Regeneration Boost

The various types of cells in our skin each have distinct functions, and all of them age over time, which diminishes their performance. Fibroblasts, for instance, need to attach to healthy collagen to thrive. However, as they age, they are adversely affected by matrix fragments, reactive oxygen species, oncostatin-M, and other intrinsic and extrinsic factors.

We demand a lot from our aging fibroblasts, expecting them to produce collagen and elastic fibers, yet we subject them to harsh treatments. Rarely do we provide them with proper nutrition, care, and protection.

Injecting hyaluronic acid into the dermis can negatively affect its normal structure and function, even if it shows great integration in the skin. This is why I advocate for bioregenerative aesthetic medicine. We now understand very well the mechanism of action of calcium hydroxylapatite (CaHA). CaHA particles mechanically activate fibroblasts, leading to the upregulation of collagen types I and III, elastin, proteoglycans, and angiogenesis.

A study published in the Journal of Drugs in Dermatology in September 2023 hypothesized that skin priming with poly-revitalizing micronutrients could be an effective panfacial injectable regenerative treatment. The study suggested that in healthy skin, the polyrevitalizing micronutrients in NCTF 135HA might amplify the bioregenerative and anti-aging effects of CaHA by supplying supraphysiological amounts of essential micronutrients for extracellular matrix (ECM) regeneration and fibroblast activity. This approach provides protection from reactive oxygen species, along with the necessary nutrition and hydration for fibroblasts to differentiate and perform optimally. The combination treatment in the study, known as Bionutriblend™, showed improvements in skin laxity, wrinkle severity, skin luminosity, hyperpigmentation, and the thickness of the skin and subcutis in 100% of patients after a single treatment.

Although those NCTF 135HA polyrevitalizing micronutrients are not available in the United States, NCPR (TOSKANIMED) has shown comparable results, especially in terms of improving skin elasticity. Despite the labeling as a topical treatment in the US, it is crucial to understand that any skin about to receive an injury or insult needs appropriate nourishment and protection for optimal results.

Skin optimization with micronutrients is still achievable using NCPR on-label by electroporation or microneedling to deliver the bioactive nutrients into the dermis when using biocollagen stimulators. Dr. Allessio Redaelli in Milan demonstrated remarkable results from a combination of poly-L-lactic acid (PLLA) and polyrevitalizing micronutrients, highlighting the importance of skin priming with biocollagen stimulators.

Clinicians today should adopt and understand the concept of mesosynergy™ in aesthetics, ensuring that no fibroblast is forced to perform without nutrition, protection, and hydration.