- Best Results18-24 months
- Treatment Recovery0 days
- Procedure Time15 minutes
- Skin SpecialistDr Davin Lim
- Duration of Results Long-term
- AnaestheticNumbing to sedation
- Back to WorkImmediately
Rigenera for scars
Regenera Activa & Rigenera is a device that uses autologous micrografts harvested from the patient’s skin. These grafts are then re-injected into areas of pathology, including acne scars, dermal scarring, as well as keloid scarring. Over time scars are remodelled using your own stem cells. Treatments are quick with little or no downtime. Read more to understand the concepts behind this treatment.
FactsFacts on Rigenera for Scars
- This is a form of non-cultured autologous cellular grafting
- This means donor tissue is harvested from your skin then processed
- Processed tissue contains dermis, fat, fibroblasts, hyaluronic acid & stem cells
- This is also a natural source of growth factors & cytokines
- This solution is then re-injected into the areas of scarring
- Scar remodelling takes place over 12 to 24 months
- Scar types amenable to Rigenera include atrophic, keloid, hypertrophic & mixed scars due to acne, trauma, burns, & surgery
What is Rigenera?
This is a novel treatment for a variety of skin conditions including acne scars, traumatic, keloid scars, burns & hair loss. It is also used to address age related reduction in collagen & dermal matrix. It uses the concept of micrografting dermal components of skin.
What is the science behind stem cell therapy, Rigenera & Regenera Activa?
The theory behind micrografting & stem cells is that transfer of normal dermal matrix (including fat) causes wound repair cascade. Mesenchymal stem cells can, in theory secrete growth factors, cytokines & chemokines to repair scar tissue & wounds. They can increase blood vessels (angiogenesis), reduce inflammation & promote migration & induction of collagen producing cells known as fibroblasts.
What types of scars can be treated with Rigenera?
Ideally, small areas of atrophic scars have the potential to remodel with Rigenera. Remember, with published studies, it can take up to 2 years to see the best results.
Studies have shown that the following types of scars can potentially respond to micrografting- atrophic scars, hypertrophic & keloid scars, red scars, & hypopigmented scars.
When are the results seen?
In the context of dermal remodelling, results are slow. Studies have shown some improvement is seen at 6 months, more at 12 months, & maximal at 24 months. Therefore I normally recommend a combination of treatments including lasers, peels, PRP (in the context of synergistic treatments) as well as surgical procedures including subcision & excision.
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How many sessions will you require?
Studies have shown that one treatment can produce results. I normally combine more effective procedures with Rigenera. They include lasers, microneedling, surgery & deep peeling. This gives a faster response compared to Rigenera alone.
How do we harvest stem cells & tissue?
We use a special instrument known as a punch biopsy to harvest your own skin. Typically, we take out 2-5 pieces of tissue from a hidden area like the back of your ear, the inner arm, upper thigh, or upper buttock.
Harvesting is conducted under local anaesthetic & is painless. It takes between 3-6 seconds in total. Yes, it is that easy.
How do I inject the stem cells back?
I use a syringe to inject the processed tissue solution back into the areas of concern. The level of injection is in the hypodermis- just under the dermal layer of skin. This typically takes between 2-4 minutes. Unlike true dermal grafting, micrografting & ReCell, the recipient area skin is not broken.
What is the recovery following Rigenera treatment?
Immediate. Unlike other procedures, injected autologous non-cultured cellular grafts like Rigenera do not have associated downtime. Harvest sites heal up within 5 days & are inconspicuously placed. You may be some very mild bruising in the injected site (areas of scarring). The flipside? You have got to wait 6 months before seeing results, & it takes 24 months before maximal benefits.
What are other methods to regenerate tissue?
Broadly, stem cells can be divided into culture & non-culture cellular grafts. The former is more complex as it means extracting stem cells from the donor, growing it in a laboratory for 4-6 weeks, then reinjecting back into the areas of concern. This method is hugely expensive (upwards of 30-50K). In the next two decades it may be feasible in an outpatient setting. Other methods I currently employ include-
- Dermal grafting. It is like Regenera but the dermis is manually chopped not placed in a microblender.
- ASC or adipose tissue stem cells, derived from autologous fat cells.
- ReCell – for autologous non-cultured melanocytes
- SSG – split & split micrografting. This is primarily for hypopigmentation & vitiligo.
How does Rigenera compare with dermal fillers?
Rigenera & Regenera Activa rely on your body’s immune system to regenerate cells from stem cells. Dermal fillers act as either a spacer filler or as a way of replacing collagen & fat. Fillers rely less on your body’s ability to regenerate adipose tissue, extracellular matrix & collagen.
