4-6 weeks apart, however if you reside overseas, I can extend the second session out to 6-8 weeks. It just means your results won’t be seen as quickly compared to the official guidelines of 4 weeks.

My team & I primarily use bioremodulators to treat atrophic rolling acne scars without much anchoring. We can also treat broad based boxcar & polymorphic acne scars.

If you have lots of tethers, you will also benefit from either blunt dissection or sharp multiple level subcision to release scar tissue. Other scar signatures follow the usual scar revision algorithm. 

This injectable is a pisces DNA derived polynucleotide. It has been TGA approved since 2023, but has a long safety record in Asia & Europe. It works by stimulating fibroblasts to produce collagen. It is classed as a biostimulator & not a dermal filler. 

Suitable scar types include low volume atrophic scar including shallow boxcar scars, saucer shaped acne scars & mild rolling acne scars. It can be delivered via a needle, or a cannula. The latter is combined with limited subcision. More on Rejuran Polynucleotide.

2-4 sessions, spaced 4 to 10 weeks apart. Rejuran S has a higher viscosity as compared to Rejuran. Downtime following each injection ranges from 24 to 48 hours (small blebs in the injection sites).

Cost varies from $795 (nurse injector) to $990 per ml (Davin). Factor in 2-4 treatment sessions.

Biostimulators provide synergistic neocollagenesis (collagen production) when combined with energy devices such as lasers, RF microneedling, & microfocused ultrasound. They compound the clinical gains of devices. 

A recent paper (2023) has shown that combination treatments with MFU, collagen stimulating injectables & hyaluronic acid based injectables produce a thicker band of collagen compared to monotherapy alone (one treatment modality). 

I perform biostimulators at weeks 4 to 6 weeks post laser. Depending on the age of the patient & degree of atrophy, 2-4 sessions are required for optimal outcomes.

PLLA or poly L lactic acid & CAH or calcium hydroxyapatite are older biostimulators that are still relevant in treating atrophic acne scars. Here is how I use them-

• Sculptra (PLLA) & PDLLA is useful in more atrophic scarring where volume depletion is significant. This especially applies to mature age patients, or those who have genetically low facial volume. 2-5 sessions are required for optimal outcomes. Spaced 8 weeks apart. Only suitable for rolling acne scars. 
• Radiesse (CAH) is useful for deep atrophic acne scars. It gives more immediate volume than Sculptra, but may not last as long. It is not suitable for boxcar acne scars. With adequate dilutions, 2-4 sessions are recommended. 

Costing for Sculptra-Radiesse varies from $1190 to $1590 per syringe, performed by Dr Davin Lim.

Yes, in a way as they offer 1:1 correction. This means for every 1 ml injected, you will have 1 ml in your skin (but that can be spread across all levels, eg, deep to superficial).

The downside is that HA fillers can migrate, & metabolize faster. Nevertheless they are useful for correction of age related volume loss in more mature patients. The degradation of HA based fillers ranges from 6 to 24 months in the context of acne scar management.

Yes, as I usually perform deep layer subcision (deep fat tissue) with superficially placed Profhilo. This is called the dual plane technique. 

Similarly, Rejuran S can also be performed this way. If subcision is performed with biostimulators, you can expect to have swelling for up to 72 hours post procedure. Bruising lasting up to 6 days can be seen in 20% of cases. 

To give your immune system the best possible chance of remodelling scar tissue you should have:

• Zero inflammation, this means no pimples, zilch. Exceptions are one to three non-scarring pimples that may occur with your menstrual cycle.
• Eat healthy, collagen building requires nutrients.
• Don’t smoke, don’t stress

If you cannot generate enough tissue & remodel acne scars, your choices are; dermal HA fillers, dermal grafting or fat transfer. You may want to consider lasers & RF microneedling as other options.

On a scale of 1 to 10, it is about 2-3. If you are needle phobic, speak to me or my nurses to give you some sedation or anti-anxiety medication. There is nothing wrong with being anxious, as we deal with this several times a day. 

Just remember, if you take oral sedation, you can’t drive home.

About 3 to 24 hours. Yes, downtime is minimal. Out of all the scar revision procedures, biomodulator injections have the least amount of recovery. If you have extensive scars, expect some bruising for a few days. This injectable integrated into the tissue within a few hours. 

Profhilo starts from $850 by my nurses & $990 from me.

Rejuran S price starts from $890.

Discounts apply for multiple sessions & or syringes. We will provide you with a quote prior to treatments.

The most important factor is to obtain absolute control of your acne. This means as close to zero outbreaks as possible. This is the most important factor overlooked by both physicians & patients. It has the greatest impact on results- more so than any other factor. If you have background inflammation, your skin is not functioning at the utmost efficiency to produce collagen & repair scarring. 

Acne is an inflammatory condition. Scar revision is a form of neocollagenesis (collagen remodeling & stimulation). For optimal collagen production, inflammation, ideally, should be non-existent.

Active acne means active inflammation. Your body’s immune system is distracted by fighting inflammation in your skin & not recruited to generate collagen, elastin & scar tissue remodelling.

If you have acne, please book an appointment with our dermatologists for effective control. It will accelerate your treatment results. 

Depending on the depth of laser resurfacing, we can combine bioremodulator injections in the same visit. Examples of combinations include-

• Picosure Pro or Picoway with bio-modulators
• Vascular laser with bio-modulators
• CO2 low power with bioremodulatory injections

The primary reason why I do not carry out deep erbium or CO2 resurfacing is that hyaluronic acid is a sugar molecule. If there is a breach of skin to the level of HA placement, there is a theoretical risk of infection. 

