Stem cells for skin quality and facial volume

The more technology develops and becomes a part of our lives, care, in particular skin care, the more patients with different types of complications.
Today we will consider a fairly common request after microneedling – loss of facial volume and a sharp decline in skin quality. Observation of loss of facial volume and flabbiness of the skin after microneedling procedures can be associated with a number of factors, including:

1. Too aggressive exposure:
If the procedure was performed using too long needles or was performed with excessive intensity, this can lead to damage to the skin structures, especially if the integrity of the dermis and subcutaneous fat is compromised. Such damage can disrupt the normal regeneration of collagen and elastin, which leads to a decrease in volume and deterioration of skin tone.
2. Frequency and number of procedures:
Excessive procedures in a short time can overload the skin, lead to chronic inflammation and a slowdown in regeneration processes. This, in turn, can contribute to the deterioration of the structure of the dermis and loss of volume. 3. Improper post-operative care:
Insufficient hydration, lack of sun protection and other skin care deficiencies after the procedure can negatively affect tissue regeneration. Without proper care, the skin can lose elasticity and volume.
4. Individual characteristics of the body:
In some patients, with age or due to genetic factors, the skin may be more vulnerable to microdamage. Concomitant skin diseases or metabolic disorders that affect skin regeneration, the immune system’s response are also possible
5. Procedure technique:
The result greatly depends on the qualifications of the specialist and the methods used. Improper use of microneedling can lead to uneven stimulation of regenerative processes, which ultimately affects the appearance of the skin.

Loss of skin turgor after microneedling

Loss of skin turgor after the microneedling procedure can be associated with a number of biochemical processes and factors affecting the condition of the skin. Let’s look at the main ones:
1. Increased transepidermal water loss (TEWL): Microneedling creates microscopic punctures in the skin, temporarily disrupting its barrier function. This can lead to increased water evaporation through the epidermis, causing dehydration of the skin and decreased elasticity.

2. Collagen and elastin imbalance: The procedure stimulates the production of collagen and elastin, but excessive or improper microneedling can lead to an imbalance of these proteins. For example, excess collagen production without an adequate amount of elastin can make the skin less elastic and stiffer, which is visually manifested as a loss of turgor.

3. Inflammatory response: Microdamage to the skin initiates an inflammatory process, which is part of the natural healing mechanism. However, excessive inflammation can lead to the degradation of existing collagen and elastin fibers, which negatively affects the elasticity of the skin.
4. Impaired Skin Hydration: Damage to the skin barrier function can lead to increased transepidermal water loss (TEWL), which contributes to dehydration and decreased skin elasticity.
Therefore, loss of skin turgor after microneedling may be due to a combination of factors, including increased water loss, skin protein imbalances, and inflammatory processes.

Facial Fat Loss After Microneedling

Facial fat loss after microneedling may be associated with the use of radiofrequency microneedling (RF microneedling). Traditional microneedling uses fine needles to create micro-damage to the skin, stimulating collagen production and improving skin texture. However, when microneedling is combined with radiofrequency (RF) energy, additional effects occur on the subcutaneous structures.
How RF Microneedling Works on Fat:
1. Penetration Depth and Tissue Heating: RF Microneedling penetrates the skin to a certain depth, delivering radiofrequency energy directly into the dermis and subcutaneous fat. This energy causes tissue heating, which can lead to coagulation and destruction of fat cells (adipocytes). Research shows that at temperatures around 42–47°C, adipocytes become sensitive to thermal damage, which can lead to their apoptosis (programmed cell death) and subsequent reduction in fat tissue volume.
2. Subcutaneous Tissue Remodeling: In addition to destroying fat cells, RF energy promotes remodeling of the fibroseptal network (FSN), the structure that supports fat tissue. Heating causes collagen fibers to contract and stimulates neocollagenesis (new collagen formation), resulting in skin tightening and lifting. However, excessive exposure may result in unwanted reduction of fat tissue volume, especially in areas with thin subcutaneous fat layers such as the face.
Factors that affect fat loss:
• Depth and intensity of treatment: The use of needles that penetrate deeply (e.g. 3 mm or more) and high RF energy intensity increase the risk of affecting fat tissue. Some experts note that improper selection of procedure parameters can lead to unwanted fat loss on the face.
• Number of treatments: Multiple RF microneedling sessions with short intervals between them can increase the cumulative effect on fat tissue, increasing the risk of its reduction.
• Individual patient characteristics: The thickness of the subcutaneous fat layer and tissue sensitivity to thermal effects vary from person to person, which can affect the results of the procedure.
Thus, the loss of facial fat volume after RF microneedling is associated with the thermal effect on adipocytes, leading to their destruction.

The methodology of our clinical practice on the restoration of skin volume and turgor.

The technology involves a combination of a number of procedures that will affect the restoration of the subcutaneous fat layer and persistent elastin compounds in the skin.
1. Lipografting + MSCs of adipose tissue, or autologous fat transplantation, is a procedure in which the patient’s own fat is transferred from one area of ​​the body to another to restore volume. The patient’s own fat cells are supplemented with mesenchymal cells of adipose tissue, which have regenerative potential. They can differentiate into various cell types and contribute to the restoration of damaged tissue, and also participate in the neovascularization process, supporting the survival of adipocytes
2. Introduction of endothelial cells (neovascularization – formation of new vessels) After transplantation, fat cells (adipocytes) need an adequate blood supply to obtain oxygen and nutrients. The neovascularization process involves the release of growth factors, such as vascular endothelial growth factor (VEGF), stimulating the growth of new capillaries into the transplanted tissue. This promotes the survival and integration of fat cells in the new area.
3. Intra and extra cellular material: Fat grafting causes a moderate inflammatory reaction, which is a normal part of the healing process. Macrophages and other immune cells infiltrate the transplant area, promoting the removal of damaged cells and the secretion of cytokines that regulate the remodeling of the extracellular matrix and promote the integration of the graft. For this purpose, a complex of exosomes, ribosomes, cytokines, mitochondria and other active cells is additionally used, which help to cope with the local inflammatory process and stimulate active regeneration of transplanted cells.

Result from the procedure for restoring the fat layer and skin turgor:

The procedure takes 1-2 days, depending on the volume of lesions. As for the result of the procedure, there are basic periods for its onset:
• Immediate effect: Immediately after the procedure, an increase in volume is observed in the treated area. However, this initial result is due not only to the injected fat, but also to swelling after the procedure.
• First weeks: During the first 1-2 weeks, swelling and possible hematomas gradually decrease, allowing you to assess the preliminary result.
• First months: In the following 2-4 months, the process of engraftment of the transplanted fat tissue occurs. Some cells may not engraft and dissolve, so the final volume will become apparent after this stage.
• Final result: After about 4-6 months, you can assess the stable and final effect of the procedure.