Andrea Alessandrini explains how the Biorivolumetria range of products provide practitioners with the tools to achieve a total anti-ageing effect for their patients.

The ageing of the face is a process that involves every part: from the bones and support structure to various soft tissues1,2. Due to bone resorption, more evident in certain areas, the glabellar, pyriform, and maxillary angles appear reduced, which causes the soft tissues to collapse and, the flattening of proportions of the face (Figure 1)3.

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However, the earliest and major cause of changing facial volumes is given by alterations that appear in the compartments of subcutaneous fat. As a matter of fact, if the fat layer turns thinner in an area where its presence is naturally moderate (cheeks, temporal and frontal area) there will be a skeletonization effect; while in other areas, due to gravity as well as a hypotrophy process, the fat will migrate downwards and accumulate, causing folds and wrinkles. Examples of the latter can be found in the nasolabial fold and the Jowl deformity.

There is, therefore, a lack of balance between the skin that has to contain too much and the reduced content (fat), whereby the face loses its three-dimensionality while folds and wrinkles appear. It is necessary to carry out an accurate physiognomic analysis of the face and restore a correct distribution of volumes, working on areas most affected by hypotrophy4.

What is Biorivolumetria

Recently a new method in aesthetic medicine was designed and set up: the Biorivolumetria. This word is a synonym for volumization and regeneration. The aim pursued by this method is to associate simple volumization to regeneration. That is to say, to offer a real anti-ageing treatment5,6.

This is made possible by special formulations of highly pure hyaluronic acid, free of residual proteins and solvents; and created with an exclusive and patented chemical process. The peculiarity is given by the fact that the hyaluronic acid, cross-linked with BDDE, contains native intercalated hyaluronic acid in different amounts which depend on the formulations. Hence, the cross-linked hyaluronic acid can be compared to a sort of scaffold that protects and contains biointeractive HA7.

It has been demonstrated that the biointeractive hyaluronic acid, while protected by the scaffold, is released more slowly than the same acid injected into the skin and not protected; this way the stimulation of receptors performed by the acid is prolonged8,9. In addition, due to the native HA, these products are particularly elastic, meaning that they have the ability to adapt to a three dimensional space. These properties make it possible for Biorivolumetria products to precisely follow the mimics of the face, making natural corrections.

What is actually stimulated?

Numerous studies show that the hyaluronic acid interacts with specific receptors, the CD44, which can be found on the surface of various cells, such as the fibroblasts and the mesenchymal stem cells in adipose tissues10–13. When injected into the hypoderm at different levels, the Biorivolumetria products not only create a physical volumetric result, but also biologically stimulate the CD44 receptors of mesenchymal stem cells, boosting the adipogenesis, so new adipose tissues are produced. Tests confirm that adipose tissues increase by 10–15%.

There are several formulations of Biorivolumetria products, which depend on the type of correction required, the degree of de-structuring and the areas to be treated. Regenyal Idea Bio-Expander, very soft and elastic, is especially suitable for the superficial hypoderm and is recommended for areas such as cheeks, forehead, barcode, temporal, and perioral areas. Injected into the most superficial part of the hypoderm, at the dermal connection, this product interacts with the CD44 receptors of the fibroblasts improving the reticular dermis and the skin14,15.

Regenyal Super Idea and Regenyal Idea are ideal for injections into deeper layers, where a more significant volumetric action is necessary: cheekbones, nasolabial fold, and mouth angles.

Effects created by the treatments

Sometimes it is useful to combine deep-action products with the ones injectable into superficial layers, like in the clinical case in Figure 2. Here you can see that the volume in the malar area was restored at deeper levels with Super Idea, while treatments at the superficial hypodermal layer in the malar area were performed with Bio-Expander.

As shown in the post-treatment picture, not only is the volume restored in a natural way, but the skin itself appears improved. In fact both, the patient and the physician, notice a natural volumization and improvement in the skin texture, elasticity and firmness.

The skin improves progressively with each treatment; the patient will not return to their initial conditions.

The chart (Figure 3) clearly shows the concept of Biorivolumetria. While going down, the curve that indicates the volumetric action crosses the curve representing the regeneration: as the volume decreases, there is an increase in the regenerative effect. This means that even after the product is absorbed, there is still a volume related to the regenerative effect.


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All this is a big step ahead in the evolution of aesthetic medicine, that leaves behind the important but simple experience of the so called ‘Filler’, where a long-lasting correction was often the target with the risk of compromising the aesthetic result.

Biorivolumetria creates natural results while preventing and treating skin ageing; this has been observed in thousands of patients treated.