a young woman tilted her head to the side after reading the Guide To Juvederm Cost

Guide To Juvederm Cost

How Much Does Juvéderm Cost?

Juvéderm is a popular dermal filler commonly used for the treatment of facial wrinkles. The average treatment cost per syringe is approximately $500 – $600.

However, the exact cost of Juvéderm depends on the chosen formula, provider fees, and locations. For these reasons, the cost per session varies by patient, and the amount needed to achieve the desired results.

Juvéderm treatment requires a short recovery time, minimizing time off work and lowering the cost of having work performed. It is typically not covered by insurance.

What Are the Total Costs of Juvéderm Treatments?

Juvéderm is a quick and affordable option compared to cosmetic surgery procedures such as facelifts. Dermal fillers are non-invasive, and no surgery is required.

You can expect to pay somewhere between $500 and $600 per syringe, although more extensive work can cost more. For example, in some situations, it may be recommended that a patient take two syringes per session.

Unlike other wrinkle treatments, Juvéderm’s different products are formulated specifically for certain areas of the face, such as the lips, which is why the cost per syringe can vary. The main types of are:

1 . Volbella.

2. Vollure.

3. Voluma.

4. Ultra.

An “XC” variant is also available, which contains lidocaine to make the procedure less painful.

Aesthetic procedures like dermal fillers are not considered medical necessities by medical insurance providers. This means that it is unlikely your insurance will reimburse for Juvéderm.

Juvéderm for the Under Eyes

Juvéderm Voluma is ideal of adding volume to under your eyes. While the treatment isn’t specifically approved for this use, it can be effective regardless.

The average cost of this treatment comes to around $1,500 per syringe.

Juvéderm For Your Lips and Mouth

When treating your lips, two main formulas of Juvéderm used. Ultra XC and Volbella XC are both effective for treating common issues in this area. Ultra XC helps to add volume to your lips, while Volbella XC removes wrinkles around the area.

These options have varying price ranges, with Ultra XC going as high as $1,000 dollars in some cases.

Juvéderm for Your Cheeks

Plump cheeks and youthful looking skin are highly desirable traits often obtained through facelifts. Juvéderm Voluma XC and Vollure XC can be effective at replicating these results.

Vollure XC is estimated at $750 per syringe, while Voluma is much higher at $1,500 per syringe.

Treatment Recovery Time

Taking time off work to recover from treatment often adds the cost of having it done. Unless you are being paid for your time off, you’ll lose money in wages.

Luckily, Juvéderm has little to no recovery time. You may have some swelling and bruising, but you will be able to work under these conditions if you choose.

How Long Does Juvéderm Last?

Juvéderm is not a permanent treatment and will need to be performed at least once every year to maintain the desired results. These results vary by formula and may need to be repeated more often depending on the specific needs of the patient.

The procedure takes approximately 15 to 60 minutes, and the results are noticeable almost instantly.

Preparing for Juvéderm Treatment

Before using Juvéderm, your doctor will give you strict instructions on things you can and cannot do. You will need to avoid activities like:

1.  Smoking of any kind.

2. Drinking alcohol.

3. Tanning and similar skin treatments.

If you are on any medications, you may need to adjust your dose or stop using them entirely leading up to your appointment. This includes drugs that make you bleed in any way, like nonsteroidal anti-inflammatory drugs.

Finding a Treatment Provider

While mainstream spas are starting to offer injections, Juvéderm is still considered a medical procedure. For this reason, it is advised that you have your procedure done at a licensed medical doctor.

Ideally, you will have your treatments performed by a cosmetic surgeon or dermatologist. Ask anyone you intend to use as a provider about their experience, and if possible, to see their portfolio.

Restylane vs. Juvéderm

Restylane is another dermal filler brand that is commonly used to plump skin and reduce wrinkiles. While the two treatments are similar in cost, many say that Juvéderm provides better results, specifically when using:

1. Voluma.

2. Vollure.

3. Volbella.

How to Reduce the Costs of Juvéderm

As patients must pay the full cost of Juvéderm, it is common to try and find ways to lower the overall price. To achieve this, you can ask your doctor about:

1. Possible payment plans.

2. Membership related discounts.

3. Manufacturer rebates.

4. Available financing options.

Juvéderm is also part of a program known as Brilliant Distinctions. This allows you to accumulate points to reduce your treatment costs.

