It’s been more than 20 years since Botox first stunned the aesthetics world, revolutionising the realm of needle-based treatments—and compelling us to anticipate every next big shot. In 2023, we have dozens of tried-and-true injectables at our disposal—myriad hyaluronic acid (HA) gels for instant plumping and contouring, collagen stimulators that give a more gradual swell, neuromodulators like Xeomin to minimise furrows and frown lines—yet our gaze still wanders to the horizon.
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The most captivating of the current up-and-comers are the skin boosters or “skin-quality injectables”—a niche group of hydrating, smoothing hyaluronic acid-based potions that have been flowing through syringes in other countries for years. “Skin boosters are incredibly popular here,” says London-based plastic and reconstructive surgeon Ashwin Soni. In the harried lead-up to last Christmas, he adds, “we did more skin boosters than Botox for the first time ever.”
We did more skin boosters than Botox for the first time ever.
The shots are similarly in demand across Canada, where their appeal is remarkably universal. “Young patients often come in wanting pre-juvenation and radiant ‘glass skin,’ and skin boosters can be a great option,” explains Katie Beleznay, a board-certified dermatologist in Vancouver. On the other hand, she says, “my older patients really love the increase in hydration [boosters give], as their skin gets drier with age, as well as the improvement in fine lines and texture.”
Despite their global success, only one buzzworthy booster has been (very recently) approved by the FDA. Known abroad as Juvéderm Volite, it will be called Skinvive when it launches in the U.S. later this year. Similar products in the pipeline, all presently used elsewhere in the world, include Teoxane’s Teosyal Redensity 1, Profhilo and Profhilo Body, and the Restylane Skinboosters Vital and Vital Light.
What are skin boosters?
“Skin boosters are a class of products that I like to call microdroplet HA,” Amelia K. Hausauer, a board-certified dermatologist in Campbell, California, tells us. “These are tiny aliquots or ‘sprinklings’ of hyaluronic acid [delivered] into the top layers of the skin, intended to replenish hydration, improve light reflection, and smooth the canvas of the skin, without changing the structure of the face.” (Translation: no worry of pillow face.)
Indeed, the results they aim to confer are unlike those achieved with traditional fillers—or any other cosmetic treatment in your dermatologist’s or surgeon’s arsenal. “These products represent a missing link to the fountain of youth,” explains Sarmela Sunder, a board-certified facial plastic surgeon in Beverly Hills. “We have surgery to address skin laxity; fillers to address volume loss; neuromodulators to address dynamic lines; lasers to address pigment and textural skin issues—but we have no definitive way to address the tone, hydration, and firmness of the skin structure as of yet.”
These products represent a missing link to the fountain of youth.
This is something American patients are reportedly yearning for—“a solution for the concerns of skin quality and skin integrity,” Sunder adds, especially as they relate to “the aging neck, the delicate skin around the eyes, and the sun-damaged skin of the décolleté.” Some folks, unwilling to wait for the boosters to arrive Stateside, are routinely traveling—to London, Paris, Vancouver, Sydney—for these treatments and their addictive dewy glow.
“Radiant skin is an integral part of what we perceive as attractive, healthy, and youthful,” Hausauer notes. “These treatments tap into this idea of a refreshed complexion without [making you] look different or changed”—which is a huge boon at the moment, she adds, as we’re collectively shifting away from all things extreme or overdone. “Skin boosters allow you to look like yourself, just more luminous.”
How are boosters different from traditional fillers?
While each product under the skin-booster umbrella is unique in terms of its composition, these treatments all share a common mission—one that sets them apart from the ordinary HAs we may use to plump our lips or define our cheekbones. “The goal of skin boosters is to hydrate the skin from within, improving its overall quality and health,” Beleznay reiterates. Rather than adding fullness, shape, or contour, “they’re often used to address fine lines and texture, as well as to improve the appearance of dry, dull, or uneven skin.”
In a way, “skin boosters are more akin to laser, microneedling, or other canvas-improving therapies [than they are to fillers],” adds Hausauer.
Crosslinking is a hallmark of conventional hyaluronic acid fillers. This refers to the way their individual HA molecules are chemically bound together. The more tightly crosslinked a filler is, the more robust and durable the gel tends to be. A filler’s specific crosslinking formation influences not only its thickness and longevity, but its intended effect and placement in the face.
“Skin boosters are either non-crosslinked or are only minimally crosslinked, so they are much thinner and have a lighter feel by comparison,” Sunder explains. What’s more, “the concentration of hyaluronic acid in skin boosters is typically less [than that in brawnier fillers], so they are softer and less viscous,” Beleznay says. These qualities allow them to be injected superficially, directly into or just below the dermis, while remaining undetectable.