Yes, you can, but your gains won’t be as good compared to getting your acne under absolute control. Inflammation in your skin, however small, will compromise your immune system’s ability to heal & remodel. If you have active acne, you should discuss effective treatment options with your medical dermatologist. 

Ideally, no. The reason is that deep RF (greater than 0.5 to 0.7 mm) will be in the same anatomical plane as bio-modulatory injections/Profhilo. Whilst RF will not destroy or melt fillers & injectables, they do increase the risk of infection.

Yes. TCA is used to treat ice pick scars & narrow boxcar scarring, whilst bioremodulators are used to treat broad based scars, & atrophic scarring, hence scar signatures are usually independent of each modality. 

Dermatologists at Cutis & senior nurses perform this procedure. My senior nurses have over 8 years’ experience in the management of acne scars, including injections of bioremodulators & soft tissue fillers.

Profhilo is less inflammatory compared to traditional fillers, it can be performed with relative safety, depending on the level of placement within the skin. 

Profhilo bioremodulators have been performed in Europe for the past 8 years, hence there is good long-term safety & efficacy data. I use this product to:

• Rejuvenate skin without volume changes
• Tighten saggy skin of the face & neck
• Improve skin luminosity & dullness
• Reduce static wrinkles due to sun damage & age
• Treat the chest, neck & decolletage
• Prejuvenate the younger age group 

No. Ice pick scars are easily treated with TCA Paint, CROSS, focal CO2 lasers as well as punch excision. In super deep ice-picks, I also free up the base with sharp subcision. Frequently we combine Profhilo injectables with other scar directed treatments, including chemical peels & lasers.

Collagen stimulating fillers include PLLA, Ca Oh, & in the United States PMMA. I have used most of these fillers in the past 18 years. Whilst hyper diluted formulations can give great results, these fillers are placed in the mid fat areas. They give better volumetric correction compared to Profhilo.

PLLA has marginal improvements in the upper epidermis, however hybrid HA injectables are superior when it comes to improving skin quality. 

Yes. In fact, most acne scar treatments are safe if you are on Accutane. You do need to clarify this with your treating dermatologist. If they are up to date with current evidence-based medicine, they would have read the papers from 2015-16. 

Side effects are fortunately rare. In order of safety (highest to lowest)-

1. Profhilo
2. Rejuran S
3. PLLA, PDLLA, CAH
4. PMMA

Risks include –

• Misplaced injectable gel
• Infection
• Vascular occlusion 
• Urticaria, temporary bruising
• Nodules, calcification, prolonged swelling

No. Though they are established as a treatment of acne scars with a high level of evidence in the literature, Medicare does not recognise biostimulators as a treatment modality for acne scarring. 

Medicare is run by outdated dermatologists & pencil pushers who only believe that excision of scars & or total laser resurfacing of the entire face is the ONLY treatment for acne scarring. This is based upon the literature from the 1980s. That is why they sit in the office as policy makers.

There are variations of atrophic acne scars including, rolling scars, boxcar scars, saucer scars, ice-pick scars & polymorphic undifferentiated scarring. Treatments are directed at the type of acne scar. 

Ice-pick scars, which account for up to 70 per cent of atrophic scars, are little holes that go deep into the skin. Easily treated with TCA Paint or excision.

Boxcar scars form a round or oval indent on the skin and have a flat bottom, a lot like chicken pox scars. Best treated with partial paint & lasers. 

Rolling scars create soft indents on the skin, creating a wave-like effect. This type of scarring can respond well to injectables. In most cases there will be a need for some sort of subcision procedure.

Yes. Injectables are color blind. The caveat is that whilst scarring is worse in darker skin types, collagen remodelling is better. The same applies to energy devices such as laser resurfacing, peels, RF & RF microneedling.

The HA in Profhilo is unique. Compared to dermal fillers from Allegan, Merz, Teoxane, & Galderma, the hyaluronic acid in Profhilo is:

• Higher concentration at 64 mg per syringe. Other fillers range from 15 mg to 22 mg.
• Is not crossed linked but rather heat bonded
• Cause less inflammation in the skin
• Stimulates collagen synthesis as well as fat, stem cells, & skin cells (in theory)
• Has unique properties that enable integration with the surrounding tissue (high tan delta), low G prime.

My team & I practice objective assessments for scar revision, meaning to reduce the appearance of acne scars from a predetermined distance. Results are assessed by photographic documentation under normal lighting conditions. 

Your progress is largely dependent on your immune system to remodel scar tissue. As each individual’s immune system lies on the bell curve, so too are the results. If you cannot remodel scar tissue, we may need to swap you to traditional hyaluronic acid fillers. 

Lots. With each passing year after your early 20s, you lose 1% of collagen stores. In your late 30s to early 40s you are behind by 25%. Collagen supports the skin, reducing sag & laxity. 

With age, the loss of collagen with time plus the reduction of collagen in acne scars makes any job challenging. In this age group we need to address volume loss in scar areas & treat age related volume depletion. This is why Profhilo biomodulation is an excellent choice for treating superficial atrophic scars. 

Conversely, normal hyaluronic acid dermal fillers are placed in the deeper layer of skin, most frequently on bone. This addresses age related changes. 

I will be starting in Sydney in late 2023, early 2024. My practice will be with Dr Van Park in the Eastern Suburbs of Sydney. This practice is a boutique skin clinic without an operating theater. Scar revision treatments will be limited to-

• Dermal fillers & biostimulants for acne scars
• RF microneedling
• TCA Paint
• Blunt subcision

An expression of interest form will be sent out to you prior to the consultation