By doctors Philippe DEPREZ and Evgenyia RANNEVA
The future of anti-aging care?
Skin biorevitalization is a completely new method of giving new energy to the skin’s natural biological processes.
This is a technique that applies to people who want to preserve the quality of their skin, its appearance or to those who discover signs of aging and wish, without surgery, without laser, without peeling, to improve their appearance. and achieve skin rejuvenation effect, skin color improvement, better facial oval tension. It intends to regenerate the functioning of all the cells present there.
Hyaluronic acid is of course a prime candidate for biorevitalization since it is a natural molecule found in large quantities in the dermis of young skin. When the dermis is degraded, dry, deflated, the nutrients distributed by the vessels can no longer diffuse into the tissues or towards the epidermis and we enter directly into a vicious circle responsible for aging. Indeed, it contains – among other things – fibroblasts which are the cells responsible for the synthesis of collagen, elastin and “glycosaminoglycans”, a scholarly term that we will shorten here to hyaluronic acid. Malnourished fibroblasts due to lack of possibility of diffusion of nutrients in the dermis will no longer produce these essential components of the quality of the skin. The dermis is finally refined, dried out and depopulated. The Holy Grail of biorevitalization therefore consists in stimulating the activity of fibroblasts which, on its own, would allow complete dermo-epidermal regeneration.
Hyaluronic acid will be used for biorevitalization
HA injections provide this hydration which the dermis lacks in order to remain a fertile environment for biological exchanges and to tighten the epidermis which covers it. Cross-linked hyaluronic acid is primarily used to fill in wrinkles but can also be used in some biorevitalization formulations. The latter generally uses non-crosslinked hyaluronic acid for its moisturizing properties and its permissive effect on the diffusion of substances into the dermis. Injectable biorevitalization hyaluronic acid must of course be of pharmacological quality, sterile, manufactured and controlled according to ISO 13485 and CE class III standards.
What about passing through the skin?
Hyaluronic acid is a very large molecule that is unlikely to be able to cross the stratum corneum of the epidermis, which is responsible for over 70% of the overall impermeability of the skin as a whole. Two methods have been demonstrated to circumvent this pitfall. First, the marketing of small-chain hyaluronic acid: the giant molecule of hyaluronic acid has been cut artificially into very small pieces that pass more easily through the epidermis and can partly reach the dermis. However, the moisturizing power of hyaluronic acid is directly linked to the length of its molecule: the smaller the hyaluronic acid, the less moisturizing it is. The mini chains of hyaluronic acid are therefore better used in cosmetic products than in medical biorevitalization since once in the dermis, even if they can induce transient hydration there, the short chains of hyaluronic acid will be very quickly destroyed by hyaluronidases.
Secondly, it has been demonstrated that multiple perforations of the skin allow molecules, even large molecules, to penetrate through the epidermis: this is one of the functions of “microneedling”, a small sterile device (AD ROLL TD) equipped with multiple needles (540 needles), from 0.25 mm to 2.5 mm long, which rolls on the skin and microperforates it, allowing the diffusion of products to the subcutaneous tissues and stimulating at the same time mechanically the phenomena of dermo-epidermal regeneration. Here too, you have to be careful because the multi-perforation allows all the products that are applied to the skin to pass through: the application of gels, for example, is not recommended after micro-perforation because a gel certainly contains active products, but also a whole series of gelling agents, preservatives (parabens), perfumes which have no role to play in the dermis.
Biorevitalization is aimed at a dermis in the process of devitalization. Injected too early, the solutions are ineffective. Injected too late, the biorevitalization will not be spectacular enough to give the result expected by the patient. The ideal age will therefore be between 30 and 65 years old. It concerns tired, undernourished skin, in the process of losing the oval of the face.
It does not hurt if 0.25 or 0.5 mm needles are used: this is the case with the biorevitalization of early aging or eye treatment or pigmentation treatments. Results are not definitive because the body greedily uses vitamins and other growth factors and cuts through hyaluronic acid at a rate that is unique to each patient. It therefore requires a starting treatment of 4 weeks, at the rate of one injection or microneedling per week, followed by a single injection or microneedling after 6 weeks. The maintenance will be done every 3 or 4 months, at the same time as the possible session of botulinum toxin.
Daily after-treatment care exists, which globally contains the same active ingredients as the solutions injected or used in microneedling. For example AD daily care EYES is a daily care that is used after Reparestim TD eyes or RRS-HS eyes (products of Aesthetic Dermal, sl). A biorevitalization session costs from 100 to 350 euros if non-crosslinked hyaluronic acid has been used.
Biorevitalization is a very recent method, which has expanded the indications and possibilities of classic mesotherapy. Some precautions should be taken to avoid applying, after multiple perforation of the skin, gels, products containing perfumes, preservatives or non-sterile solutions.
Two examples of indications: anti-aging and eye contour
The indications for biorevitalization resemble those of classic mesotherapy, but unlike the latter, biorevitalization formulas have become complex, combining many elements, up to sixty, whereas classic mesotherapy does not allow of mixtures that exceed three components.
Overall anti-aging: Hyaluronic acid (by injection or by multiple perforation) therefore makes it possible to reinflate the dermis, to tighten the epidermis and to erase fine lines, to improve the tension of the skin, its quality, its touch. Aesthetic Dermal sl has recently developed injectable biorevitalization solutions (injectable RRS-HA line, CE class III) and sterile solutions, without additives, for “needling” use (Reparestim TD line) which contain more than 60 components (vitamins, trace elements, hyaluronic acid, essential fatty acids, cofactors, antioxidants including resveratrol etc…). Biorevitalization is also interested in many other parameters, other natural, biological mechanisms which, by degrading over time, contribute to skin ageing.
Eye contour: the eye contour suffers from typical aging, combining swelling, fine lines, thinning of the dermis, vascular problems. “RRS-HA eyes” is an implantable product, CE class III, based on non-crosslinked hyaluronic acid, which also acts on the vascular and pigmentary side of the aging of the eye contour. The eyelids deflate, the vascular or melanic pigmentations diminish. The appearance of the eyes is rejuvenated.
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