Bioremodulator - Biostimulator Injections; At A Glance
- Best Results1-3 treatments
- Treatment Recovery10 Hours
- Procedure Time5-15 minutes
- Skin SpecialistNurse, Davin Lim
- Duration of ResultsLong-term
- AnaestheticNot Required
- Back to WorkImmediately
Bioremodulator Injections for Acne Scars
Biomodulators or biostimulator injectables have revolutionized acne scar treatment. Biostimulators comprise of unique compounds that include hyaluronic acid molecules, polynucleotides & collagen stimulating compounds. These are different from ‘dermal fillers’. Biostimulants refers to an increase in collagen production which results in reduction of atrophic acne scars. Unlike lasers, injectables provide fast results with little to no recovery time. Read more to understand the what types of acne scars respond to these injectable treatments.
FactsFacts On Bioremodulator Injections for acne scars
- These injectables stimulate collagen production to help remove acne scars
- Unlike dermal fillers, biostimulators recruit collagen producing cells
- Biostimulators can be hyaluronic acid based; Profhilo
- Biostimulators can also be DNA polynucleotide based; Rejuran
- Other agents include PLLA, calcium hydroxyapatite & polycaprolactone
- The ideal injectable depends on the degree & depth of atrophic acne scaring
- Biostimulators can be used as a stand alone treatment for atrophic scars
- Biostimulators can also be combined with lasers & peels for synergistic results
- Injectables are not associated with any downtime
How is this injectable different from dermal fillers?
Dermal fillers add volume via the injection of man-made hyaluronic acid, whist bio-remodelling or biostimulating injectables stimulate your own immune system to manufacture collagen, skin cells & adipose (fat) tissue. Most atrophic acne scars will have an element of collagen & fat loss.
In theory biostimulator injections provide a long-term solution to acne scars as it regenerates your own dermal matrix, providing your immune system can do it.
For acne scar revision, I employ both dermal fillers & biostimulatory injectables. This article explains the algorithm in greater detail.
How do injectable bioremodulators improve acne scarring?
In the context of acne scars, the aim is to stimulate your own immune system to repair atrophic scars by remodeling & regenerating collagen, fat & hyaluronic acid. Unlike normal hyaluronic acid dermal fillers, bioremodulators are aimed at providing long lasting results.
Secondly HA molecules provide an environment conducive to producing collagen. Thirdly, HA’s can act as a spacer, preventing re-attachment of acne scars post subcision.
What is the advantage of biostimulators over lasers in the treatment of acne scars?
Biostimulators can give immediate results with little to no downtime as most work in two phases. The first phase is tissue swelling due to compounds mixed with the primary collagen stimulator. The second phase occurs 2-4 months after when your skin generates collagen.
As these compounds are injected under the skin’s surface, the skin recovers very quickly. Lasers on the other hand treat from the top down, meaning that the upper layers of skin have collateral damage as the laser beam needs to penetrate these layers.
Lasers work by collagen stimulation through thermal wounding, whilst biostimulators work by stimulating cells via receptors.
Note: for scar signatures that are superficial, lasers will work better than injectables. Injectables work better than lasers for deep scar types.
When will I see the results?
Results are seen as early as two weeks, however, will be maximal at 8 to 12 weeks after your second session. Hence you will need to wait for your immune system to regenerate healthy skin & collagen.
If you have a strict timeline & want faster results, consider HA dermal fillers (traditional. The advantage of HA fillers is a faster time of onset. The disadvantage? Not permanent.
How many sessions will I need?
A minimum of two, a maximum of 4. It depends on the extent of acne scarring, the type of scars, volume of atrophy, location of scars, your immune system’s ability to regenerate tissue & most importantly, your expectations.
Remember, this treatment is only for select scar types, namely rolling scars. With skill & precision it can improve broad based boxcar scars & saucer scars.
What are other factors that I consider in choosing the optimal biostimulator for my acne scars?
