Collagen Stimulation – Turning back time in a natural way

Collagen is a key structural component that keeps skin youthful looking and smooth. As we age, our body's collagen production decreases, and we may begin to see wrinkles. Collagen Stimulation works to correct shallow to deep facial wrinkles and folds as it stimulates our bodies collagen production and replaces lost collagen, which can help provide a refined, more youthful looking appearance.

Collagen Stimulation  is a well-established type of facial injectable made from poly-L-lactic acid, which helps to replace lost collagen and naturally stimulates the skin cells to produce its own collagen.

The main ingredient is a biocompatible, biodegradable synthetic material that has been used by physicians for decades.

Poly-L-lactic acid was approved by the FDA for the treatment of facial fat loss (also called facial lipoatrophy). According to documents from the US Food and Drug Administration, the FDA initially approved the drug on the basis of small studies conducted on HIV patients, specifically “for restoration and/or correction of the signs of facial fat loss (lipoatrophy) in people with human immunodeficiency virus (HIV). Facial lipoatrophy is a condition in which people lose fat in their faces, especially in their cheeks and around their eyes and temples. People with HIV who take anti-HIV drugs may develop lipoatrophy. Collagen Stimulation was subsequently approved by the FDA for use with non-HIV patients with wrinkles, despite substantial complications reported to the FDA.

While traditional dermal fillers only address wrinkles, lines and folds; Collagen Stimulation works differently in replenishing lost volume by stimulating growth of your own collagen to treat the underlying cause of facial ageing and giving a more youthful appearance.

The 3 major types of facial treatments can be classified as resurfacing, facial injectables and surgery.

FACIAL Resurfacing    FACIAL Injectables  FACIAL Plastic Surgery


Facial resurfacing works by modifying the surface of the skin to correct visible signs of sun damage, such as fine lines, irregular pigmentation, and blemishes. Some common techniques are chemical peels, microdermabrasion, and laser resurfacing.

Facial injectables include a broad range of substances that are administered by injection to reduce the appearance of lines and wrinkles and restore facial contours. These include toxins, traditional fillers, and collagen stimulators, and each treatment works differently.

Facial plastic surgery is usually the most invasive treatment and includes a wide range of procedures — most of which are used to lift sagging skin, remove excess fat, or fill hollows. The most popular surgical options are liposuction, face-lift, and fat transfer.

Dr Ayham Al-Ayoubi at London Medical & Aesthetic Clinic proves how Collagen Stimulation is bridging the gap between invasive surgery and non-surgical facial countering.

One of the things that most compels people to visit a cosmetic aesthetic surgeon is concern about facial ageing.

When does facial ageing begin?

Facial aging usually begins in your 20s when the firmness of your skin begins to decrease. Wrinkles, blemishes, and sunspots may also start to appear, becoming more pronounced with age. Of course changes vary from person to person.

What factors contribute to facial ageing?

Facial ageing is caused by both internal and external factors. Internal (or chronological) factors happen over time and are caused by genetics and the natural aging process. External (or environmental) factors are things in the world around you, including sun exposure, smoking, pollution, gravity, facial expressions, and sleep position. All of these factors can contribute to changes in the skin, as well as changes in facial bones.

What is the role of collagen loss in facial ageing?

Collagen is a fibrous protein in the dermis that gives structure to the skin and provides the foundation for the retention of elastin and hyaluronic acid. Elastin is an elastic protein that helps maintain shape, while hyaluronic acid cushions and lubricates to keep the skin moist. More collagen enables the presence of more elastin and hyaluronic acid.

With age and environmental damage, collagen is lost, and as time goes on, the body's natural production decreases. The damage to the underlying structure of the skin reduces the skin's ability to maintain elasticity and retain moisture.

We pride ourselves in being the leading clinic in Collagen Stimulation treatment in the UK and Europe. Dr Ayham Al-Ayoubi is a leading Collagen Stimulation Training Surgeon and he is an internationally recognized expert in the procedure with more than 5000 cases of Collagen Stimulation treatments performed at our clinic.