While Juvéderm is an attractive and affordable alternative to facelifts and other costly skin treatments, the cost varies significantly on a case by case basis and will depend upon your desired results and the needs of your skin.

The box of Bocouture 100 Units for buying online with the Best Wholesale Prices

Buy Bocouture Online: Best Wholesale Prices – Help & Guide

Botulinum Toxins, Cosmetic Treatments / By  Medical Community

10 Jul

Where to buy Bocouture?

You can buy Bocouture, also known as Xeomin, online through online retailers and also from brick and mortar authorized merchants. Buying online can be more convenient and save you time. Shopping online usually requires you to simply select the strength and quantity you want to purchase, submit your medical license number, complete payment and provide a mailing address. Buying online has become more popular among medical practitioners since it allows them to focus on their practice and manage their supply inventory better.

Need help finding Bocouture or another product?

If you cannot find what you need in our extensive product catalog, we can help source any medical or aesthetic product for you.
Simply use our product request form or  speak to one of our expert purchasing agents and start saving today!

What is Bocouture?

Also known as Xeomin or Xeomin Aesthetic, this is a cosmetic injectable made of botulinum toxin type A—similar to Botox and Dysport, but with units that are not equivalent. The botulinum toxin comes from the Clostridium botulinum bacterium, known for causing the illness botulism, but this neuromodulator is beneficial in small quantities. It temporarily paralyzes muscles, which relaxes wrinkles or treats certain medical conditions. Unlike its rival neurotoxins, this brand is free of complexing proteins, which the manufacturer claims makes it less likely to trigger antibodies. The lack of these complexing proteins helps to maintain the treatment’s effectiveness over time. Available in 50 units and 100 units, this neuromodulator comes in a powder ready for reconstitution using saline solution. Botulinum toxins such as this are the most popular minimally-invasive cosmetic treatments, used in millions of injections each year in the U.S. alone.

What makes a good candidate for this treatment?

Only patients over the age of 18 are suitable candidates for these cosmetic treatments. Although most mature patients wait until wrinkles are visible, patients in their 20s and 30s now choose these injections to help prevent future wrinkles. Since these injections work by relaxing muscles before wrinkles have the chance to form, doctors can offer this as wrinkle-prevention treatments. Doctors may also use this injectable for medical uses, targeting muscle spasms. This injectable is usually not suitable for use during pregnancy or breastfeeding, if the patient has a nerve or muscle disorder, or if the patient has a bleeding disorder.

Areas treated with Bocouture:

Doctors use this injectable to target muscles underlying wrinkles or other medical conditions. These uses can include:

• Glabellar lines, which are vertical frown lines between eyebrows;

• Horizontal frown lines between the eyebrows;

• Crow’s feet, which are lateral periorbital lines;

• Blepharospasm, which is involuntary muscle contractions around the eyes;

• Cervical dystonia, with neck spasms causing an abnormal head position;

• Upper limb spasticity;

• Other wrinkles caused by facial expressions and other medical conditions.

How does Bocouture work?

Botulinum toxin A is a natural neuromodulator that acts on nerves. The neurotoxin helps block the release of acetylcholine, so the nerves are unable to signal muscles to move. Without this signal to move, the muscles remain in a paralyzed position temporarily. They are then unable to spasm, in the case of medical conditions, and are unable to fold the skin to produce wrinkles. Since certain wrinkles are caused by repeated muscle movements, temporarily preventing these movements will temporarily smooth the wrinkles.

Treatment details

Before using this cosmetic injectable, you must reconstitute the powder with saline solution, obtaining an appropriate concentration for your needs. Clean the target area using an antiseptic, and if desired, apply an anesthetic. Then, inject the solution directly into the muscle or muscles targeted, possibly with multiple injections in the same area. The procedure should usually last less than 30 minutes, allowing your patients to return to their usual activities immediately.

How long does Bocouture last?

After an injection, patients usually see results as soon as 2 or 3 days later, with their maximum results about 30 days later. The effects will usually last about 4 months, and you can repeat the treatment at this time. You should not inject this botulinum toxin any more frequently than every 3 months.

