Rho 2024 — Injectable Skin Boosters: A Current Overview
Full citation: Rho NK, Kim HS, Kim SY, Lee W. “Injectable ‘Skin Boosters’ in Aging Skin Rejuvenation: A Current Overview.” Archives of Plastic Surgery 2024;51(6):528–541. DOI 10.1055/a-2366-3436. PMID 39544509. PMC11560330 (open access).
Role in this wiki
This review is the synthesis anchor for the injectable-skin-boosters umbrella page. It provides the classification scheme for injectable skin boosters used in aging skin rejuvenation — organizing the field into hyaluronic acid formulations, polynucleotides/PDRN, biodegradable synthetic polymers (biostimulators), polycomponent products, and emerging biologics (exosomes).
Scope
A narrative review evaluating injectable biological materials used as “skin boosters” for aged/aging skin. The paper covers:
- Definition: injectables that deliver bioactive/biostimulatory agents intradermally or subdermodermally to address hydration, elasticity, and neocollagenesis deficits in aging skin
- Classification: natural biopolymers (HA, PDRN/polynucleotides, collagen, PRP) vs. biodegradable synthetic polymers (PLLA, PDLLA, PCL, PDO, CaHA) vs. other ingredients (glycerol+HA, amino acid complexes, botulinum toxin microdoses) vs. polycomponent products (NCTF-type) vs. exosomes
- Delivery methods: intradermal multipuncture (33–34G needles, ~10° tangential approach), automated/multineedle injectors, needle-free jet injectors
- Safety: adverse events (erythema, bruising, transient lumps), rare serious events (vascular occlusion, necrosis, nodule formation — severity is polymer-dependent)
- Evidence appraisal across the product categories (primarily Asian/Korean practice literature; limited large RCT evidence for most categories)
Evidence quality
Per CLAUDE.md review conventions: this is a narrative review without systematic review/meta-analysis methods (no search strategy, no risk-of-bias assessment, no PRISMA reporting). Level of Evidence V/expert opinion for the curated clinical judgments. The underlying primary studies it synthesizes vary widely in design quality — most are small, uncontrolled, or non-blinded.
Human evidence: yes (review of human clinical studies and trials)
Organism model: human
Key citations to verify against primary source
- HA formulations: cross-linked vs. non-cross-linked product characteristics
- Glycerol + HA (CPM-HA20G): multicenter RCT, n=159 subjects, hydration improvement to 16 weeks and lasting ~9 months post-last-injection (verify against Kerscher 2021, doi:10.1097/GOX.0000000000003973)
- PDRN/polynucleotides: mechanism via adenosine receptor (A2AR) activation; fibroblast collagen stimulation
- NCTF-type polycomponent products: in-vitro data (fibroblast collagen/MMP/TIMP mRNA over 11 days); comparative clinical study n=50 vs HA alone (verify against primary sources cited in review)
- CaHA biostimulator: dual fill + biostimulation mechanism
- PLLA (Sculptra): FDA-cleared 2009 for facial lipoatrophy, established biostimulator class
Contextual note — retracted companion paper
A companion classification paper by Yi et al. (2024, Skin Research and Technology, DOI 10.1111/srt.13627) that covered overlapping content was retracted on November 21, 2025 (retraction DOI 10.1111/srt.70297) for insufficient peer review, uncited/unlicensed images, promotional bias, and factual inaccuracies. The Rho 2024 Archives of Plastic Surgery paper is the appropriate anchor for this topic; Yi et al. should NOT be cited for any biological or clinical claim. See injectable-skin-boosters § Note on the retracted classification paper.