Renuva — You, but better?

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Has Ozempic face left you looking deflated? Are you suffering from filler fatigue? Before you reach for another syringe of hyaluronic acid, STOP!  There’s a groundbreaking, minimally-invasive, long-lasting injectable on the market that will restore the lost fat.  And it will do so with your own fat.

Dr. Michael Gold.

No, it’s not a surgical fat transfer. It’s called Renuva, an FDA-approved biological treatment which stimulates the regeneration of fat cells. “It is one of the most unique products that has ever been developed,” says Nashville-based Dr. Michael Gold, the lead dermatologist for the manufacturer’s clinical program, adding that “a lot of my Renuva patients today are my hyaluronic acid patients of the past.  They just don’t want it anymore.”

What is Renuva and how does it work?

Our bodies stop making fat cells after puberty. When we gain weight, the existing cells just get bigger. We don’t actually make new fat cells. This is where Renuva becomes a game changer. Derived from donated purified fat cells, i.e. cadaver tissue, when injected into areas where there is hollowness, Renuva creates a honeycomb-like scaffold, supporting the growth of new fat cells.

“Renuva is made from the wispy material that forms the matrix around the fat cells, separating them into compartments,” explains Fort Lauderdale-based, board certified dermatologist, Dr. Shino Bay Aguilera.

After about three months, the body produces new fat and blood vessels in the injected area and the Renuva scaffold dissolves and is excreted out of the body. “You put it into wherever there is a volume deficit and over a period of a few months, that mixture turns into livable, breathable fat,” says Dr. Gold. “There’s nothing else in the world that does that.”

Before and after photos of Renuva injections. Photos: Dr. Alan Durkin

Renuva is manufactured by MTF Biologics, a nonprofit organization that is the world’s largest tissue bank, located in Edison, New Jersey. “The important thing about the Musculoskeletal Transplant Foundation,” says Dr. Gold “is they’re all about the gift. They’re not about the product. The gift is the donor – the person that is no longer with us but has made a gift to a foundation which has the capability of giving this gift to a donor that needs something. That makes it special to me.” Photo: MTF Biologics

Dr. Shino Bay Aguilera.

Treatment areas

Renuva has been approved by the FDA for use throughout the face and body.  In addition to filling out hollowed cheeks and temples, it can be injected into the neck, hands and anywhere in the body where fat exists.  For instance, “it’s great” when combined with subcision to treat cellulite, according to board certified University of Miami dermatologist, Dr. Shasa Hu.  It’s been used to correct liposuction and breast implants lumps and bumps.  It’s been used on HIV patients, breast cancer patients and even babies born with facial defects, according to Dr. Hu.  That’s right, babies.

“Renuva is a great option for facial reconstruction, for congenital facial defects,” says Dr. Hu, adding that Renuva is also a good choice for smokers as they are not good candidates for an autologous fat transfer.  In addition, the injectable can be used to treat scars, dimpling and for nonsurgical butt lifts.  The first person Dr. Gold injected with Renuva was in the buttocks.  The patient had a dent from a steroid shot.  “It’s rare, but it happens,” says Dr. Gold.  One injection and six and a half years later, there’s still no sign of an indentation.  “It grew fat where that deficit was.  Renuva did what it was supposed to do.”

Photo: Rejuve Medspa

For all its versatility, Renuva, a thick gel-like substance, is not suitable for the lips or under-eye area, however.  It leads to significant swelling in the orbital area and because it can only be injected where fat exists, it cannot be injected into the lips.

Dr. Shasa Hu.

Effects on skin

As Renuva consists of growth factors and collagen, does it also affect the skin?  “It has not been clinically studied,” says Dr. Hu, ‘but we’re seeing that patients’ skin looks brighter and more supple, which makes sense because when there’s more padding, you get healthier epidermal support.”

The growth factors are the same growth factors that make stem cells and the skin takes full advantage of them, according to Dr. Aguilera. “So, not only do we create volume by bringing the fat back, but your skin gets so beautiful, so lustrous. Those growth factors are very, very beneficial for the skin itself,” says Dr. Aguilera.

