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Microneedling can significantly improve the skin's appearance.
July 2, 2024
Juliane Diesner
The trend in aesthetic medicine has been emerging for some time: content creator Juliane Diesner (@styleshiver) has tested the alternatives to fillers.
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Never before has the desire for naturalness and a method to delay the visible aging process a bit been as great as it is now. The so-called "pillow faces"—those faces often treated too much with fillers even at a young age—have recently been ubiquitous as negative examples. We have images of celebrities in their twenties in mind who look like they are in their early forties.
The paradox with fillers is that if used improperly, they do not lead to a younger or fresher appearance, but can make the treated person look significantly older. So the opposite of what one actually hoped for as a patient is achieved. Some even claim that fillers are the new "tanning bed" of our time.
A synonym for something that has often been used excessively without much thought, even though, if wrongly dosed, it causes more harm than achieving the desired effect. Even though this is in no way meant to be filler-bashing—great results can still be achieved with the right use case and the right injector—I would still like to introduce the really great alternatives to fillers available by now.
Because admittedly, due to the influences of TikTok and K-Beauty, so much is now offered that it can be hard to keep track. Below, I talk about my personal favorite treatments and the latest state of research.
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© Juliane Diesner
Our author after microneedling with PRP and a polynucleotide treatment under the eyes
But first, an explanation of what exactly is meant by biostimulators. Biostimulators are innovative treatments in aesthetic medicine that aim to stimulate the skin's natural regeneration processes. By introducing them into the skin, collagen synthesis is also stimulated. New collagen and elastin are formed, which in turn leads to a more youthful and firmer appearance, without unpleasant side effects.
Classic micro-needling may be a basic treatment in this context, but in my opinion should not be underestimated. It is safe, causes little downtime, and gives a great glow right away, which is why it is one of my favorite applications that you can treat your skin to every now and then.
Radiofrequency needling delivers additional radiofrequency heat into the skin, promising a firmer skin appearance. However, opinions on RF needling are divided. Some talk about the treatment as if there is hardly a better one in non-invasive aesthetic medicine, while others, including doctors, remain skeptical.
There is an assumption that improper use can cause one's own fat deposits in the face to melt due to the combination of needling and radiofrequency, which should of course be avoided. I have tried RF needling once and cannot confirm this from my own experience.
Especially in combination with the so-called PRP therapy (PRP stands for platelet rich plasma), RF needling can really achieve excellent results. In any case, it is still important to choose the right practitioner who is familiar with the device's settings and has been working with it for a longer time.
© Juliane Diesner
PRP (platelet rich plasma), also known as liquid gold. Obtained from one's own blood plasma.
One of the newest and most promising trends and a major topic at this year's IMCAS Paris, one of the world's most important congresses in the field of aesthetic medicine and dermatology, are exosomes.
Exosomes are tiny particles responsible for communication between cells. A distinction is made between exosomes that are synthetically produced in the laboratory and those that are obtained from autologous blood similar to PRP.
Synthetic exosomes have not yet been approved in Europe, which is why I would like to exclude them a little at this point, even though they are an incredibly exciting topic and could certainly develop into one of the most important topics in the field of aesthetics in the next one to two years.
Dr. med. Timm Golüke , who in his Munich practice is one of the first in Germany to offer treatment with autologous exosomes, explained to me that the process of obtaining the exosomes is initially more complex than the classic PRP therapy, as the plasma is centrifuged not once, but twice.
This stimulates the regenerative processes of the skin more strongly, and it also has an anti-inflammatory effect. Additionally, the fibroblasts are stimulated to form new collagen and elastin. Personally, I am a big fan of working with autologous options before using foreign material.
The treatment with exosomes is non-invasive and without significant downtime. I would say a trip to Munich is definitely on my agenda soon to visit Dr. Golüke at his practice.
Dr. med. Eveline Urselmann in Hamburg offers the Exokine treatment. Here, one's own plasma is centrifuged for a full six hours, resulting in a higher concentration of growth factors and regenerative factors. The highly purified serum, which is injected back into the skin, is free of white blood cells and other disruptive factors due to the special purification, and thus has a somewhat stronger effect in the anti-aging area.
The latest trend from South Korea: Polynucleotides. Many young women there already have the skin booster injected into their skin in small mini-doses. These are nucleotides from salmon DNA. At first, this sounds very fancy, and it indeed is.
The naturally obtained DNA/RNA fragments stimulate the skin to renew itself and increase the viability of the fibroblasts, which in turn produce new, fresh collagen and elastin. Polynucleotides are expected to soon outperform the classic hyaluronic acid filler, especially under the eyes, as they are said to bring no complications or unwanted side effects.
It's fascinating what has happened in this area in recent years and I'm very curious where the journey will go. The shift in thinking to promote skin and the body's own regeneration processes, instead of injecting hyaluronic acid wildly and thoughtlessly, I find correct and good, and it also more closely matches my own ideas.
I have not yet dared to try Botox and instead rely on the many alternative methods that stimulate the body's own processes, rather than immobilizing or plumping up areas of the face with injections of Botox or hyaluronic acid. Because all these alternative methods are designed to prevent one of the main causes of skin aging, collagen loss, and what more could we want in the end!
