Your questions - our answers

    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.

    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 hydration and skin elasticity are already decreasing. Skinbooster treatment prevents the development of skin wrinkles. The better the skin is cared for at an early age, the later and the less the skin shows signs of aging. 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.

    For special occasions, for example a wedding, a vacation or a photo shoot, we recommend planning the hyaluronic acid treatment better several months in advance. Thus, the full effect of the treatment can unfold and, if necessary, the treatment can be repeated for a more intensive 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, dry and sun-damaged skin is regenerated by hyaluronic acid injections.
    • 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 most affordable for you? If your goals can best be met with a Skinbooster treatment, a treatment plan is drawn up. We can usually meet the frequently expressed desire for treatment immediately following the consultation. In order to better assess the effect, the skin’s appearance is precisely documented before and after the treatment. The application of an anesthetic 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 treatment is performed under strict hygienic measures after careful disinfection of the skin with an alcohol solution. The Skinbooster is injected into the planned regions at intervals of about one centimeter using the finest cannulas. Injection is carried out systematically according to the treatment plan in the specified order and amount of hyaluronic acid. As a rule, 0.02 milliliters are injected at intervals of one centimeter. In the case of deeper wrinkles, the injection is performed at shorter intervals. The skin elasticity and thickness as well as 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 muscle relaxant. The effect can be enhanced by a complementary autologous blood treatment. Skin pigmentation is significantly improved by microneedling treatment. 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.

    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 muscle relaxants leads to higher skin hydration, elasticity and finer skin texture than hyaluronic acid treatment alone (Cartier H, et al., 2020, Dermatol Surg.). The combination of a hyaluronic acid injection with an autologous blood 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

    Both skin boosters and microneedling improve the tone and hydration of sun-damaged or pre-aged skin. Both procedures should be used three times for optimal effect. For the treatment of acne scars, the efficacy of both procedures has been proven (Amer A, et al., 2020, Dermatol Ther.). For the areal treatment of stretch marks as well as the treatment of burn scars, the microneedling procedure is more suitable (Alster TS, et al., 2020, Dermatol Surg.). Microneedling treatment, in contrast to Skinbooster treatment, has been shown to be effective in the treatment of hormonally induced hair loss (Aggarwal K, et al., 2020, Int J Trichology.). For rejuvenation of the skin on the face or décolleté, we recommend combining both procedures.

    Author’s statement

    Author: Stéphane Stahl, MD, PhD. There are no financial relationships with the pharmaceutical or medical device industries that could have influenced the above text. Any reproduction, even partial, is permitted for personal use only. All texts used on this website are protected by copyright.

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