Before and After photos of Renuva injections. Photos: Dr. Shino Bay Aguilera.

Does weight fluctuation affect the treated areas?

In a word, yes.  Weight gain or weight loss will show at the injection sites.  But, here’s the interesting thing:  unlike with an autologous fat transfer where the patient’s own fat is transferred via liposuction from, say, the thighs to the cheeks, the fat created by Renuva is a native fat.  “It’s supposed to be there,” points out Dr. Hu.  With a fat transfer, “when patients gain weight or go through hormonal changes, they may notice a larger, more exuberant, more sensitive response,” says Dr. Hu.  But you don’t see that with Renuva because “we’re stimulating the fat cells that belong there.  Your cheeks will just naturally be a little plumper with weight gain.”

Before and After photos of Renuva injections. Photo: Rejuve Medspa

How does the effectiveness of Renuva compare to a fat transfer?

Several studies have shown that as long as Renuva is injected at the right depth into the fat pad, it’s more reliable than fat grafting in that there’s a better chance for fat stimulation and survival.  Dr. Hu estimates that there’s a 50%-70% chance of success with fat grafting vs an 80% chance of success with Renuva.

With autologous fat grafting, there are many variables.  It depends on how the surgeon extracts the fat, the processing of the fat, the health of the fat cells and the injection technique.  “With Renuva, we know that as long as there’s native fat and the injection is at the right depth, there’s going to be stimulation.  So, it’s more predictable,” says Dr. Hu.

The biggest variable is the skill of the injector.  “It’s incumbent on the patient to get it done by someone who’s very skilled at injecting because it’s going to be there for a while.  So, you have to make sure that the injector knows how to inject a long-acting volume replacement,” advises Dr. Gold.  This is especially true because unlike hyaluronic acid products, Renuva is not reversible, although Kybella, a fat dissolving injectable, may serve as an antidote.

How long does it last?

Clinical studies show that of all the volumizing options available today, Renuva offers the most enduring results, lasting for about ten years — that’s the approximate life span of a fat cell.  A touch up may be needed eight weeks after injection.

Any safety concerns?

The source of Renuva, donated tissue, is screened extensively.  “It is placed under the same stringent processes as blood products such as transfusions of platelets or hemoglobin.  The donor products have been screened for a large variety of viruses, they have been put through the whole panel of testing, so there’s really no concern,” says Dr. Hu.

The manufacturer, MTF Biologics, goes beyond the very strict FDA guidelines to ensure there is no debris in the product, adds Dr. Aguilera concurring that “they test for everything so there’s no possibility of an adverse reaction or contamination, devoid of cellular or DNA debris.”

Furthermore, as it contains the same proteins and components as your own fat tissue, your body won’t notice its presence, so it won’t react as if it were a foreign substance.

Illustration: Politis Plastic Surgery.

How much does it cost?

Renuva comes in a 1.5 ml packet and a 3 ml packet.  The national average is between $1,200 – $1,500 for 1.5ml and $3,000 for 3ml.

Last words.

For all its advantages, Renuva is not very well known even though it has been on the market for several years.  The pandemic and the initial limited rollout to  plastic surgeons may be to blame.  But the treatment is becoming more popular in tandem with the prevalence of weight loss drugs and as research and development in the field of regenerative medicine surges.

“I want to emphasize that Renuva serves a very important niche in aesthetics. For a lot of people who are volume deficient, filler can be a problem.  You can get bumps or nodules, you can get migration,” stresses Dr. Hu.  “Instead of trying to struggle with hyaluronic acid or a biostimulator, Renuva really is a much more elegant way for bioregeneration because this biological, biostimulatory concept is becoming more widely accepted now as people are realizing fillers are temporary and have a lot of issues in the long run.”

“Why would you want to imitate fat with a gelatin when you can bring back your own fat?” asks Dr. Aguilera.  “If we continue to just imitate it with a gel, we’re not advancing.  Renuva raises a lot questions that will lead us to a better understanding of the aging process and slowing and even reversing it.  We need to embrace this field of bioregenerative science because we all benefit from it.”

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