What are Microneedling and Microinjection Skin Rejuvenation?

Summary

The basis of microneedling (MN) relies on physical injury. It has been proposed that the trauma generated by needle penetration in the skin induces dermis regeneration. This results in the deposition of collagen by fibroblasts. The technique of microneedling has been well-exploited to increase the penetration of drugs across the skin barrier, including macromolecular biopharmaceuticals and drugs such as minoxidil, tretinoin, and L-ascorbic acid, vitamins and hyaluronic acid (Mesolift), platelets rich plasma (PRP), and nanofat (vampire facelift) and even botulinum toxin microinjection (mesobotox) into the deep layer of skin and subcutaneous tissue. Microinjections and microneedling are successful in skin rejuvenation, hair loss, and scars therapy.

What are the Types of Microinjections Skin Rejuvenation?

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mesotherapy-injections

Vitamins: Vitamin A acts on the skin’s flexibility by regulating the growth of new skin cells. By working on the keratinization process, it corrects the thinning of the derma due to skin aging.  Vitamin E is an antioxidant due to its significant anti-free-radical properties. It maintains the natural integrity of tissue by preventing the formation of toxic peroxides. Vitamin C helps stimulate collagen synthesis, lost through aging, and inhibits the synthesis of melanin, which causes age spots. Vitamin B is indispensable for the sound biological balance of the skin. Vitamin K plays a significant role in the regulation of micro-circulation. Essential Amino Acids and Minerals: These natural water-soluble elements provide the basis for healthy skin architecture.

prp-injections

Vampire Facelift is a name for a non-surgical cosmetic procedure involving the injection of platelet-rich plasma (PRP) derived from a patient’s blood back into multiple areas of the skin of their face to treat wrinkles and “rejuvenate” the look.  Platelet Rich Plasma (PRP) is an innovative therapy in the field of cosmetic enhancements. Although the procedure is new in aesthetics, PRP has been recognized as an effective treatment in sports injury, diabetic ulcer treatment, and orthopedics, to name a few. The newer application of platelet-rich plasma (PRP) has shown effectiveness in androgenic alopecia in males and females. PRP is injected subcutaneously into the area of alopecia with many growth factors and stem cells. This new addition in cosmetic enhancements has many possibilities, such as eliminating skin wrinkles, rejuvenating the skin, improving the appearance of those with acne scarring, and hastening the healing process after a facial peel. Hair transplantation is no exception, and MSI is at the forefront in developing these applications.

We still do not know precisely how, but it seems platelets release protein growth factors vital to wound healing, tissue regenerating, creating new blood, and stimulating stem cells. This all means that the platelets, once injected, release all the steady growth and healing proteins. These chemicals include PDGF (Platelet-Derived Growth Factor), TGF-beta (Transforming Growth Factor Beta), FGF (Fibroblast Growth Factor), IGFs (Insulin-like Growth Factor types 1 and 2), VEGF (Vascular Endothelial Growth Factor), EGF (Epidermal Growth Factor), KGF (Keratinocyte Growth Factor), interleukins, connective tissue growth factor and possibly other growth factors, too. Recently there has been a great interest in adding PRP to the transplanted fat. The goal is to improve the fat retention, or survival, rate. Several well-conducted studies have shown exciting and promising results. The results showed increased retention and overall enhanced wound healing. No doubt, we are witnessing a promising role of PRP in fat transplantation.