Safety information

Botulinum toxins have established their safety after many millions of injections around the world. Some patients may experience minor side effects, and rarely, a patient may experience a rare allergic reaction, overdose, or the spread of toxic effect to another area of the body. If your patients experience symptoms such as difficulty breathing, difficulty swallowing, drooping eyelids, or hives, they should seek medical attention immediately because this could be life-threatening. The majority of patients may experience minor side effects at most, usually related to the injection itself and not specific to the solution injected. These side effects can include:

• Pain at injection site;

• Tenderness at injection site;

• Swelling;

• Bruising;

• Localized muscle weakness.

Recovery time after a treatment

These injections are minimally-invasive with no downtime. In fact, they are sometimes referred to as the lunchtime facelift because someone can have treatment and return to work immediately, with none the wiser. If the patient does experience side effects, they are usually minor, involving some pain, swelling, or bruising, but these usually resolve within a few days after treatment. Rarely, side effects can appear later and last longer. The majority of patients can immediately resume their normal activities after their injection.

Cost of Bocouture treatment

Doctors may charge different amounts for a treatment depending on their geographical location, but the cost to a patient may also vary by the amount of botulinum toxin needed, which depends on the size of the area treated, the condition of the patient’s skin and severity of their wrinkles, and other factors. The cost to the patient may be per unit, per vial, or per treatment area, but since the entire vial of reconstituted solution should be used within a certain time frame, many clinics will offer a limited-time sale or discount so patients book their appointments around the same time. In the U.S., injections usually cost between $240 to $415, or about $700 for a package. According to a study, Xeomin was the most cost-effective treatment compared to medications from Dysport and Botox, so although Xeomin and its cosmetic version Bocouture are less well-known to the patient, many opt to save money with this more affordable option.

How does this botulinum toxin differ from Xeomin, Botox, and Dysport?

Bocouture and Xeomin are both made by Merz, with Bocouture marketed for cosmetic uses and Xeomin for medical uses. Otherwise, they are the same product, with equivalent units of botulinum toxin type A. Both are similar to Botox and Dysport in that they contain botulinum toxin type A, with units that are not equivalent, although Merz claims there are fewer complexing proteins in their products, making them less likely to trigger antibodies. They claim this means the product is less likely to lose effectiveness with repeated injections.

A happy woman is satisfied by the usage of Juvederm and Radiesse for Marionette Lines

Juvederm vs Radiesse for Marionette Lines | Medica Depot

How do dermal fillers treat marionette lines?

As the body ages, it slows production of elastin, collagen and hyaluronic acid, which are essential to keeping the skin firm, elastic, and plump. As these substances degrade, the skin becomes weaker and begins to loosen and sag, causing lines and wrinkles to form.

Dermal fillers treat marionette lines by volumizing the skin, and some formulations boost essential proteins. The added volume from the implanted dermal filler gel lifts the skin, smooths lines and wrinkles, and adds a youthful plumpness to the skin that is often lost due to the process of aging and other harmful environmental factors.

How long do results last?

Aside from the difference in ingredients, the biggest difference between fillers from Juvederm and fillers from Radiesse is the longevity of the effects of treatment.

Juvederm offers longer lasting results than many other hyaluronic acid-based fillers currently available on the market. On average, the results of Juvederm fillers last from 12 to 18 months, with some patients seeing results up to 2 years after treatment.

The results of Radiesse fillers typically last from 9 to 18 months. Some patients may experience longer lasting results as the skin forms new collagen and is strengthened. It is important to note that the longevity of results varies according to patient and depends on a number of factors, including the lifestyle and age of the patient, as well as the severity of correction required and the injection technique used during treatment.

Juvederm vs Radiesse for marionette lines

Hyaluronic acid fillers like Juvederm are great for marionette lines because they are easy to inject and the results are reversible if the patient is unhappy. Juvederm also hydrates the skin and assists with the intracellular structure. It is most effective on marionette lines that are superficial to deep, and provides a filling effect without the patient looking overstuffed or frozen. Juvederm is favored for its natural-looking results.

Radiesse is also an effective filler for marionette lines. Unlike Juvederm, which is simply a wrinkle filler, Radiesse is a stimulatory filler that boosts the production of collagen within the skin, leaving collagen in its place even after it has been metabolized. For deeper marionette lines, Radiesse may be the best option, as it is thicker and provides more lifting capabilities.

