The Changing Face of Fillers

For her 43rd birthday, Elena Duque wanted to treat herself. Already experienced with Botox and lip fillers, the Florida-based TV presenter was intrigued when her nurse told her about a new injectable on the market, Skinvive. “I’m always looking at myself, whether it’s TikTok, or I’m on TV a lot. I want to always have my skin look the best it can look,” said Duque, who looked for examples of Skinvive on social media before booking the procedure in November. “I liked the idea that it wasn’t a filler, that it didn’t change your facial structure.”

Produced by Allergan Aesthetics, which also owns the likes of Botox and CoolSculpting, Skinvive by Juvéderm is the first filler in a new category coined as “injectable moisturisers” or “skin boosters’’ to arrive in the US, having received FDA approval for use in the cheeks last May. The hyaluronic acid-based injectable is both thinner in consistency than dermal fillers used to plump up lips or craft liquid nose jobs and is injected at a more superficial level to give skin a hydrated appearance. Results are projected to last around six months.

With the promise of a natural, filter-like effect, Skinvive speaks to a contemporary market where good skin is the ultimate accessory. The product has an edge stateside over competitors like IBSA’s Profhilo or Galderma’s Restylane Skinbooster, and it can appeal to Gen-Z consumers looking both for an entry-level treatment or an add on to routine procedures like Botox. But with a high-price tag and relatively subtle results that can take weeks to fully emerge, Skinvive’s ability to become a regular part of consumers’ cosmetic routines remains untested.

“We’re still learning who are the best patients that will really benefit from this because we’re just starting to play with it now,” said Susanna Franks, a physician assistant at Washington Square Dermatology in New York City.

Like many cosmetic procedures, social media plays a key role in helping new products reach consumers, with early adopters of Skinvive sharing their experience on TikTok. But that also leaves room for negative feedback to shape public perception — after a round of Skinvive, Duque shared with her audience that she was left with bumps across her face at the points of injection.

The New Face of Injectables

The Covid-19 pandemic helped normalise filler use amongst millennials and Gen-Zers — but their increased popularity has also made consumers more attuned to signs of an overfilled face. “We’ve seen people doing more filler than ever in our practices,” said Vanessa Lee, an aesthetic nurse and founder of Southern California aesthetics clinic The Things We Do. “We also do more dissolving than we’ve ever done.” According to a 2023 report from the American Society of Plastic Surgeons, hyaluronic acid filler procedures rose 70 percent from 2019 to 2022.

“People went from having no cosmetics, no Botox and fillers to overdosing on it,” said Dr. Kseniya Kobets, director of cosmetic dermatology and assistant professor in dermatology at Montefiore-Einstein. In response, consumers are moving away from obvious augmentation and towards cosmetic procedures that mimic the body’s own regenerative properties, like collagen boosters. “People don’t want to be filled,” she said. “They want to be stimulated.”

With the aesthetic pendulum swinging away from obvious filler, Lee said, Skinvive can fill a gap for consumers who want to improve their appearance without looking like they’ve had work done. At The Things We Do, Skinvive costs $750 a session compared to other fillers that cost $650 to $1,200 per syringe; Lee says clients are using it alongside rather than in lieu of routine procedures like Botox or chemical peels.

While Skinvive is suitable for patients of all ages and skin types, Lee says that patients in their 50s or 60s with crepey skin texture or those with especially dehydrated skin may need additional injections, making the procedure more costly. Dr. David Kim, a dermatologist at Idriss Dermatology in New York City, believes it could be a game-changer for acne-prone patients of all ages seeking extra hydration without using heavy moisturisers. The common denominator is those seeking minimally invasive treatments.

While more research is needed to make such claims, initial clinical research has shown Skinvive to increase aquaporins, water channels in the skin that indicate hydration. And because Skinvive involves multiple injections throughout the cheeks, Dr. Kobets added that the procedure could also help stimulate collagen similar to microneedling. “You’re basically using something external, but you’re also helping your body do what it naturally does,” she said.

Risks and Rewards

Physician assistant Susanna Franks was excited for Skinvive to arrive at her practice, Manhattan’s Washington Square Dermatology, believing it would be attractive to her Millennial and younger clientele who are starting to dabble in fillers and “baby Botox.” “On social media, everyone wants to have glass skin, the perfect skin,” said Franks.

But after trying the product on herself, she was underwhelmed by the lack of visible improvement. For patients in their 20s and 30s who already have smooth skin, Skinvive’s high-price tag — $1,200 a session at her office — may not be worth the subtle effect. “It’s unlike a filler where you show the patient the mirror afterwards and there’s a wow factor,” she said. “For $1,200 you could do a lot of other things, you could do a really hardcore laser where you’ll definitely see a difference.”

Even if patients aren’t wowed by the results, Skinvive’s superficial injection means there is a lower risk for serious side effects like vascular occlusion compared to other fillers, noted Dr. Kim. But that comes with other downsides.

Skinvive uses Juvederm’s proprietary Vycross technology, which cross-links different sized hyaluronic acid molecules for a smoother effect. While Kim has not seen such instances at his practice, he notes that studies have shown Vycross technology to be more associated with nodule formation. “When you have a nodule, sometimes if it’s deep you could feel it, but you may not see it. But with Skinvive, because it’s injected pretty superficially, you will see it if it does happen.”

That may make competitors like Profhilo more attractive should they receive FDA approval. IBSA did not confirm or deny if it is currently seeking FDA approval for Profhilo; Galderma, maker of Restylane Skinbooster, did not respond to requests for comment. “There may be a split in dermatologists, who prefer one over the other because of that slight risk of nodule formation,” said Kim.

The Road To Mass Adoption

Botox has had more than 20 years since it was FDA approved for cosmetic uses to become the leading name in neuromodulators. In today’s market, a new trend or product can take off almost overnight. While social media is a mixed bag when it comes to reliable information, Franks notes that it has the ability to get consumers excited about new products like nothing else — just look at the “Barbie Botox” or Traptox trend that took over TikTok last summer.

That means consumers now have more power to dictate whether a new product like Skinvive makes it to their providers’ offices. “It’s so commercialised that when the patient comes in and they’ve heard of Skinvive and they’re like, ‘Oh, do you have it?’ you’re kind of, not forced, but you’re encouraged to get that product,” said Dr. Kobets.

Skinvive and skin boosters have yet to achieve the viral popularity of Botox, though the right influencer could quickly change that. But while social media can help consumers try new cosmetic procedures, that doesn’t mean they’ll be repeat customers.

Months after trying out Skinvive, Duque is still left with bumps across her cheeks. “I would try other things in the future, but not a skin booster,” she said.

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