“We now have over 28 kinds of collagen all through our physique,” says Ben Talei, MD, a double board-certified facial plastic surgeon in Beverly Hills. And whereas we’ve all been taught that collagen is central to youthful pores and skin, it’s merely one variable, together with “elastin, hyaluronic acid, fats, and a thousand different parts that are obscure,” he says.
However right here’s the place issues get actually fascinating: Throughout my interviews, medical doctors stored utilizing the phrases “collagen” and “scar” interchangeably, which I discovered a bit perplexing till Dr. Probability broke it down like this: “Scar tissue is collagen and collagen is scar tissue. You possibly can get super-nerdy about it, however the distinction between them is mainly branding.”
Within the context of nonsurgical remedies, collagen is usually a euphemism for scar tissue: Collagen-stimulating units and injectables “create managed accidents,” explains Sarmela Sunder, MD, a double board-certified facial plastic surgeon in Beverly Hills. In response, “scarring is the reparative course of whereby new collagen is shaped.” And although “we wish to suppose we’re doing it in a managed method, you possibly can by no means totally management how the physique scars,” Dr. Tenenbaum says. That’s why biostimulators make some medical doctors uneasy. The end result — be it underwhelming, strong, or simply proper — is basically out of their palms, pushed as a substitute by a person’s anatomy and genetics in addition to the whims of their immune system.
What’s extra, the collagen born of cosmetic treatments doesn’t essentially mirror our native provide. It could be organized in a different way or sprout the place it shouldn’t. Injecting biostimulators underneath the pores and skin, as an illustration, “tends to create localized collections of collagen which can be inconsistently distributed,” says Jessica Weiser, MD, a board-certified dermatologist in New York Metropolis. If the merchandise are positioned improperly, these “rope-like bundles” can develop in layers of the face the place collagen will not be usually discovered, like within the fats lining the underside of the pores and skin or within the muscle beneath.
Our intention right here isn’t to scare you or put any model on blast. These collagen-building procedures are usually FDA-cleared or FDA-approved and thought to be protected and efficient. “When used effectively, they’re very profitable,” says Dr. Probability. “This isn’t like The Emperor’s New Garments, the place persons are saying, ‘That is actually working’ when it’s not.”
Whereas nobody loves the thought of scar tissue, in some circumstances “that irregular structure is definitely what we’re aiming for,” provides Amelia K. Hausauer, MD, a board-certified dermatologist in Campbell, California. It’s conferring the specified impact: Biostimulators’ collagen clusters fill out hollows. The scarred or contracted tissue from radiofrequency makes pores and skin really feel slightly firmer. When requested to touch upon whether or not scar tissue creates Sculptra’s desired impact, Galderma mentioned, “Sculptra promotes tissue regeneration and improves pores and skin high quality by serving to to revive the pores and skin’s personal collagen and elastin.”
Every therapy could have its personal implications for future facelifts
Given the absence of conclusive proof, there are few black-and-white truths on this subject. Nonetheless, when requested which kinds of interventions are likely to trigger the most important complications throughout facelifts, most surgeons cite the identical ones: biostimulators, thread lifts, and deep-energy remedies (radiofrequency and ultrasound) that purport to “tighten” or “carry.” Fats-freezing and overly-aggressive previous surgical procedure (together with liposuction) are two others that come up.