- Fillers pros: More predictable. Better correction. Fast results.
- Rienera pros: Natural way to stimulate collagen & remodel scars. Slow results, if any. Unpredictable. Less useful in moderate to large volume atrophic scars.
How does Rigenera compare with ReCell?
Both processes use your own cells, & both are kits with their own patented cell harvesting technology. ReCell is better for superficial problems such as hypopigmentation, burns, textural changes & skin quality issues. Rigenera is better suited for what goes on underneath the skin, dermal scarring & hair pathology are examples.
How does Rigenera compare with stem cell transfer?
There are no head-to-head studies comparing Rigenera to adipose stem cells. I suspect the results may be similar (in the context of scar tissue). I understand that Regenera Activa has possibly the edge when it comes to regenerative hair studies, namely for the management of male & female pattern hair loss.
Rigenera has the advantage when it comes to ease of harvest & delivery. For fat stem cells, liposuction is required, followed by processing then re-injection.
How does Rigenera compare to dermal grafting?
I was taught dermal grafting by the great Dr Rob Sinclair in the early 2000s. Back then filler technology was still in evolution. Dermal grafts are more predictable than Rigenera as I transfer dermis to the scars directly. Dermis consists of collagen, hyaluronic acid, ECM & fibroblasts. It does not rely on stems that may or may not regenerate tissue.
- Dermal graft pros: Faster results, does not require stems to evolve. Under Medicare. Technically challenging, more side effects including inclusion cysts.
- Rigenera pros: Slower results, but very easy to do. Less invasive. No side effects but there is no Medicare rebate.
What are the papers combining Rigenera & PRP about?
Clinic Cutis & my colleagues use PRP. I have used this technique in every way possible, injected, saturated on the outside, mixed with lasers, microneedling & in concentrations ranging from 3X to 7.5X. I believe it can have marginal effects with healing, but it does not give meaningful volumetric correction of scars.
If you would really like me to use PRP with your treatment (based upon your research), just tell me beforehand. It is against my advice, but if you want it, I can deliver PRP at an additional cost.
The current literature suggests that there may be a synergistic effect with PRP & Rigenera. I do agree, however only in the context of androgenetic alopecia.
How should you approach acne scars?
If you are serious about removing acne scars, a targeted approach is best. This means finding suitable treatments based upon your scar type. For most cases of scarring, simple nurse-led treatments like fractional laser or TCA peels can give better results than Rigenera at a fraction of the cost.
Tethered, anchored & atrophic scars can be treated with surgical modalities including subcision. Rigenera is an option for those who exhibit atrophic scarring and would like to try out an alternative to dermal fillers.
What are the side effects of Rigenera?
This treatment has the least amount of side effects compared to other surgical modalities. Unlike full or split grafting, Rigenera only removes 7-8 mm of full thickness tissue, taking only 4-5 seconds. No sutures are required. As the solution is injected in the hypodermis, there is no requirement to prepare the recipient (scar site) area.
Is Rigenera covered under Medicare?
No. This procedure is not covered under Medicare, neither is stem cell or adipose stem cell transfer. Medicare does cover dermal grafting, full thickness & split skin grafting.
As a guide, Rigenera cost between $2490 to $4990. The lower figure is the cost for a simple 7 ml solution, the higher figure also combines multi treatment modalities such as subcision, chemical peels, surgery & laser resurfacing.
Davin’s Viewpoint on Rigenera
Rigenera is not a new treatment, having been on the scene for nearly a decade. It also goes by the name of Regenera Activa. In essence it is a dermal graft that is cut into small bits with microblades within the device itself. Normal dermal grafts are about 0.5 to 1.5 mm in diameter. Rigenera dermal grafts are 50 to 80 microns or 5/100 to 8/100 of a millimeter.
Studies in the context of scars are few & consist of a small series of treatment. To date (in 2022), there are no split placebo (saline) studies on scars. This means blinded large number studies where half the scar is treated with normal saline & the other half with Rigenera. Regardless, it can be useful as adjunctive therapy for small volume deficits.
Moderate to severe atrophic scars whereby tissue loss in both dermal and subcutaneous may have a real time volume deficit of 5 to 10 millilitres. This is substantially more than say 20-30 2.5 mm punch grafts. In this context it is highly unlikely that mesenchymal stem cells derived from dermal punches (even if they contain a small amount of mesenchymal adipose stem cells), can differentiate into cells such as fibroblasts.
If you think that this treatment is for you, please note that it can take up to 2 years before you see the best results. Regardless of the paucity of research, this has some merit (as dermal grafts do work). If patients are risk averse to potential dermal filler complications & would like a non-cultured cellular graft, consider Rigenera.
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