“If we were to borrow terminology from art,” Sunder says, “our traditional fillers would be like clay or other media used for sculpting, whereas the skin boosters would be like watercolors.”
If we were to borrow terminology from art, our traditional fillers would be like clay or other media used for sculpting, whereas the skin boosters would be like watercolors.
How does treated skin look—immediately and over time?
“Immediately post-treatment, a patient may not see a result, but over the ensuing weeks, they will feel as though their skin is better hydrated, has that lovely glow that everyone wants, and has improved elasticity and firmness,” Soni says.
The gradual firming effect comes from enhanced collagen production—something each booster aims to deliver in its own way. Profhilo, for instance, fuses hyaluronic acids of varying weights, via a thermal-cooling process, which is said to preserve the product’s purity while maximizing its ability to bind with the skin’s collagen receptors to subtly improve laxity. Teosyal Redensity 1, on the other hand, is supercharged with collagen-building ingredients, like amino acids, antioxidants, vitamins, and minerals.
Such regenerative properties lend boosters a next-level appeal, particularly for “patients who are losing collagen rapidly in those first few years of menopause and are looking to firm their skin and improve its elasticity,” Soni says.
Beleznay makes the point, however, that the short-term effects of these shots are generally more modest than those seen with regular HA fillers. “It’s a subtle overall improvement in the quality of the skin, so the before and afters may not be as dramatic,” she says. “It’s important for patients to have realistic expectations.”
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How are skin boosters injected?
While prescribed injection patterns and timelines vary from product to product, a unifying trait of skin boosters is their superficial microdroplet delivery—meaning injectors painstakingly place small amounts of HA throughout the dermis, just beneath the skin’s surface, typically administering it with a customized needle that ensures precise dosing and depth.
Beleznay says she treats primarily the cheeks, the lower face, and the upper lip lines, as well as the neck, chest, and sometimes the backs of the hands.
The number of treatments one needs depends on the booster they choose: The Restylane Skinboosters, for example, require an initial three sessions, spaced four weeks apart, with a maintenance treatment every four to six months, Beleznay tells us. With Skinvive, a single treatment can last six to nine months. Plan on two rounds of Profhilo, one a month, and three for Redensity 1, for benefits that last about six months in both cases.
What are the risks and side effects of skin boosters?
The complication profile for products like Skinvive and Profhilo is comparable to that of other hyaluronic acid injectables. Side effects include injection-site redness, swelling, weltlike spots, and pinpoint bruising—most of which subside within a day or two. Bear in mind, however, that since boosters require multiple needle pokes across the face, the marks they leave can be rather obvious, widespread, and hard to hide.
While boosters are finer and more fluid than basic fillers and injected less deeply, “serious vascular complications are still possible,” Beleznay warns, so choose a provider who has a thorough understanding of facial anatomy.
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Are there any good dupes for skin boosters?
You won’t have to wait too much longer for the real deal, but, yes, there are a handful of treatments that can quasi-mimic the effects skin boosters are famous for.
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- Skin stamping is a solid substitute for boosters, our experts agree. Pressing a cocktail of HA, Botox, and platelet-rich plasma (PRP) into the upper layers of the skin with a short-needled tool, like Aquagold, can render skin similarly vibrant and supple. “The neuromodulator [in the mix] can affect sebaceous glands and impact pore size, thereby helping overall skin texture,” Sunder explains. “The diluted HA filler can plump the skin, and the PRP plays a role in wound healing.”
- Diluted HA filler: Some doctors will take a light FDA-approved filler, like Restylane Silk, and thin it out further with saline before injecting it in a boosterlike fashion. Silk is actually identical to Restylane Skinbooster Vital, but it doesn’t come with Vital’s dose-regulating needle, since it’s not made to be used as a booster here in the U.S.
- Microneedling with or without PRP can refine your complexion, blurring scars and pores, while ramping up collagen production.
- Light resurfacing treatments, like mild fractional lasers and radiofrequency microneedling devices, can speed cell turnover for smoother, glowier skin. Hausauer will often pair a gentle laser, like Clear + Brilliant, “with a well-thought-out and scientifically backed skin-care regimen to ensure good hydration and appropriate skin barrier integrity.”
- High-tech facials that follow a deep-cleaning with brightening acids, antioxidant infusions, oxygen therapy, red LED light, and/or moisture masks can leave skin impossibly plump, rosy, and reflective—for a weekend, at least.
This article originally appeared in Harper’s BAZAAR US.