skin-rejuvenation-botox-injection

Mesobotox is similar to the technique of Mesotherapy. Instead, I chose the term “Microbotox” to reflect the small doses of toxin delivered in each microdroplet. Micro Botox refers to the systematic injection of multiple tiny blebs of diluted Botox at 0.8- to 1.0- cm intervals into the skin or just below that into the superficial fibers of the facial muscles. The intent is not to completely paralyze the underlying facial muscles but only to weaken the superficial fibers inserted into the undersurface of the skin, which are responsible for the fine lines and wrinkles on the face and neck. These intradermal injections would have the desired effect of smoothening and tightening the skin (due to the neurochemically induced bulk atrophy of the sweat and sebaceous glands) and decreasing the subtle pulling and tethering effects of the facial muscles where they are attached to the skin. Small injection volumes would prevent unwanted solution diffusion into deeper muscles, thus retaining more muscle function to give a natural appearance. This is especially useful in the forehead or under-eye regions where traditional Botox dosage and droplet size often lead to a stiff immovable forehead or inanimate lower eyelids. Microbotox of the lower face and neck is a simple, non-surgical solution ideal for patients who seek improvement of mild neck laxity and howling, crepey neck skin with a rough texture, horizontal necklines, and vertical banding but do not wish to undergo surgery.

skin-rejuvenation-filler-injection

Hyaluronic Acid: Another essential ingredient of Mesolift is hyaluronic acid. Hyaluronic acid is a “hydrophilic” (“water-loving”) linear polysaccharide (natural sugar) that plays a critical role in tissue hydration and lubrication. Used in mesolift, it results in increased smoothness, softening, and decreased wrinkles. Using an excellent 32 or 33 gauge needle, hyaluronic acid is injected to raise the wrinkle level and, in effect, make it disap­pear or strongly fade. The depth of the injection will depend on the wrinkle depth. All wrinkles, even the finest, can be treated. An injection that is too superficial can leave tiny visible beads, and too deep an injection can be ineffective. Thus, the quality of the result will rest on the appropriate depth of the injection, the size of the needle used, and the amount of injected hyaluronic acid.  The effect on superficial wrinkles is remarkable—the skin texture changes. The product seems to integrate the dermis and contributes to actual tissue regeneration. Even if it reappears afterward, a well-treated wrinkle will no longer have the same texture; some will even disappear. It is difficult to answer the question, “How long does the result last?” People willing to take care of their skin and face should consult their clinician annually to receive the necessary treatment and have their wrinkles treated as and when they arise. Patients will then notice that the annual appointment requires fewer pro­cedures. People who have been consulting their clinicians for several years enjoy a natural rejuvenation because the trophic and moisturizing effects of the hyaluronic acid on the skin acts as a healing and preventive treatment on the aging process.

fat-injections

Nano fat is prepared through the mechanical destruction of fat aspirate. The fat liquid emulsion ensures a smooth fat injection through 27-gauge sharp needles. Nano fat cannot build up a significant fat volume. Therefore, nano fat grafting is combined with other modalities of micro fat graft. Nano fat is injected superficially intradermal in a fanwise.  The significant impact of nano fat injection is stem cell activity. Thus, the co-injection of fragmented adipocytes might stimulate stem cell differentiation and tissue regeneration. Likewise, nano fat injection might instead be considered as an in vivo tissue-engineering process.

What are the Types of Microneedling Skin Rejuvenation?

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How is the Procedure of Microneedling (MN) Done?

During the process, your doctor makes tiny pricks under the skin with a pen-like tool. The pinpricks are so tiny that you won’t notice them after the procedure. Your doctor will move the device evenly across your skin so that the new skin that rejuvenates will be even, too. Before getting started, your doctor will use a topical anesthetic to reduce the chances of pain. Microneedling takes about an hour before your treatment. The actual microneedling process takes 30 minutes. Your doctor may then apply a serum or calming treatment. In total, you can expect to be at the office for a couple of hours at least.

Microneedling vs. Home Rollers

Microneedling is a professional procedure that is performed in a board-certified doctor’s office only. To save money, some people opt for home rollers instead. Unlike professional microneedling, rollers do not puncture the skin hardly at all. While this might seem a less painful option, the problem is that you will not achieve the same results. The punctures made during professional microneedling are designed to induce skin rejuvenation. According to the American Academy of Dermatology, you may achieve brighter skin at best with a roller device. If you are interested in more dramatic, long-term results, microneedling is a better option than a store-bought roller device. You may still choose to try the latter version if you want less invasive (and more temporary) results.

