Dermapen) or a roller-like instrument (Dermaroller). Both Skinbooster and Microneedling improve the elasticity and moisture of sun-damaged or pre-aged skin. Both procedures should be applied three times for optimal effect. Treatments differ in terms of downtime and reasons for treatment. With a Skinbooster treatment you are fit for society again after a few hours. In the first five days after a needling treatment you have to expect a noticeable reddening of the face. The effectiveness of both procedures has been scientifically proven for the treatment of acne scars [2]. For the treatment of stretch marks as well as the treatment of scars, the microneedling procedure is more suitable [3]. Microneedling treatment has also been proven to treat hormonal hair loss [4]. For rejuvenation of the skin on the face or décolleté, we recommend combining both procedures.

    Skinbooster versus mesotherapy

    Mesotherapy is a technique in which a mixture of plant extracts, homeopathic active ingredients, growth factors or vitamins are injected under the skin. Mesotherapy is very popular with alternative practitioners. Despite its appeal as a purported rejuvenating injectable, the effectiveness of mesotherapy treatment remains unclear. High quality studies proving the superiority of mesotherapy over skin booster treatment do not exist. A comparative study of treatment with platelet derived concentrate and mesotherapy in only twenty patients suggests the superiority of the former form of treatment [5]. We evaluate each treatment according to its scientifically proven benefit. You can also get more information on our Serious Health Information page.

    Before and after pictures of a Skinbooster treatment

    Before patients decide to have a Skinbooster treatment, they wish to see before and after pictures of the skin treatment that was done at the said practice. Since such photographs may not be published on the Internet, Centerplast offers the possibility of having the results of the treatment shown to you during a preliminary consultation. You can find more information about this in the category “About us” and the point “Quality”.

    Field report on the Skinbooster treatment

    Evaluations play a big role in the process of choosing a specialist these days. Patients want to inquire about other patients’ experiences before undergoing aesthetic treatment at a practice. On our home page you will find numerous such patient testimonials on a wide variety of treatments. In addition, we have set up a separate website for you, where you can access the experience in bundled form. To do so, click on the corresponding menu item in the menu category “About us”.

    What are the costs for a Skinbooster treatment?

    Use our interactive price calculator now to find out the price of a Skinbooster treatment. If you have any questions, you can of course contact us. In the course of a consultation, we will also be happy to explain to you how the costs are made up.

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    The author

    Dr. Adelana Santos Stahl

    “Our goal is to provide the best, most discreet and precise treatment based on our extensive expertise in plastic surgery. „

    Dr. Adelana Santos Stahl is distinguished by a unique international perspective with a feminine view of plastic surgery. Her personalized and detailed approach is key to the beautiful and natural results she achieves. Having trained in Brazil, one of the largest and most well-known countries for aesthetic and reconstructive plastic surgery, she understands her patients’ desire to look and feel their best.She completed her medical studies and her training as a specialist for plastic and aesthetic surgery in Brazil. In 2009, she also successfully passed the German equivalence examinations for the medical state examination. Two years later, in 2011 she received the German and in 2012 the EU specialist recognition (EBOPRAS) for plastic surgery.From 2009 to 2013, she deepened her knowledge of aesthetic and reconstructive facial surgery with world-renowned representatives of plastic surgery such as Professor Gubisch at the Marienhospital and Madame Firmin in Paris.A VDÄPC Fellowship (continuing fellowship for graduate students) in Switzerland, France and the USA has further enriched her professional experience.Dr. Santos Stahl is active in several prestigious professional societies. Besides the DGPRÄC and DGBT, she is also a member of the Brazilian Society of Plastic Surgery – SBCP.She is also the author of several scientific articles and, together with her husband, is dedicated to research and clinical studies in the field of plastic surgery.

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