The algorithm is complex as many factors are considered for your injectable treatment. Factors include-
- Depth of acne scars & scar signatures (as described above)
- Degree of non-scarring related atrophy of both fat & collagen (facial aging)
- Constitutional facial volume (genetic based)
- Patient’s age (mature patients require more powerful stimulation, & more sessions)
- Previous treatments
- Time frame
- Lifestyle choices – especially in superactive patients
How would I know if biostimulators are suitable for my acne scar type?
Biostimulators are best for specific acne scar signatures. They are not a blanket treatment for all scar types. Here is a glimpse of the treatment algorithm based upon scar morphology–
- Boxcar acne scars: polynucleotide DNA, heat stabilized hyaluronic acid biostimulator
- Saucer & polymorphic acne scars: polynucleotide DNA, heat stabilized hyaluronic acid biostimulator
- Low volume atrophy: CAH hyper dilute, heat stabilized HA, PLLA, PDLLA
- Medium volume atrophy (+/- rolling scars): CAH hyper dilute, PLLA, PDLLA, PCL
- High volume atrophy (+/- rolling scars): CAH hyper dilute, PLLA, PDLLA, PCL
- Ice pick scars / pits: TCA vs excision
- Enlarged pores: polynucleotide DNA, heat stabilized hyaluronic acid biostimulator
Will all my scars go with biostimulatory injectables?
Deeper scars respond better to biostimulation as compared to more superficial scarring in the context of injectables.
For superficial acne scars, the primary aim of injectables is to provide a universal objective improvement in acne scar severity. For ‘complete’ or near complete effacement of boxcar acne scars, lasers & or deep peels provide better outcomes. In the context of deeper rolling scars, we can expect a 50 to 95% improvement in scar severity after 2-4 treatment sessions.
*This refers to an objective before & after photograph, it does not take into account your subjective assessment, as end points are subjectively measured.
Are the results of biostimulators predictable?
The results are predictable in over 80% of cases, but the results lie within a Gaussian curve. This means some individuals lie to the very right (highly effective, wow effect), conversely, others lie to the left (less effective, meh effect).
Poor responders include-
- Those with active acne (hence why absolute remission is encouraged)
- Mature patients
- Poor lifestyle choices
- Idiopathic (genetic reasons)
What is the longevity of biostimulators & will I require repeat treatments?
The longevity is not well studied however the general consensus is that if one stimulates dermal collagen (your own collagen as compared to HA dermal filler), then an age related reduction in collagen can be expected. This is called aging (both chronological ie. genetically predetermined, as well as exogenous aging, due to environmental factors).
- Longer lasting results can be expected with the following: CAH, PLLA, PDLLA, high & low molecular weight HA biostimulators, PCL.
- Shorter lasting results can be expected with: HA dermal fillers, skin boosters, non-cross linked hyaluronic acids, polynucleotide DNA.
A recent study has shown that a collagen stimulating HA based injectable (Profhilo) has produced longer duration of improvement compared to traditional cross linked dermal fillers, namely Juvederm. Patients in the Profhilo group continue to improve after one year post injection.
In summary, the degradation of collagen is controlled primarily by your body’s own aging process.
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What is the time interval between treatments with bioremodulators?
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.
Why are injectables a good choice for purely rolling atrophic acne scars?
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.
What is Rejuran S for acne scarring?
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.
How many sessions will it take to improve scars?
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.
Why do I use biostimulators post laser resurfacing & what is the timing?
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.
What is the role of older biostimulators like Sculptra & Radiesse?
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.
Are hyaluronic acid dermal fillers more predictable?
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.
Can surgical subcision be performed on the same day as bioremodulator injections?
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.
What if my body’s immune system cannot regenerate collagen & fat cells?
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.
Does the treatment hurt?
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.
How long is the downtime?
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.
What is the cost?
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.
What can you do to improve chances of success?
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.
