Sponsored By BENEV;
Regenerative aesthetics is an emerging field of medicine with a focus on multi-layered approaches to regenerating tissue structure and function. Results have led to innovative strategies that help patients reach their aesthetic goals of achieving a naturally younger and more refreshed version of themselves. BENEV Company (Mission Viejo, Calif.) provides cutting-edge treatments to meet the demand for skin revitalization and regeneration with products including their revolutionary MIRACU® PDO threads and the Viviscal™ line of hair products.
PDO Thread Treatments Determined to offer providers proven treatment methods for regenerative aesthetics, BENEV was the first company in the U.S. market to obtain 510(k) clearance from the FDA for a pre-loaded polydioxanone (PDO) thread with a designation for soft tissue approximation. BENEV is also the only U.S. company in a direct joint venture with Dong Bang Medical (Dosan-daero, Gangnamgu, Seoul, South Korea), the largest manufacturer of cannulas and PDO threads in the world. MIRACU PDO threads include an extensive variety of molded threads that provide 10 to 20 times the tensile strength of other PDO threads.
MIRACU’s Forte Basic threads use bi-directional cogs for strong fixation. The company’s newest product, Forte Fix, provides superior traction, hold, and fixation with four-dimensional (4D) multi bi-directional blocking technology. MIRACU’s Elasty Line is double coated with polydioxanone and provides superior tensile strength with deep, bi-directional cogs, while their revolutionary Elasty Meshfill thread uniquely features a 16-layer mono woven scaffold.
“I was one of the first adopters of MIRACU PDO threads in the U.S., and I chose the brand specifically because they are molded threads,” reported Scott Callahan, PA-C, director of Dolce Vida Medical Spa (Westport, Conn.). “The line includes MIRACU Forte Basic and Forte Fix, which may be used for cheek enhancements, to help lift and shape the eyebrows, and for jawline definition. MIRACU Elasty Line can enhance these treatments and Elasty Meshfill can be used to inhibit the migration of filler.
“I use the MIRACU PDO molded barbed threads first for many facial rejuvenation treatments,” Mr. Callahan continued. “I place these threads to reposition the tissue and finish with smooth threads, which help seal the tissue and build collagen. It is important to emphasize that smooth threads do not lift the tissue, which is why you need to utilize both.”
According to TJ Tsay, MD, medical director and owner at Ageless MD (Tustin, Calif.), MIRACU’s Elasty Line is created with a hook at the end of the thread for robust anchoring and latching onto tissue. “I use the Elasty Line for heavier jowling because of how strong the thread is. Their Elasty Meshfill thread is unique in that it consists of 16 monofilament threads interwoven into a mesh that exponentially increases the surface area for improved collagen synthesis. This thread can be used as an alternative to dermal fillers for those that want a more natural treatment and something that is more biostimulatory. The Forte Fix is a very special thread because it has a butterfly shaped, double blocking barb design that prevents the tissue from moving once it is ‘fixed’ to the desired position.”
MIRACU PDO threads are created with double molding for superior strength and exceptional lifting power, making them a top choice for cosmetic facial surgeon Tabasum Mir, MD (New York, N.Y.). “From a scientific perspective, PDO threads have been extensively studied and proven effective for their skin-tightening and collagen-stimulating properties. MIRACU’s double molding process enhances their structural integrity, making them even more reliable.
“MIRACU’s Elasty Meshfill threads are a gamechanger,” Dr. Mir continued. “They are ideal for volumization of hollow areas, and the remarkable part is that you can achieve this without the need for fillers. This versatility is a significant advantage in achieving natural, youthful results.”
Dr. Mir uses MIRACU PDO threads for many procedures, including her MIRACU ‘My Miracle Treatments’. According to Dr. Mir, her facial rejuvenation thread procedure restores a youthful appearance by lifting and tightening sagging skin, while patients notice improvement in skin firmness and a more defined facial contour. Other treatments she performs are neck and jawline lifts to address loose skin of the neck and jawline, and an eyebrow lift as a noninvasive solution to lift and rejuvenate the eyebrows without surgery. “MIRACU threads are also integral to my signature nonsurgical nose job and nasal tip lift,” she added.
MIRACU PDO threads are used by physicians and practitioners to maximize results of other aesthetic treatments such as lasers, dermal fillers, radiofrequency (RF) and microneedling. Gideon Kwok, DO, co-owner and medical director of eight Skin Perfect Medical Clinics in Southern Calif., uses MIRACU threads to lift and reposition the face, nasolabial fold and the jowls. But he also noted the importance of using combination treatments for long-lasting results.
“I definitely recommend a combination of treatments to extend the longevity of thread results and for a more natural look,” Dr. Kwok shared. “Toxins are a must to relax muscles pulling on the thread results. Smooth threads and energybased devices stimulate more collagen to firm and tighten skin and are important to get the best overall results. Fillers help create projection so that threads can do a better job of repositioning the superficial fat pads. Providers should understand that for the most optimal and natural results, combination therapies can address all layers of aging.”