Fractional Radiofrequency Microneedle and Excessive Sweating and Body Odor Treatment

Microneedles Fractional Radiofrequency (MFR) uses an array of microneedles arranged in pairs between which bipolar RF energy is delivered. The fractionally distributed energy creates zones of affected skin adjacent to unaffected areas. The affected skin area is the result of thermal energy. Thermal energy results in deep dermal collagen injury that stimulates wound healing, dermal remodeling. New collagen, elastin, and hyaluronic acid also occur. The unaffected areas maintain skin integrity but, in the long term, serve as a reservoir of stem cells that promote and accelerate wound healing. MFR showed skin wrinkles, laxity, texture, pigmentation, acne scars, and large facial pores. The most common side effects are erythema and edema, which are transient, and patient discomfort does not seem to be a significant disadvantage. I may use a topical anesthetic cream before the treatment to minimize pain.

Proudly at MSI, a newer bipolar RF device is effective in reducing the amount of sweating. The combination of RF and fractional microneedle technology termed fractional microneedle radiofrequency (FMR) creates an effective method and better safety profile to destroy eccrine sweat glands by thermolysis at the interface of the deep dermis and subcutis. Fractional microneedle radiofrequency (FMR) treatment appears to be a new safe and effective treatment alternative for moderate to severe primary axillary hyperhidrosis. Prof Moawad suggests repeating treatment sessions to achieve a complete response.

What is the Microneedling Transdermal Drug Delivery System (TDDS)?

The technique of microneedling has been well-exploited to increase the penetration of drugs across the skin barrier. This has been proven in in-vitro skin models where enhanced absorption of larger molecules such as calcein has been observed. Microneedles cover a range of activities between a transdermal patch and a hypodermic needle, attempting to gain the advantages of both and eliminate the disadvantages of each one of them. Microneedling has been used for the transdermal delivery of various types of drugs, including macromolecular biopharmaceuticals such as insulin, growth hormone, heparin, and albumin; immunobiological such as hepatitis B, tetanus toxoid, and influenza vaccines; proteins, peptides, and drugs such as aspirin, minoxidil, tretinoin, and L-ascorbic acid. Microneedling has also been combined with other advanced techniques such as micropumps, sonophoresis, iontophoresis, and electroporation for better drug penetration. As described above, concerning dermatology, microneedling is often combined with topical tretinoin and vitamin C to treat acne scarring and skin rejuvenation. Penetration enhancement of minoxidil and platelet-rich plasma for androgenic alopecia is another application. Microneedling enhances the effect of 5-aminolevulinic acid for more efficacious photodynamic therapy. They have been used in combination for the treatment of actinic keratosis and photoaging.

Who is a Good Candidate for Microneedling Skin Rejuvenation?

Various MN products have been developed to treat scarring and wrinkles, enable skin rejuvenation, and improve skin appearance. Over the last several years, clinical trials have shed light on the applications of MN beyond cosmetic indications, including actinic keratoses (AK), disorders of pigmentation, hyperhidrosis, and striae. Additionally, the role of MN in the treatment of hair pathology has become a new field of focus as it is thought to stimulate stem cells in the dermal papilla, increase blood flow to hair follicles, and recruit growth factors and signaling pathways which induce hair restoration. Microneedling can also be used to augment transdermal drug delivery (TDD) by creating pores in the stratum corneum. These pores allow for enhancement in the absorption of mainstay topical therapies across the thick stratum corneum. It has shown promising results as adjuvant therapy for enhanced drug delivery in treating atrophic scars, alopecia, actinic keratoses, and pigmentation disorders such as melasma. The efficacy in the treatment of vitiligo remains limited.

Who is Not Candidate for Microneedling Skin Rejuvenation?

