Cosmetic Treatments Available in South Korea but Not the United States

What Cosmetic Treatments for the Face are Currently Available in South Korea but Not the United States?

Following my previous post on the development of facial plastic surgery in South Korea, this blog post includes a list of cosmetic treatments for the face that are available in South Korea but not the United States (US). It is important to note that none of the treatments listed below have been evaluated, much less approved, by the Food and Drug Administration (FDA). That is, to the best of my knowledge, why the medications and devices are not yet available in the US. I will do my best to update this list as I identify additional treatments as well as any additional publications that weigh in on the actual safety and effectiveness of these treatments. It is important to seek not only a fellowship-trained but also a double board-certified facial plastic surgeon if you have aesthetic concerns about your face and/or neck.

Rejuran® (PRM-001 Polynucleotide Product [Pharmaresearch Products, Inc., Seoul, South Korea])

I first learned about this product while reading Flawless: Lessons in Looks and Culture from the K-Beauty Capital by the National Public Radio (NPR) reporter Elise Hu. She mentioned the use of a product derived from salmon gonads (seriously) that South Koreans inject in their face at cosmetic clinics, ostensibly for the purposes of improving the appearance of the skin. Additional research revealed that this product, called Rejuran®, is available not only in South Korea but also now in Europe and Australia. It is an injectable like hyaluronic acid fillers but rather than using cross-linked hyaluronic acid to add volume to the face, fish gonadal polynucleotides are injected to increase the production of collagen and elastin in the skin, both of which are important to maintain the smooth and supple qualities of youthful skin.

Polynucleotides are simply a string of signaling molecules which DNA and RNA is composed of. I am skeptical that a chain of these molecules from fish can somehow induce signaling in another species (i.e., humans) to achieve cosmetic results. Interestingly, the only study I found in the literature on this product was a phase III trial of Rejuran® conducted in South Korea in 2014 that was retracted from the medical literature two years after its publication (1). That, to me, is a red flag regarding its actual safety and effectiveness. Additional studies should help determine whether this product is worth evaluation by the FDA.

Local Dynamic Micro-ultrasound (LDM) or Micro-Massage or Dual Frequency Ultrasound

Termed Local Dynamic Micro-Ultrasound, Local Dynamic Micro-Massage (LDM), or Dual-Frequency Ultrasound, this treatment consists of an ultrasound device (probe) that alternates between two very high frequencies when applied to the surface of the skin. The device is being promoted as a technique to improve skin surface quality, with mechanisms of action which are unclear but may include changes in the inflammatory cascade that affect skin surface quality. My review of the literature identified studies that found improvements in bruising and swelling after rhinoplasty and improvements in redness in patients with rosacea and acne with the use of LDM (2, 3). However, as is common with facial plastic surgery studies, the methodology included largely subjective physical assessments by surgeons and patient satisfaction scores to determine their results. Moreover, papers I found that published on the effects of dual frequency ultrasound on wound healing had no comparison group from which to determine whether this treatment accelerated the healing process. This somewhat limits the value of the research itself. Moreover, while I was able to identify the above studies reporting the effects of the device on bruising, swelling, redness, and wound healing, I found no patient studies evaluating the aesthetic qualities of the skin as would be used in a cosmetic practice.

Skin Botox©

Skin Botox is exactly as it sounds. The technique involves the use of botulinum toxin injections with products including, but not limited to, Botox© more superficially in the skin. It is argued that, when injected superficially to the facial muscle, botulinum toxin decreases pore size without affecting the muscle. This is considered an FDA off-label use of the medication in the United States, which is sometimes mixed with diluted hyaluronic acid filler and injected in the superficial surface of the skin. I would imagine it to be extremely challenging to place Botox© or other similar products precisely in the skin such that it is unlikely to diffuse to the underlying musculature which, if affected, could adversely affect facial movements including, but not limited to, smiling. Certainly, an appropriate dilution of the medication(s) and a needle that controls the depth of injection may make such a treatment consistently safe. Otherwise, it would seem a challenging thing to perform safely consistently, regardless of considerations of effectiveness. In my opinion, additional research is required.

Trust Your Face to a Double Board-Certified Facial Plastic Surgeon

It is important to seek a fellowship-trained, double board-certified specialist in plastic surgery of the face and neck when you have concerns about your face or neck.

Why Choose Dr. Harmon

  • The mission of Harmon Facial Plastic Surgery is to help people along their journey towards self-confidence, to feel good about feeling good.
  • Dr. Harmon is a double board-certified facial plastic surgeon
  • Dr. Harmon values making patients feel welcomed, listened to, and respected.
  • Dr. Harmon graduated with honors from Cornell University with a Bachelor of Science degree in molecular biology.
  • Dr. Harmon earned his medical degree from the University of Cincinnati.
  • Dr. Harmon underwent five years of extensive training in head at neck surgery at the prestigious residency program at the University of Cincinnati.
  • Dr. Harmon then underwent focused fellowship training in cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with the world-renowned surgeon, Dr. Andrew Jacono, on Park Avenue in New York City.

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This blog post is for educational purposes only and does not constitute direct medical advice. It is essential that you have a consultation with a qualified medical provider prior to considering any treatment. This will allow you the opportunity to discuss any potential benefits, risks, and alternatives to the treatment.