Dr. Kwok explained some of the creative ways he incorporates MIRACU thread treatments. “I typically like to use a combination of traditional and reverse vectors, and the MIRACU Forte threads are my go-to threads for this combination vectoring,” he began. “The Elasty Line is the most robust thread product on the market and used to lift really heavy tissue. Elasty Meshfill threads are placed in the nasolabial fold, marionette and nasojugal areas to smooth out the surface. Once complete, you can place some filler into the mesh thread, which is very unique because you get support from the thread filled with the filler.”
Dong Bang Medical also has a history of making great cannulas for improved ease and efficacy of thread placement, noted Dr. Kwok. The Company offers an extensive variety of cannula tips and innovative pre-loaded cannulae, giving practitioners more options and smoother treatments.
Mr. Callahan explained that he uses MIRACU PDO threads in combination treatments to optimize patient results. “When lifting the face and making people look youthful, one part of the treatment is to restore volume. I use products like Sculptra (Galderma) to do this and build collagen. But people also lose three ligaments in the face: the zygomatic, mesenteric and the mandibular ligament, and to me the threads are a replacement of those ligaments in that they build the tissue back up again.”
In addition, Mr. Callahan also incorporates MIRACU threads in combination with fat transfers for long-term results. “Fat will uptake for five to ten years, so the patient may only have to come in once every three to five years rather than every year, as is common with other fillers that do not last long,” he said. Dr. Callahan added that he also uses threads with plateletrich plasma (PRP) and BENEV exosomes for hair treatments, and for his brow lift that he named the ‘Cleopatra Lift.’
According to most physicians, thread treatments last from 12 to 24 months, depending upon patient concern, combination treatments used, and thread placement. Threads placed in areas with a significant amount of natural movement such as around the mouth, will break down faster than threads placed in areas such as the forehead and midface. An experienced eye, combined with skillful thread placement and product knowledge, contribute to ideal outcomes and long-lasting results.
“I use a combination of traditional (top down) vectors and reverse vectors, as well as the ‘Hammock’ technique for addressing submental fullness,” said Dr. Kwok. “It is really about understanding how the threads and the barbs work as well as designing the best vector pattern for each patient that addresses their specific anatomy. This is not a cookie cutter procedure and different patients can have completely different vector patterns. The learning curve can be steep with PDO threads; it took me over a year to really get good at it.”
“Training is key with anything,” said Mr. Callahan. “BENEV offers bootcamps all over the U.S. My practice offers a popular bootcamp once a month that allows the students to do six to eight cases. I would advise going online to RJ Clinical Institute to get connected with a MIRACU Trainer. Each trainer will have different techniques, so the key is to keep learning.”
Hair Treatments in Aesthetics
Hair loss affects both men and women impacting more than 50% of the population. Many turn to aesthetic physicians for help, paving the way for a variety of aesthetic hair treatments. “We know that hair needs blood supply, but it also needs certain nutrients so the hair can continue to grow in both length and thickness and BENEV’s Viviscal Pro helps my patients achieve that,” said board-certified plastic surgeon Richard Goldfarb, MD (Langhorne, Pa.). “I use Selphyl platelet-rich fibrin matrix (PRFM) for blood supply along with Viviscal Pro to supply nutrients. The main nutrient in Viviscal is AminoMar®, which is the patented growth factor complex not found in other supplements that promotes hair growth by nourishing the hair follicles.”
In ten published clinical studies with Viviscal Pro supplements, 94% of participants saw an increase in hair volume, 92% saw an increase in hair thickness and 39% noticed a decrease in hair shedding.1,2
Dr. Goldfarb’s hair treatment plan includes three Selphyl PRFM treatments, six weeks apart and Viviscal twice a day, 12 hours apart beginning the day of the first Selphyl treatment through to six months after the last treatment. “I did a 100-patient study using the Selphyl treatment and then I did a 100-patient study with the Selphyl plus the use of Viviscal and there was a significant increase in hair growth when Viviscal was used,” Dr. Goldfarb added.