You may not be an ideal candidate for microneedling if:

  • You are pregnant
  • have certain skin diseases, such as psoriasis or eczema
  • have open wounds
  • have had radiation therapy recently
  • have a history of skin scars

How do I Prepare for Microneedling Skin Rejuvenation?

At MSI, Prof Moawad prefers to prepare his patients before any cosmetic procedure, especially in dark skin people. Our physician, skincare products, will do that job. Before the procedure, talk to your doctor about ways to prepare to have the best possible outcome. You may need to stop taking certain medications, such as ibuprofen and those for acne treatment, well in advance of the procedure. Your doctor may also recommend that you stop using topical retinoids beforehand too. Doing so may reduce the risk of specific side effects.

Does Microneedling Skin Rejuvenation Hurt?

With the administration of a local anesthetic to the areas to be treated, you will experience minimal discomfort. Most individuals find it a rapid and painless treatment—also, the use of a derma roller decreases the pain for those who are needles phobic.

Are there any Side Effects from Microneedling Skin Rejuvenation?

Microneedling is associated with a low rate of AE. The histologic examination took 24 hours after therapy demonstrates an intact epidermis and no change in melanocyte number, resulting in limited downtime and minimal risk of dyspigmentation. Adverse effects are rare and temporary, with transient post-procedure erythema being most common. Tram-track markings are also rarely reported. Minor side effects include bleeding, bruising, hematoma, swelling, or itching. These are all very minor, usually subsiding in a few hours to a few days.

What to Expect Immediately After Microneedling Skin Rejuvenation?

Microneedling is not invasive like plastic surgery, so the recovery time is minimal.  You may notice skin irritation and redness within the first few days following the procedure. This is a natural response to the minor “injuries” made by the needles in your skin. You can go back to work or school after the procedure if you are comfortable. Some people apply camouflage makeup during the first few days as the redness dissipates. Your skin will also be more sensitive to the sun, so sunscreen is necessary. To maintain the results of your treatment, you will need multiple sessions and other complementing therapies. Your doctor will advise you on the best plan of action based on your individual goals

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Microneedling is not invasive like plastic surgery, so the recovery time is minimal.  You may notice skin irritation and redness within the first few days following the procedure. This is a natural response to the minor “injuries” made by the needles in your skin. You can go back to work or school after the procedure if you are comfortable. Some people apply camouflage makeup during the first few days as the redness dissipates. Your skin will also be more sensitive to the sun, so sunscreen is necessary. To maintain the results of your treatment, you will need multiple sessions and other complementing therapies. Your doctor will advise you on the best plan of action based on your individual goals

Microneedling is not invasive like plastic surgery, so the recovery time is minimal.  You may notice skin irritation and redness within the first few days following the procedure. This is a natural response to the minor “injuries” made by the needles in your skin. You can go back to work or school after the procedure if you are comfortable. Some people apply camouflage makeup during the first few days as the redness dissipates. Your skin will also be more sensitive to the sun, so sunscreen is necessary. To maintain the results of your treatment, you will need multiple sessions and other complementing therapies. Your doctor will advise you on the best plan of action based on your individual goals

What Results Can You Expect?

After treatment, patients commonly describe their skin as looking younger, rested, radiant, glowing, and firmer. Microneedling does not take the place of a facelift but will diminish fine wrinkles and help to even skin tone. We recommend an initial series of four facials—spaced about a week apart—followed by a touch-up every six months; both dehydrated summer skin and skin was worn by harsh winter heating can benefit from the treatment. This is because the treatment effects are cumulative and enhance the stimulation of your collagen and elastin over this period. This procedure is excellent for any woman who wants to reduce the look of wrinkles on the neck or face. It is simple, quick, and virtually painless. With mild side effects, and there is no recovery period. Over the past 20 years, the applications of microneedling in dermatology have grown drastically. The concept of subcision for scars has progressed to automated microneedling pens, microneedles fractional radiofrequency, and facilitation of TDD.

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