Dr. Yula Indeyeva details her approach to skin rejuvenation using microneedling and stem cell recruitment therapy — a combination of very superficial hypodermal injections as well as topical application.
This is part 2 of a 2-part series.
Yula Indeyeva, M.D., a facial plastic surgeon in Gulf Shores, Ala., demonstrated the Stem Cell Recruitment Facial in a non-CME session at the meeting.
“I'm here to demonstrate my approach and technique to skin rejuvenation using Stem Cell Recruitment Facial in conjunction with microneedling and radiofrequency,” she told the audience, explaining that her patient had already been prepped by washing off makeup, applying a topical anesthetic and performing a perioral block.
The facial protocol:
Step 1: Microneedling Pass 1
Step 2: Application of amniotic fluid topically and via transdermal injection
Step 3: Microneedling Pass 2
“The way I do this is in two passes. I do the first pass all over the face, varying depths of my microneedling based on the patient's skin condition, concerns and areas of the face.”
The first pass creates the micro channels necessary for the growth factors in the amniotic fluid to pass through the epidermal barrier.
After performing the stem cell recruitment therapy — a combination of very superficial hypodermal injections and topical application — she follows up with a second pass to push the product through.
“This is not a peer-reviewed claim, but my thought is that the second microneedling pass pushes the product into the dermis a little bit deeper and that's why I tend to increase my depth on the second pass, after administering the product topically.
As she performed the first pass using the PiXel8-RF Microneedling System (Rohrer Aesthetics), she talked about the product itself.
“This is a cryopreserved, acellular amniotic fluid that’s used very similar to how we would use PRP in terms of skin rejuvenation. I became interested about a year ago after PRP was just getting to be a little cumbersome, so when a promising alternative came up I wanted to try it and I've seen really good results, just the ease of preparation, speeding up the procedure itself and the results really made me want to continue.
“It comes in 1 cc and 2 cc vials that are the cryopreserved amniotic fluid. They are then diluted with normal saline at a 1:1 ratio so that we would add 1 cc to the 1-cc vial and 2 cc to the 2-cc vial.”
Generally, Dr. Indeyeva says she uses two 2-cc vials, which provides her with a total of 8 cc product to use for the treatment.
However, cutting the amount in half would probably be enough, she admits.
Step 2: Stem Cell Recruitment
“As you can see, I'm just injecting tiny little aliquots, placed pretty evenly apart,” she says. “And oftentimes as you're injecting, there's a little bit of a runoff and that's enough for a topical application.”
Not to be confused with exosomes, “It's acellular embryonic fluid, which contains a lot of growth factors, cytokines, but it's not exosomes.”
Exosomes are extracellular messenger vesicles containing mRNA.
The treatment is called stem cell recruitment because the aforementioned agents recruit the endogenous stem cells and set off a regenerative cascade, she explains.
“It's a complex set of molecules such as proteins, growth factors, cytokines, hormones that are secreted or shed off the surface of stem cells that are responsible for creating the regenerative microenvironment that supports the reparative and regenerative cellular mechanisms that ultimately lead to skin rejuvenation.”
Step 3: Second Pass
For the second microneedling pass, Dr. Indeyeva says she increases the needle depth.
“I like doing it in two sessions spaced three weeks apart. I found that to be to be effective in my practice but there really is no clear particular formula. I used to do it six weeks apart. And then I've had to do it closer together for some patients just because of timing constraints. And I actually found that they did better with decreasing the interval between treatments, so now I recommend 3 to 4 weeks apart for all of my patients.”
Dr. Indeyeva’s post-procedure protocol includes a topical antioxidant and sunscreen. For the first 24 hours, the patient is instructed not to wash the face or apply any product. Starting at 24 hours after the procedure, she instructs patients to wash with a gentle soap and apply a topical antioxidant twice daily, followed by 100% mineral sunscreen.
“I love using SkinBetter Alto Defense Serum for a topical antioxidant because of its additional hydrating and anti-inflammatory properties and the SkinBetter Sunbetter Tone Smart SPF 68 Sunscreen compact because of its 100% mineral formula and slight tint to camouflage any redness and bruising, which can occur with this procedure.”
After 72 hours, patients can return to their regular skincare regimen, she says.
As for other applications, Dr. Indeyeva says she’s also used this microneedling-RF-amniotic fluid approach with the chest and back.
Although she says she hasn’t tried it, this treatment may also be appropriate for hand rejuvenation and hair restoration.
Dr. Indeyeva is a medical advisor for Russell Health.