Science of Viviscal
For Suneel Chilukuri, MD, a board-certified dermatologist and owner of Refresh Dermatology in Houston, Texas, focusing on the science is the first step to determining the efficacy of any product. “I get asked a lot by patients how we can be sure Viviscal works,” he started. “From a physician’s standpoint, there are ten clinical trials that show the efficacy, with over 690 people treated. In about six weeks we see a reduction in hair shedding and at three months a 40% reduction in hair shedding. We find that there is an increase in the number of hairs after three months, with a 57% improvement in the terminal or thick hairs, and at six months it is an 80% increase, so that is pretty significant. We also know that at six months there is going to be a 12% increase in the size of hair diameter, so all of this shows there is an improvement, giving me confidence that my patients can benefit from Viviscal Pro.”1,2
Glynis Ablon, MD, board-certified aesthetic dermatologist and founder of the Ablon Skin Institute (Manhattan Beach, Calif.) explained that the effectiveness of Viviscal Pro supplements lies in the unique formulation.“These supplements contain a proprietary blend called AminoMar, which is a marine protein complex derived from key marine sources, containing specific proteins, amino acids and polysaccharides that have been shown to support healthy hair growth,” Dr. Ablon explained. “This complex combined with other essential vitamins and minerals such as L-Cystine and L-Methionine, which are essential amino acids in the formation of hair and skin, offer a positive effect on hair growth. Apple Extract (Procyanidin B2) is known to increase hair density and diameter, promoting healthy hair growth, and vitamin C is shown to protect hair and skin from the damaging effects of free radicals. Viviscal Pro is backed by over 30 years of clinical results including ten published clinical trials, of which I have been a principal investigator in five of those trials.
“My study (with Dr. Dayan) that was published in the Journal of Clinical and Aesthetic Dermatology supports the efficacy of Viviscal Pro products in a randomized, double-blind, placebo-controlled, multi-center trial,” Dr. Ablon continued. “It involved women experiencing temporary hair thinning. Participants were divided into two groups: one group received Viviscal Pro supplements, while the other received a placebo. The results showed that the group taking Viviscal Pro supplements experienced a significant improvement in hair density, hair diameter, and overall hair growth compared to the placebo group. These findings demonstrate the effectiveness of Viviscal Pro products in promoting hair thickening and growth.”3
Richard Jin, MD, PhD, a cosmetic surgeon at the RJ Clinical Institute in Mission Viejo, Calif. and chief medical officer for BENEV, explained that as treatments for hair loss continue to evolve and advance year after year with new techniques and technologies, Viviscal Pro has been a mainstay in his practice. “From nonsurgical to surgical cases of hair restoration I always recommend for my patients to start on Viviscal Pro before, during and after their treatment sessions.”
Dr. Jin described recent studies by Augustyniak and colleagues titled, Dietary Marine-Derived Ingredients for Stimulating Hair Cell Cycle, published in July of 2023 in Biomedicine & Pharmacotherapy. “This was an in vitro study using primarily human dermal papillae cells where they showed that Viviscal increased the proliferation of these cells and also stimulated hair growth via anagen activation which is a vital step in determining overall hair length and rate of growth,” he explained. “Through the cell culture experiments they were able to show that Viviscal did not exert any cytotoxic effects on the dermal papillae cells. It also increased expression of genes related to the B-catenin/Wnt signaling pathway as well, which is considered to be one of the most important pathways for growth and development of follicles.4 Viviscal has published over ten clinical trials showing safety and efficacy of their supplement but this may be one of the first independent studies evaluating the effects in vitro, confirming what we see clinically.”
Viviscal in the Aesthetic Practice
The Viviscal Pro line includes the Viviscal Pro Dietary Supplements along with Viviscal Pro Thickening Shampoo, Conditioner and Elixir. While practitioners advocate supplementing aesthetic hair treatments with at-home hair care, the Viviscal supplements also play an integral part of treatments so as not to overlook nourishment for hair health.
For any type of hair restoration procedure, Dr. Chilukuri’s first step is to optimize the scalp with Viviscal Pro for up to six seeks. “Next, I may combine RF microneedling using Sylfirm X and then topically apply the BENEV exosomes. Exosomes are communication factors and when you apply that to those open channels, we see a tremendous amount of hair growth. But my first step is always starting with Viviscal to address the root cause and fertilize the scalp properly before we add any other procedure.”
“I take into consideration each patient’s individual needs and incorporate Viviscal Pro supplements as part of a comprehensive approach to address their hair concerns,” Dr. Ablon expressed. “By combining these products with other treatment modalities, such as PRP or exosomes, microneedling, red light therapy and topical or prescription oral medications, I create customized protocols that aim to improve hair thickness and overall hair health. Patients love participating in their hair loss treatment, and supplement use is an easy way to get them involved.”
BENEV products can help ensure that aesthetic physicians and practitioners stay on the cutting edge of the latest technologies in regenerative aesthetics. MIRACU PDO threads and cannulas, along with Viviscal Pro dietary supplements can benefit practices by providing treatments their patients want with science they can trust.
1. Bloch, L; J. Self-assessment results. Dermat Cosmetol, 2017
2. Ablon, G. Existing hair growth. Dermatol Res Pract., 2015
3. Ablon G; Dayan S. Multicenter Extension Study of Viviscal Professional Strength Oral Supplement in Females with Self-Perceived Thinning Hair, JCAD Dec 2015, vol 3(12):20-26
4. Augustyniak A, Mc Mahon H. Dietary marine-derived ingredients for stimulating hair cell cycle. Biomed Pharmacother. 2023 Jul;163:114838. doi: 10.1016/j.biopha.2023.114838. Epub 2023 May 8. PMID: 37156114.