Rapid Polymerising Collagen: Tissue in a Syringe

01 May 2014

Collagen could be returning to the UK aesthetics market with the development of a new collagen dermal filler portfolio. But what benefits does collagen have to offer the modern practitioner?

Collagen was the original dermal filler; it rapidly became so synonymous with volumising that it is still often used as a popular term for all fillers, particularly in the lips. Introduced in the 1980s, it was skin-friendly, safe, soft and natural. However, there was a small risk of allergic reaction to bovine collagen, so patients required a skin test, and the product lasted as little as two to four months post-injection. The emergence of safe, long-lasting and reversible hyaluronic acid fillers decreased the demand for collagen. A durable, cross-linked, porcine collagen product, Evolence, was launched in 2004 but was withdrawn again in 2009 for business reasons. However, whilst HA fillers are now incredibly sophisticated, some doctors are still nostalgic for the unique properties of porcine collagen, particularly for fine, delicate skin indications.
At IMCAS, at the beginning of 2014, EternoGen attracted a great deal of interest as the company unveiled a new collagen portfolio comprising Rapid Polymerising Collagen (RPC) and Gold Nanoparticle Collagen (CG Nanomatrix). Charles Weatherstone, EternoGen’s marketing director, announced that, “Both have been formulated with unique integral shielding protection from collagenase degradation to offer long-lasting, natural-looking treatment results.”
“They are also designed to provide high biocompatibility, facilitating natural integration with the skin at a cellular level, which minimises the risk of inflammatory reactions and post-treatment problems,” says Weatherstone. “A lidocaine combination has also been developed
to ease discomfort on injection of RPC.” Given the sheer number of hyaluronic acid fillers, we might question why the aesthetics market needs a new collagen filler. Weatherstone explains, “Skin is 80% collagen, and collagen is lost with age. Injected hyaluronic acids hold the skin up well, but they stay as a bolus, and don’t integrate with the skin. On the other hand, RPC is a liquid that trickles through the dermis. After a few minutes, it polymerises to form a mesh of tissue that won’t migrate or change shape.”

Figure 1a: Rapid Polymerising Collagen resembles host tissue's cellular and vascular structure
Figure 1b: HA one month post-injection. Hyaluronic Acid remains as a distinct blue bolus
“In our studies, just two weeks after injection, blood vessels started to grow into the injected collagen,” he says. “After 53 days, you could look at the injection site under a microscope and the collagen was completely integrated into the dermis. It all became one tissue, which is why we call it ‘tissue in a syringe’. It also improves skin smoothness and radiance.” EternoGen has conducted investigations into conjugating collagen with gold nanoparticles to provide additional benefits and enhanced duration. The research, carried out at University of Missouri, demonstrates that Gold Nanoparticle Collagen (CG Nanomatrix) has the potential to further increase resistance to degradation with treatment results lasting for up to two years. The addition of gold nanoparticles also provides antioxidant benefits. “This has the potential to reduce possible inflammatory reactions, such as swelling,” Weatherstone says. “The product will also not need a skin test before use, and it will be long-lasting and easy to use.” Christopher Inglefield, plastic surgeon and medical director of London Bridge Plastic Surgery, has recently been conducting human trials using the new collagen portfolio. He says, “The RPC collagen is a clear liquid which injects very smoothly through a 30 or 32G needle, having the lowest extrusion force for fillers. It is associated with mild to moderate discomfort on injection. We are in the middle of a human safety study and all is proceeding well. “RPC is unique in replacing the skin’s lost collagen,” he says. “Therefore it is suitable for rebuilding the skin, where lines or wrinkles are a concern, or for example, for treating acne scars and post-surgical scars.” He continues that RPC’s unique ability to integrate with human skin is its key strength compared to other fillers. “RPC collagen can be used in a mesotherapy treatment or as a volumising produce because of the in-situ polymerisation,” he says. “This remains stable with no risk of product migration.” Some doctors remain wary because of previous cases of patients experiencing reactions; However, Mr Inglefield says, “There will always be concerns about the use of porcine collagen despite numerous safety studies and hundreds of thousands of patients who have benefited from porcine products.
“The producers of EternoGen are being scientific and ethical in the development of the product to ensure that they launch a highly developed and researched product,” he says. “Collagen started the revolution in non-surgical aesthetic medicine; HAs have provided a very beneficial tool in restoring lost volume, but collagen is the gold standard in providing true rejuvenation of the skin.
“I firmly believe there is a clear need for a skin friendly collagen- based filler to provide safe, natural-looking results and the skin health benefits that both consumers and physicians seek today,” says Mr Inglefield. “RPC is particularly suited for delicate and challenging treatments in the peri-orbital and peri-oral areas where the risk of lumps and product migration needs to be minimised.” Whilst hyaluronic acid fillers produce long-lasting, safe results, recent developments of RPC, enabling it to integrate completely into the dermis, and the potential of Gold Nanoparticle Collagen to last for up to two years, mean that there could soon be an increased demand for collagen in the aesthetics market. 

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