Can lasers be conducted on the same day?
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.
Can I have this procedure if I have active acne?
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.
Can RF microneedling be performed on the same day?
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.
Can TCA Cross or paint be conducted on the same day as bio-modulators?
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.
Who performs this procedure?
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.
Can Profhilo be mixed with other dermal 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.
What are other indications for this injectable?
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
Can ice-pick scars be treated with Profhilo- Bioremodulator injections?
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.
How does bioremodulator injections compare to traditional fillers such as poly-L-lactic acid & calcium hydroxyapatite?
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.
Can biomodulator injections be performed if I am on Accutane?
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.
Are there any side effects or risks with bioremodelling injections?
Side effects are fortunately rare. In order of safety (highest to lowest)-
Risks include –
- Misplaced injectable gel
- Vascular occlusion
- Urticaria, temporary bruising
- Nodules, calcification, prolonged swelling
Are biostimulators covered by Medicare?
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.
How do dermatologists treat other types of acne scars?
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.
Can all skin types & colors be treated with biomodulator injectables?
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.
How is the hyaluronic acid in Profhilo different from other HA dermal fillers?
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.
What is the end point of scar revision?
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.
What has age got to do with scar revision?
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.
How do I get an appointment in Sydney for acne scar treatment?
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
Davin’s viewpoint on bioremodulator injectables
This product, namely a biomodulator injectable that consists of heat stable hyaluronic acid, has proven to be the most effective injectable for the treatment of acne scars. The two biggest papers with split face saline vs hybrid HA injectables came out in late 2021 & early 2022. They remain as landmark papers due to the size of the studies & importantly a control group. The only comment I would make is that in one paper the use of combined methodology was used, namely subcsion with a cannula. Ideally trials should be injectable only to the upper layers of skin, without mechanical assistance. The downside is that we still don’t have data on long term efficacy. Ideally scars should be followed up for 1, 3 & 5 years. (Once long-term data is obtained, there will be many other variables including fluctuations in weight, chronological aging & volume loss as well as other treatments during the follow ups that need to be factored in. The immense variable would make this complex, but one hell of a good study.)
My take on longevity is that there will be net gains, even when Profhilo has ‘worn out’. This implies that biomodulation occurs despite the product having broken down, remembering that fat, skin cells & collagen levels are increased. The measurable net gain of these tissue is hard to measure as there are many variables including-
- The use of other remodelling modalities post treatment as most acne scar patients have multiple scar signatures.
- Age related reduction in adipose tissue, HA, elastin & collagen (dermal matrix).
- Ethnicity, suited skewed to ethnic patients, as we know collagen remodelling is brisker in darker skin types.
- The site of injections; cheeks better at remodelling cf. temples & forehead.
- Scar signatures: atrophic scars with very little bound down or anchored tissue will respond best. In other subcision will be required. Ice pick & boxcar scars generally will require different modalities (however I treat broad based boxcar scars with Profhilo to good effect).
An important consideration is your age. This is by far the hardest message to convey to patients in their late 20s & beyond is that we are fighting both collagen loss in pre-existing scars & age-related volume loss. In your late 30s you are already behind by 25% as over time everyone’s collagen levels will deplete. Hence this age bracket, you will probably benefit from HA fillers (as volumetric replacement) & Profhilo to provide bioremodulation. Your other options include dermal grafts or fat replacement-transfer, with or without adipose stem cells.
Safety is paramount. The main risk is intravascular injection & occlusion of arteries. In acne scar patients the risk is EXPONENTIALLY higher than with normal dermal fillers. Here is why-
- Buffer zone depletion. With cystic acne, there usually is an element of fat atrophy due to collateral inflammation of deeper tissue. Additionally, the use of ILCS cortisone injections may also contribute. This means there may be less fat tissue to act as a buffer, exposing deeper vessels.