A study comparing Juvederm Ultra Plus and Radiesse found that Radiesse required less filler to achieve the desired effects. While Radiesse does provide some immediate effects, optimal results emerge gradually, as collagen is produced over time. However, different patients will require different treatments, and what will work best for one patient may not be the same for another. The best dermal filler for a patient should be based on the patient’s desired results and facial anatomy.

The gold cube trumps the silver cube symbolize the comparison of Radiesse and Restylane dermal filler

Radiesse and Restylane : Which is the best filler to you?

The cosmetic injectable industry is enjoying massive growth in recent times due to increasing demand for minimally invasive aesthetic procedures like botulinum toxin and soft tissue augmentation treatments. Along with this growth is the frequent addition of new dermal fillers to the market, spurred by constant innovation and improvements in formulation. While this increase in therapeutic options may be a positive for consumers, an unfortunate effect of this is the substantial influx of information (and misinformation) about dermal filler treatments that can potentially mislead patients to make the wrong decision. There are plenty of choices when it comes to dermal fillers, each with their own benefits and downsides. This article hopes to shed some light on 2 very popular dermal filler treatments, Restylane vs Radiesse, and see how they fare in comparison to each other.

What’s the difference between Radiesse and Restylane?

Due to the sheer number of fillers currently available, it helps when discussing them to break them down into groups. There are many ways to categorize dermal fillers, but here we will go by mode of action. The first type of dermal filler is implanted into soft tissue for the purposes of adding volume, therefore these are known as fillers with replacement volume as a primary mechanism of action. Hyaluronic acid fillers like Restylane, which constitute the most commonly used dermal fillers, fall into this category. The second dermal filler group is implanted not to replace volume but to stimulate collagen growth at the treatment site. These are known as collagen biostimulators. They are typically made out of a synthetic material that is introduced to the skin to stimulate fibroblast cells for collagen synthesis. This is the category that fillers like Sculptra injectables belong to. Here, it is important to note that Radiesse actually has both mechanisms of action—it not only has the immediate effect that comes with volume replacement, it also confers long-term effects through its role as a collagen stimulator. In this respect, Radiesse is unique among dermal fillers.

Radiesse, the versatile collagen biostimulator

Radiesse products are made of microparticles of synthetic calcium hydroxylapatite. This compound is identical to a natural component of teeth and bones. The way in which it stimulates collagen growth is considered non-inflammatory, as no foreign body response is generated; rather, Radiesse merely acts as a scaffold around which collagen is able to form. With time, these microparticles break down into calcium and phosphate ions by phagocytes, leaving behind collagen.
The benefits that Radiesse provide do not stop at its collagen-forming capabilities. Radiesse is also formulated with physical characteristics that afford it excellent volume replacement capabilities. Radiesse is highly elastic and viscous; hence, it has good lifting and augmenting properties. In short, Radiesse can function both as volumizer and collagen stimulator, and it does both of these roles well. With natural-looking results that last beyond 2 years, Radiesse has many qualities that make it an ideal dermal filler.

Restylane, a hyaluronic acid filler treatment mainstay

Even if you are only marginally familiar with dermal filler treatments, it is still likely that you would have heard of Restylane. The first commercialized hyaluronic acid filler in the United States, the ever-popular Restylane brand is a stalwart in aesthetic practice.
As mentioned before, Restylane dermal fillers are composed of cross-linked hyaluronic acid. The material is a naturally occurring, hydrophilic sugar not specific to any tissue or species, making the product biocompatible and non-immunogenic. When it is implanted into the skin, the water-retaining properties of the product keep the skin firm and hydrated. Results of a Restylane treatment are relatively durable, lasting 6–12 months on average.

Which filler should you choose, Radiesse or Restylane?

The simple answer: It depends. Because these two products are so different, they will produce different clinical effects. Thus, each filler will provide better results than the other depending on the application.
The Restylane brand comprises numerous products that can be used for many different applications, making it easy for the practitioner to develop a personalized treatment plan that meets the specific aesthetic needs of the patient. In contrast, Radiesse only comes in one formulation.

