Preventing facial sagging has become a central goal for both aesthetic practitioners and patients. A deeper understanding of the soft tissue ageing process has highlighted the key role of facial subcutaneous white adipose tissue.
Properties of the overlying skin – such as collagen architecture and fibroblast activity – are directly influenced by the structure and volume of the underlying adipose tissue; thus, fat compartments are an attractive target for anti-ageing strategies.
Two fields that have expanded rapidly, bringing major biomedical advances and forward-looking perspectives, are tissue engineering and aesthetic medicine. Within this context, the ongoing innovations from IBSA have led to two unique products: Profhilo®, the first NAHYCO®-based product introduced in 2015 and designed for intradermal injection to promote face and neck bioremodelling, and Profhilo® Structura launched in 2024, administered into the superficial fat compartments to promote adipose tissue restoration.
Patient before treatment.
Patient three months after the fourth session of treatment.
Treatment protocol
In our clinical practice, we integrate these two products with monopolar radiofrequency (RF) within a protocol of combined regenerative approaches for deep facial rejuvenation.
The rationale for combining hyaluronan hybrid cooperative complexes with monopolar RF lies in their synergistic and complementary mechanisms. The result is a multilayer regenerative effect and overall increased and balanced tissue homeostasis.
Our treatment protocol consists of four sessions, spaced two weeks apart (total duration: two months). Each session begins with monopolar RF to the whole face using a 4MHz system; 2cm and 5cm handpieces are selected according to the anatomical region. Each aesthetic unit is treated with a continuous-motion technique in a tight, overlapping spiral pattern to achieve a surface temperature of 40–42°C, which is maintained for an additional four to six passes.
During the first and third sessions, after RF, one syringe of Profhilo® is injected using the bio aesthetic points (BAP) technique. This ensures even distribution attributable to the product’s low viscosity and high spreadability of its hybrid cooperative hyaluronic acid (HA) complexes, administered as five bolus points hemiface.
Profhilo® Structura is administered during the second and fourth sessions, following the RF treatment, using the ‘Sagger technique’ to restore the superficial medial and lateral facial adipose compartments, providing improved tone, tightening and firmness. Its characteristics allow the product to integrate optimally into the subcutaneous tissue without altering its rheological properties.
Conclusion
The integration of hybrid cooperative complexes with monopolar RF represents a promising multimodal strategy in regenerative aesthetic medicine. By coupling bioremodelling activity with thermally induced stimulation, this combined approach addresses the multifactorial nature of skin ageing, offering a holistic treatment strategy.
Our clinical experience demonstrates improved hydration, elasticity and skin tightening, accompanied by high levels of patient satisfaction.
Declaration of competing interests: None declared.
