Profhilo

If what is bothering you is structural — a flat cheek, a soft jawline — this is the wrong treatment, and we will say so rather than sell it to you.

What it is

A very high concentration of hyaluronic acid — 64mg in 2ml — stabilised by heat rather than by the chemical cross-linking used in fillers. That makes it deliberately runny: it spreads through the tissue instead of holding a shape.

What the evidence actually shows

There is published evidence that it improves measured skin hydration, elasticity, density and laxity. We want you to know what that evidence is worth: the most recent review covers nine studies and 278 people in total, most of them small and without a control group, and it was funded by the manufacturer with several of its authors employed by them.

We think it works for the right patient. We do not think the evidence is strong enough to promise you a specific result, and we would rather say that than repeat a brochure.

The treatment

Two sessions, four weeks apart. Five injection points on each side of the face, chosen to sit away from the major vessels and nerves. It takes about fifteen minutes.

Hydration change is often noticed within one to two weeks. Firmness and texture are assessed about four weeks after the second session. A course typically holds for around six months, after which a single maintenance session keeps it going.

Body areas

The same two-session structure is used for the neck, décolletage, hands, arms, knees and abdomen, with an injection map specific to each area. Both hands count as one area.

Be aware that the evidence for body areas is thinner than for the face, and thinnest of all for the décolletage, which is one of the most heavily marketed uses.

Downtime

You will have ten small raised bumps, one at each injection point. They flatten within a few hours and are generally gone within twenty-four. This is expected — an unwarned patient looking in the mirror an hour later reasonably assumes something has gone wrong.

Bruising, mild swelling and tenderness are common and usually settle within seventy-two hours.

Risks

• Injection-site reactions — redness, small bumps, bruising, localised swelling.
• Late-onset reactions including swelling or nodules. Uncommon, and attributed in post-marketing reports to hypersensitivity or injection technique.
• It is still hyaluronic acid placed in tissue that contains arteries. The risk of a vascular event is lower than with deep filler placement, but it is not zero — and it can be reversed. Read the full risk information.

Not suitable if

You are pregnant or breastfeeding, have an active infection or inflammation at the site, a bleeding disorder, a history of severe allergy, an autoimmune condition in active flare, or are under 18.