The area of treatment is another factor to consider. Many practitioners have noted that Radiesse is particularly suited for hand contouring. Its opacity—typically a drawback for a dermal filler—is valued in this instance, because it is able to hide the veins and tendons normally visible in an aging hand. However, due to its high elasticity and volumizing properties, Radiesse is not the best product for treating delicate areas with thin skin like the under-eye area or forehead.

As alluded to above, the dual-role of Radiesse allows it to have both immediate and long-term clinical effects, making this treatment more attractive to patients for whom longevity of results is a priority. However, these effects are irreversible, meaning that the patient will have no other recourse but to wait for the effects to wear off if the results were not what they expected. The effects of Restylane, on the other hand, can be easily reversed with hyaluronidase treatment.


In conclusion, while both Restylane and Radiesse are remarkable fillers with proven track records of efficacy and safety, the practitioner must take into account factors like type of treatment, area of treatment, as well as the preferences of the patient when it comes to matters like longevity and reversibility of treatment, in order to select the more appropriate product for treatment.

A laser treats a scar on the skin presenting the Scars Treatment Case Study

Treating Scars Part II – Types, Case Study, Treatment, Review

Cosmetic Treatments, Scars Treatmen / By  Medical Community

20 Dec

Injury implies that there is a need to restore a specific area and its structural integrity to normal function. It is an urgent need because mechanical integrity and the barriers are required to prevent any fluid loss or, even worse, severe infection. To reorganize the injured structure so that blood and lymphatic inflow and outflow is prevented is known as wound healing. Flawless repair is neither possible nor practical in the adult body, because of the aforementioned urgency. However, that is not to say that the other end of the spectrum does not exist. Regeneration is the term given to perfect and flawless repair without any scar formation, but it is only possible during the embryonic stage, and in certain tissues, such as the bone and liver. Unfortunately, the technology available today is unable to utilize this knowledge and put it into practical use. Interestingly, all wounds experience the same repair mechanisms. Acute wounds are repaired in an orderly and timely manner, while the repair of chronic wounds is stalled at various stages of the inflammatory process and fails to heal. In any case, scars tend to occur more often when the healing activity is disrupted, which is the case in most chronic wounds. Factors such as increasing age, cardiac or renal failure, location on the body, atherosclerosis, amount of tissue damaged, and foreign material embedded can affect the development of scar formation. These scars can be a major hindrance for many patients to achieve their ideal look. As such, this article will focus mainly on the types of treatment available for the variety of scars that an individual can suffer from.

Types of scars

In general, there are five types of scars: normal mature scars, immature scars, hypertrophic scars, keloids, and atrophic scars. Not all of these scars may need to be considered for treatment. the Hypertrophic and keloid scars are commonly described synonymously, as both represent a similar concept: they are scars raised from the normal skin contour and may be itchy and painful. One key difference is that keloid scars are found extending outwards out of the normal tissue boundary, while hypertrophic scars are confined in the boundaries.

Scar treatments

From the cosmetic standpoint, plastic surgeons and dermatologists can offer a multitude of treatment techniques or methods to treat scars, depending on the type of scar. For example, steroid injections are used on hypertrophic and keloid scars, as they can help shrink them, whereas surgery is used to modify the scar. The list of treatments elaborated below do not represent an exhaustive list, but they are intended to help guide you on the treatment options.

Topical treatments

The key with any treatment modality is that it has to be evidence-based. Most topical treatments for scars remain controversial to this day, as the current scientific literature on these modalities provides limited evidence for their use. For example, take Vitamin E. It has been used worldwide as an anti-scarring agent. In theory, Vitamin E is an active component that has antioxidant properties to help reduce the severity of a scar. This theory was further bolstered by anecdotal reports that supported this use, but clinical studies later refuted this theory and instead reported increased incidences of adverse effects. As of now, there exists minimal evidence to support the use of Vitamin E to minimize scarring. More research is vital and must precede vitamin E use by patients.

Another popular option is onion extracts. They work by decreasing inflammation and reducing the fibroblast proliferation rate, the latter of which reduces collagen deposition. Despite this encouraging mechanism of action, clinical studies on postsurgical scars were not well received. The beneficial findings from these studies are small-scale, not randomized or double-blinded. Their quality of evidence is poor. There exists no solid evidence to develop any recommendations concerning their use for scars.

