Fillers are great and have their place in every dermatologist's toolbox. But lately, some patients are experiencing a phenomenon known as filler fatigue — an overfilled, unnatural, and puffy appearance from hyaluronic acid filler that doesn't provide the same results it used to — leaving them seeking alternative treatments.
Dr. Ellen Marmur, a board-certified dermatologist in Manhattan and founder of MMSkincare says patients who aren't feeling that look now want to reverse the effects of their filler. "Or they just aren't getting the same effects anymore and want natural-looking volume without having to get injected constantly or run the risk of being overfilled," she adds. And that's where a new treatment, Renuva, comes into play.
Renuva is unlike any other anti-aging treatment currently on the market. As the first and only off-the-shelf treatment, Renuva gradually replaces lost fat with new fat, all while improving contour deficiencies.
"[It] consists of growth factors and collagen that acts as a scaffold for your fat cells to populate. In other words, it causes your body to grow fat wherever it is injected into the body," says Dr. Leif Rogers, a board-certified plastic and reconstructive surgeon in Los Angeles. And the results of Renuva are so natural looking, you can barely tell you've had anything done.
Here, we spoke with several experts to share everything you need to know about Renuva.
What Is Renuva?
In our early 20s, our bodies stop producing fat and collagen, and we start to lose fat in the deep layers of the face. "Fat loss is one of the main reasons the face and body can look aged," says Dr. Anna Guanche, a board-certified dermatologist in Beverly Hills and Calabasas. That's why for years, people have plumped up deflated facial features with injectables and fillers. And while they do a great job of replacing lost volume, they don't create new fat in the face as Renuva does.
"The deep layers of facial fat make us look youthful and superficial fat makes us look healthy. By restoring these layers of fat, we can restore a youthful, healthy appearance," the MD adds.
"Renuva acts as a biologic difference engine and allows the body to create its own vibrant, youthful, and vascularized fat anywhere fat natively exists. Once injected, Renuva allows your own body to regenerate lost fat due to aging," explains Dr. Alan Durkin, a board-certified plastic and reconstructive surgeon in Vero Beach, Florida.
Renuva often gets classified under the umbrella term of fillers, but don't get it twisted — this treatment stands in its own league.
It's technically an extracellular adipose matrix (it doesn't contain live fat cells) with regenerative properties to stimulate fat growth. And other than coming in a syringe, Renuva is considerably different. Also, it doesn't attract water to the area to add volume as fillers do.
"I can inject it into the areas where someone needs volume, and it works to create plumpness by growing new fat," Dr. Marmur explains. Plus, she says it gives the skin a nice glow lasting four to six years.
For those who don't like the idea of putting something artificial or unfamiliar into their body and want more of a natural option, this is it. It's not a foreign substance like a filler because, as Dr. Rogers says, it goes away quickly and gets replaced by your fat cells. "It also involves your own body's natural regenerative processes, making it more of an active treatment than a passive one," Dr. Rogers explains.
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How Does Renuva Work?
The treatment acts like a scaffolding of sorts that temporarily adds volume and then signals the body to produce fat precisely in the placed area. At first, Renuva creates a honeycomb-like matrix that eventually fills up with new fat. As this process transpires (it takes about three months), the body produces new fat in the area. Then, while the body makes new fat and blood vessels to fill in the volume-deficient areas, Renuva dissolves and is excreted out of the body.
"Renuva is an injectable therapy known as a bioinductive agent, which means Renuva is injected, but Renuva itself is not the result — it acts only as a catalyst," Dr. Durkin says. "Once it's absorbed, your body creates the effect you see clinically," he explains.
The injection process follows that of traditional fillers — numb, inject, and wait for the full results to set in (there may be some initial swelling, tenderness, or firmness). However, unlike fillers, there's no post-treatment massaging with Renuva. Dr. Marmur adds that the addition of lidocaine in the matrix allows it to spread out evenly and nicely for a natural-looking result.
Although you'll see immediate results, it takes three to six months for Renuva to dissolve and the newly formed fat to form. "I like to have patients come back in that three- to six-month window to evaluate the treatment area and determine if they feel they need more or are happy with their results," Dr. Guanche adds.
How much fat Renuva produces is dependent on each patient. Dr. Durkin says your nutritional status, overall health, and other factors determine the amount of fat your body will create. "While human fat is made, it is produced in small aliquots as the product is absorbed," he adds. Overinjecting Renuva doesn't equate to an amped-up effect of fat production any faster or better, so staging the injections in small amounts is the best approach.
What Areas Can Renuva Treat?
Renuva is generating major buzz for its ability to reproduce facial fat and revolumize the areas where it naturally declines, mainly the cheeks, nasolabial folds, marionette lines, chin, jawline, and temples. It benefits those already seeing volume loss and facial fat pad loss due to natural aging. "Any area where fat cells already exist is ideal for Renuva treatment," says Dr. Rogers. The one area where it's not suitable to inject Renuva is the lips since they don't inherently contain fat.
And there are plenty of off-the-face benefits that Renuva offers, too. For example, doctors can use it in areas that lack volume or where contour irregularities exist. "It's the undisputed king of nonsurgical correction of cellulite, liposuction divots, and punctate areas of volume loss. It is also commonly used for nonsurgical gluteal augmentation," Dr. Durkin says. Other prime treatment spots include the hands, scars, breasts (to correct asymmetry and implant rippling), shoulder grooves, and hip dips.
Who Are the Best Candidates For Renuva?
Anyone experiencing the beginning stages of volume loss makes for a good candidate. While Renuva doesn't discriminate against age, Dr. Rogers says patients older than 65 or excessively lean seem to have less volume retention but benefit from improved skin quality. "These patients may need more treatments to achieve the desired outcomes."
Dr. Guanche likes to use Renuva as an option for patients in their 50s and 60s who want a more natural-looking alternative to traditional fillers. Renuva is also a good option for younger patients in their late 30s or early 40s who are just starting to see volume loss in the face but don't have the time or lifestyle to maintain hyaluronic acid filler.
How Long Does Renuva Last?
Of all the volumizing options available today, Renuva offers the longest-lasting results and lasts for about ten years — that's approximately the life span of a fat cell. Then, it gradually fades away. "Because the body's fat replaces Renuva, it will last as long as that person's fat lasts," Dr. Guanche says.
Like fat transfer surgery, not all the volume injected via Renuva stays indefinitely. "Approximately 50 percent of the volume remains in the new fat cells," Dr. Rogers explains. "The new fat cells are living fat cells, so if you gain a lot of weight in the future, those fat cells will get bigger just like other fat cells. However, Renuva will not cause uncontrolled fat cell growth. Therefore, the results are highly predictable."
The one caveat to keep in mind is that Renuva is not reversible like hyaluronic acid fillers are, but that doesn't mean that if you're dissatisfied with your results, you're stuck with them for the next decade. Dr. Marmur says while the reversibility of Renuva is still being figured out, Kybella may work as an antidote. "But the volume created is pretty small, so I don't worry about that."
How Much Does Renuva Cost?
Renuva isn't cheap, and if routine injectables and fillers are already doing a serious number on your bank account, expect this treatment to double that cost, since it's about 50% pricier. "It's averaging $1,800 per 1.5 ccs of Renuva," Dr. Marmur says. But, of course, that price varies depending on your doctor, and more extensive treatment areas may cost more.
Lastly, unlike brand-name injectables and fillers, you won't find Renuva at just any corner medi-spa — Dr. Marmur says it's currently only available at limited practices.