- Change of anatomy. We know that scar tissue has aberrant vessels. In extreme cases fibrosis & inflammation not only depletes fat, but also may ‘pick up’ deeper arteries-arterioles, again increasing the risk of intramuscular injections & occlusion
- Scars disrespect vascular pathways. We all know the pathway of arteries, especially the facial artery. As injectors, we avoid these pathways, however acne scars can occur anywhere, meaning that in many cases we head to the danger zones & not avoid them.
The chances of intravascular occlusion with this product is extremely low (1 case 2022 out of 4+ million treatments), possibly the rheology of this injectable follows so well that end aa occlusion is v v rare, however animal studies should come out in the next few years to determine if this is the case. Regardless, it is the law of probability that sooner or later arterial injections will occur. Hence the importance of having a specialist canter perform higher risk injections.
Profhilo has a very high tan delta, which reflects flow characteristics of the product. A tan delta of 0 is ice, 2 is water. It sits at 1.36, whilst normal fillers sit at 0.15 to 0.25. This tan delta means Profhilo flows well. It still follows flow dynamics of liquids, namely, to flow to the pathway of least resistance, however unlike normal fillers, Profhilo will flow around the tethers in rolling scars. What this means is that it provides excellent integration in tissue, whilst traditional fillers may exhibit over correction. The G Prime however is very low, this reflects the nature of this injectable.
So how does this bio-modulatory product fit in our clinic? Bioremodulatory injectable are ideal for patients who are looking for scar revision without the downtime of surgery, lasers, or deep peels. My colleagues & nurses also perform this procedure; hence it is readily available & importantly it is affordable. My nurses have had extensive experience in scar revision, including the use of soft tissue fillers, blunt cannula subcision & injecting bio-modulators for acne scars.
In my practice of treating objectively severe scars, I employ Profhilo at the end of the revision period as in most cases I subcise & excise early in the course of treatment. Alternatively, if you come to see me from overseas, to make the best of your time, my usual practice is to firstly subcise & laser, then in 5-10 days later, employ bio-modulators. For local patients, I do think that traditional treatments based upon scar signatures will give more predictable outcomes. Over the next decade we will have more hybrid injectables, namely those which give short term correction of volume & a long tail approach to neocollagenesis.
For deeper volume loss, namely large volume atrophic scars, I still employ older biostimulator injectables, namely PLLA & CAH. This group of collagen stimulating injectables have a safety record spanning two decades. 2-4 sessions are typically required, occasionally more for severe atrophic scarring in mature patients.
Conversely, if scarring is very superficial, another biostimulator that has been approved for use in Australia is called polynucleotide. This treatment uses DNA particles to stimulate collagen in the upper layers of skin. Unlike other injectables, the plane of injection is high up in the dermal layer of skin. Suitable scars include polymorphic, saucer & boxcar acne scars. The literature suggest 2-4 treatments over a period of 3 to 6 months. The recovery from Rejuran S injections is +36 hours as superficial blebs take longer to dissipate compared to HA hybrid molecules.
For those who are more inclined to ‘natural treatments’ short and long chain hyaluronic acid complexes can also increase the viability of fat transfer & ASC (Adipose stem cell transfer) as well as autologous grafting. This applies to treatment of hypopigmented acne scars. I currently mix a soup of micrografts & normal HA’s but will consider adding Profhilo to help with melanocyte activation. Additionally, HA’s can also speed up wound healing from micrografting as it provides an ideal environment for cell growth from the bone, all the way to the epidermal layer of skin. This is the power of hyaluronic acid. Don’t get high tech injectable HA’s confused with hyaluronic acid serums- it’s like comparing your iPhone 14 to your Motorola mobile from the 90s.
*Our practice in Sydney will offer biostimulators for both acne scarring in addition to Anti-aging. Our doctors employ the following biostimulators; polycaprolactone, poly-L-lactic acid, calcium hydroxyapatite, HA hybrid, polynucleotide, & upcoming PDLLA. E mail us for expression of interest.
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