Chemical peels

Chemexfoliation are mainly used on atrophic scars that are left by acne vulgaris. The chemical injury induced can remodel the collagen deposition and lead to a better aesthetic outcome. Examples of chemical peeling agents are trichloroacetic acid, salicylic acid, glycolic acid, Jessner’s solution, and phenol. For optimal results, they are usually done concurrently with microneedling and laser. 4 There is no universal standard as to how these combination treatments can be used, which has led to many differing treatment regimens.

Corticosteroid injections

Injectable steroids are known to decrease scarring through reducing inflammation and fibroblast growth and subsequent collagen synthesis, causing vasoconstriction that limits wound oxygenation and nutrition, which in turns influences transforming growth factor-beta 1 and 2 and collagen in keratinocytes. Injectable steroids also increase collagen degeneration. A widely used corticosteroid is triamcinolone. The use of triamcinolone is further supported by a few studies; the patients in these studies had reported efficacy rates of 50 to 100%, but they also had recurrence rates of 9 to 50%. Side effects such as dermal atrophy and hypopigmentation can also occur with the use of these injections. Regardless, its benefits outweigh the risks for most patients, and due to this, it is mostly recommended as a first-line therapy for hypertrophic and keloid scars. These injections must be administered intralesionally, as topical corticosteroids have little to no effect on the scars.

Silicone sheets

Silicone sheets are commonly bought and used for hypertrophy scar prophylaxis and treatment. The use of these sheets is supported by the 2001 International Advisory Panel for Hypertrophic Scarring and Keloid Management, which stated that this treatment modality is a viable option in view of other effective treatment modalities. Also, many plastic surgeons have advocated for the use of these products as well. Their mechanism of action is thought to arise from their temperature, oxygen tension, and hydration regulation. However, despite the overwhelming support from the aesthetic community, the clinical studies that support its use are considered to be of poor quality and highly prone to bias. The popularity of this treatment modality may instead stem from its cost effectiveness, availability, non-invasive nature, and the possibility that it may improve scars. A further recommendation of this treatment modality, however, requires more conclusive studies.

Dermal fillers

Injectable dermal fillers are versatile treatment methods that can be used for indications other than scars. They offer excellent and quick results for patients with atrophic scars, such as infamous “ice pick” scars. They can be used alongside with surgical subcision so as to produce better results, as they can work together synergistically. The needle used to inject one of these fillers can be inserted below the scar tissue, where the filler material is to be deposited. Filling of this particular space causes the surface of the scar to rise so that the natural contours of the body is restored. Filler materials include hyaluronic acid and calcium hydroxyapatite.


Microneedling is considered a minimally invasive technique and involves the use of a surgical tool with multiple needles. There are a wide variety of devices for microneedling use, such as manual rollers with needles from 0.5 to 3mm and a stamping battery-powered device. The needles penetrate the skin at a uniform depth at the dermis layer. This results in a skin injury that is controlled to a certain degree. The injury induces wound repair by way of collagen and elastin deposition. The outcome is improved skin texture and firmness with an overall increase in skin quality. The scars are also reduced to a significant degree. Microneedling has been used for other purposes than treating scars, such as reducing pore size and cellulite. Microneedling does not require any anesthesia, and for the best improvements, multiple sessions need to be conducted.


Lasers are specialized devices used for prophylaxis and also for restructuring hypertrophic and keloid scars. In the earliest revisions, ablative, nonselective lasers were using carbon dioxide or erbium yttrium aluminum garnet. The carbon dioxide variant caused wound contraction, induced collagen remodeling, activated fibroblast growth factor, and reduced transforming growth factor beta. The latter variant induced a heat shock response to influence the levels of transforming growth factor beta. Though the theory behind the use of either is sound, neither saw much use due to the adverse reactions they caused. They were known to cause significant burn injuries, which meant that the risks were too overwhelming to recommend them. Later on, the development of pulsed-dye laser and laser-assisted skin healing laser meant better patient tolerance and more satisfactory results. A review done in 2010 found that both of these provide excellent clinical results on scar volume, texture, and erythema. Following another review, it was determined that the 595-nm type laser consistently offers better efficacy than its 585-nm counterpart. Regardless, keloid scars are known to recur with the use of the laser modality, and their recurrence rate has been described as rapid in some cases of treatment with a pulsed laser. A combination of a laser with either intralesional steroids or 5-fluorouracil may offer better results.  Fractional lasers and intense pulsed light, on the other hand, are newer advancements in the scene. Non-ablative fractional lasers have a stronger safety profile and are more efficacious than ablative lasers. Fractional lasers are known to work by inducing thermal injury and epidermal necrosis at thermal zones where that are separated by areas of normal tissue. These normal tissues can help in the healing process by migrating to the damaged sites. However, there is currently very limited evidence supporting the use of non-ablative lasers.

Case study: hypertrophic scar treatment

Platelet rich plasma (PRP) is another available treatment method designed for treating scars. PRP is used because it can improve the wound healing process. The discussion regarding platelet rich plasma will be continued through a case study.

Patient A, who is a 36-year-old female, is an airline pilot that has a history of cervical discectomy that dates back to October 2015. The initial injury was caused when she overreached for a control in the deck, which then resulted in the paralysis of the arm. Post-surgery, she recovered and developed an aesthetically acceptable paramedian scar at the anterior side of the neck on the left. Four months after the incident, the wound started to undergo hypertrophy. She went for treatment for the scar in April 2016, and it was diagnosed as a hypertrophic scar.  Prior, she also had two papillomas over the scapula that was removed before the incident. The removal had also resulted in hypertrophic scars that

ere treated with steroid injections but to no avail. Based on this information, she was counselled to use PRP for the neck scar. She was informed that steroid injections may cause further thinning of the skin and uneven skin tone, while PRP can help strengthen the wound and reduce the scar’s appearance. Laser therapy was considered, but the wound was too confined for a chance of a successful outcome. Other treatments, such as topical creams and chemexfoliation, were similarly abandoned. PRP was believed to be the best treatment option for this patient taking into account the obvious scar location.


Growth factors that are present in platelet rich plasma are excellent for scar remodeling (e.g. vascular endothelial growth factor, basic fibroblast growth factor, and platelet derived growth factor). PRP is ideal for soft and bony tissue repair, and trials are being conducted on new and matured scars. PRP is collected via centrifuged autologous blood using PRP kits. Administration is simple and straight forward: direct injection through the intradermal or subdermal level.

PRP has been in the market for about five decades ago, and its first high profile use was in an open-heart surgery that was done in Italy in 1987. As research continues, the indications for PRP grow wider into other treatment areas. Nowadays, PRP can be used for leg ulcers, gum recession, and even genital rejuvenation.


Prior to administering PRP, a thorough medical history was obtained to make sure none of its contraindications, such as coagulopathies, warfarin use, non-steroidal anti-inflammatory drug use, and an existing infection, were present She was informed on the transient side effects that are common with injections, such as erythema, edema, and infection. After that, treatment started with 20ml of drawn whole blood with an anticoagulant. This blood was then centrifuged and the plasma activated via calcium, both of which produced 8ml of active PRP. The scar was then deposited with multiple 0.2ml PRP aliquots. 1ml of PRP was also deposited at the deep dermis level.


First, post-treatment follow-up was done after eight weeks. The scar significantly improved with an overall decrease in erythema except from the borders, which remained as before. It was also noted that the scar was flatter except for the outer side areas. She remained optimistic that the scar can still see further improvements in terms of color and shape. She also maintained that her daily routine is affected, as she found it strenuous to conceal the scar without a scarf. She underwent a second PRP procedure, and she was again reviewed in eight weeks. Subsequently, the imperfections of the previous treatment were resolved. The scar no longer looked erythematous, and the entirety of the scar seemed to have flattened out. She was booked for a follow-up six months after so as to again review her condition.

The future

The future is exciting, as more novel therapies are being pushed down the line. One such advanced treatment method is the plasma beam therapy. It is capable of delivering curved beams of plasma energy that are produced by charged gases (i.e. room air). Such a treatment modality is also portable via machines called Plasma IQ or Plexr. Significant advances include its non-invasive nature and its ability to be used without anesthetic. It is ideal for upper blepharoplasty and also for most types of scars.


1.  Kokoska M, ‘Hypertrophic Scarring and Keloids’, Medscape (2016) <http://emedicine.medscape.com/ article/876214-overview>

2. Baumann LS, Spencer J, ‘The effects of topical vitamin E on the cosmetic appearance of scars’, Dermatol Surg, 25(1999) pp.311-5.

3. Vitamin E, Evidence (US: Mayo Clinic, 2016) <http://www.mayoclinic.org/drugs-supplements/vitamin-e/ evidence/hrb-20060476>

4. M. C. Annunziata, V. D’Arco, V. De Vita, G. Lodi, M. C. Mauriello, F. Pastore, and G. Monfrecola, ‘Acne Scars: Pathogenesis, Classification and Treatment. Gabriella Fabbrocini’,Dermatol Res Pract, 2010.

5. S Kokoska, MD & Arlen D Meyers, Hypertrophic Scarring and Keloids Mimi, (2016) <http://emedicine. medscape.com/article/876214-overview#a1>

6. Juckett G, Hartman-Adams H, Management of Keloids and Hypertrophic Scars’, Am Fam Physician, 80(2009) pp.253-260.

7. Neerja Puri and Ashutosh Talwar J, ‘The Efficacy of Silicone Gel for the Treatment of Hypertrophic Scars and Keloids’, Cutan Aesthet Surg, 2(2009) pp.104–106.

8. Orentreich N, ‘Subcutaneous incisionless (subcision) surgery for the correction of depressed scars and wrinkles’, Dermatol Surg, 21(1995) pp.543-9.

9. Jesitus J, Collagen-stimulating fillers provide rejuvenating advantages, naturally (US: Dermatology Times, 2012) http://www.dermatologytimes.modernmedicine.com/dermatology-times/news/ modernmedicine/modern-medicine-feature-articles/collagen-stimulating-fillers-?page=full

10. Moers-Carpi M, Vogt S, Santos BM, et al. Dermatol Surg. 2007;33 Suppl 2:S144-S151

11. Lewis W, ‘Is microneedling really the next big thing?’ Plastic Surgery Practice, 7(2014) pp.24-28

12. Liebl H, Kloth L, ‘Skin cell profliferation stimulated by microneedles’, J Am Coll Clin Wound Spec https:// www.ncbi.nlm.nih.gov/pmc/articles/PMC3921236

13. Ngan V, Fractional laser treatment (New Zealand: DermNet New Zealand, 2015) http://www. dermnetnz.org/topics/fractional-laser-treatment/

14. Dalton M, Treating vascular lesions (US: The Dermatologist, 2013) http://www.the-dermatologist.com/ content/treating-vascular-lesions/

15. Rui Jin, Xiaolu Huang, Hua Li, Yuwen Yuan, Bin Li, Chen Cheng, Qingfeng Li, ‘Laser Therapy for Prevention and Treatment of Pathologic Excessive Scars’, Plastic and Reconstructive Surgery, 231(2013).

16. Coondoo A, ‘Side-effects of topical steroids: a long overdue revisit’, Indian Dermatol Online J, https:// www.ncbi.nlm.nih.gov/pmc/articles/PMC4228634

17. Jean L Bolognia, Joseph J Jorizzo, Julie V Schaffer, Dermatology, (2012) p.2262.

18. Textor J, ‘Platlet-Rich Plasma (PRP) as a Therapeutic Agent: platelet biology, growth factors and a review of the literature’, Springer.

19. Parrett BM, Donelan MB, ‘Pulsed dye laser in burn scars: current concepts and future directions’, Burns., 36(4) (2010), pp.443-9.

20. Hu MS, Zielins ER, Longaker MT, Lorenz HP. Scar prevention, treatment, and revision. (ed). Plastic Surgery: Volume 1: Principles, 4th ed. : Elsevier; 2018. pp. 196-213.

21. Tziotzios C, Profyris C, Sterling J. Cutaneous scarring: Pathophysiology, molecular mechanisms, and scar reduction therapeutics. Journal of the American Academy of Dermatology 2012; 66(1). https://www.clinicalkey.com/#!/content/journal/1-s2.0-S019096221101067X?scrollTo=%23top (accessed 27 July 2018).