What results can be expected from Collagen Stimulation ?

With a stimulatory product of any kind, it is important to carefully and clearly explain the process and goals of the treatment before beginning treatment.

Collagen Stimulation in particular requires this education because it is administered in usually two - three or more sessions covering a 3 month period or more with ultimate results achieved over a  3 - 6 month time frame.

Because of the volume of the water in the suspension, patients will leave the office looking filled; however, they should be aware that the improvement they see immediately will be gone in 2 to 4 days and they will then await the collagen growth that can be seen starting at 2 to 3 weeks. Patients should also be cautioned to prepare for the possibility of bruising and avoid non-steroidal anti-inflammatory medications prior to an injection.

Equally important is the use of preoperative photography, which reminds every one of the amount of improvement of the treatment; as it comes on gradually. Just like the signs of aging occur gradually and are not realized by the patient until they have advanced, improvement over time with stimulatory filler cannot always be recognized and appreciated by the patient.

Once volumization has been achieved, results can be expected to last from 2 - 5 years (non-smoker patients have longer lasting results, due to smoking reducing the blood supply to the skin, according to Dr Ayham Al-Ayoubi).

Where should Collagen Stimulation be used?

• Deep folds between the nose and mouth (nasolabial folds)

• Folds around the corners of the mouth (marionette lines)

• Wrinkling in cheeks or chin

• Sunken cheeks

• Deep scars

How Collagen Stimulation works with scarring

Scars are areas of fibrous tissue that replace normal skin after injury, they result from the biological process of wound repair in the skin and other tissues of the body. 

Scarring is a natural part of the healing process. With the exception of very minor lesions, every wound (e.g. after accident, disease, or surgery) results in some degree of scarring.

All scarring is composed of the same collagen as the tissue it has replaced, but the composition of the scar tissue, compared to the normal tissue, is different. Scars differ from other scars in the amount of collagen over expressed.

London Medical and Aesthetic Clinic is one of the leading clinics in Collagen Stimulation treatment in the UK and Europe. Dr Ayham Al-Ayoubi has invited and developed the advanced Collagen Stimulation technique to treat deep acne and traumatic scarring which has now been adopted by numerous plastic surgeons and cosmetic doctors worldwide.

Facial scarring

There are two broad classifications of facial scarring: atrophic and hypertrophic. We expand upon the classification by dividing atrophic facial scarring into four main types: ice pick, boxcar, shallow/atrophic, and valley/rolling scars.

Ice pick scars are typically small (1-2 mm) and have a wide aperture with steep edges that taper to a single point at the base, as if the skin has been pierced by an ice pick. An epithelial tract forms along the sides of the opening within the scar. These scars may be shallow or deep, and may extend as far as the dermal-subcutaneous junction.

Boxcar scars are round to oval junctions. Boxcar scars are round to oval in shape with well-defined vertical edges and a flat base, as if the scar has been punched out of the skin. They typically range from 0.1 to 0.5 mm in depth and are usually widely spaced out on the skin surface, occurring as solitary scars. Unlike ice pick scars, this type of scar does not converge to a single point.

Shallow/atrophic scars present as a cluster of miniaturized boxcar scars. They usually emerge in groups of four or more and occur mainly on the cheeks.

Valley scars (“rolling” scars) are deeper and have an undulating appearance that is best appreciated in indirect lighting. Valley-shaped scars arise from a variable loss of dermis and/or subcutaneous tissue. Because acne and varicella scars are dermal defects, they require a treatment modality that reaches the dermis in order to achieve clinical improvement.

Treatment options:

Collagen Stimulation

Collagen Stimulation is Poly-L-lactic acid which belongs to the alpha hydroxyl acid family. Collagen Stimulation is composed of crystalline, irregular sizes of microparticles of poly-L-lactic acid that are 40 - 60 um in diameter. Collagen Stimulation is packaged as a sterile freeze-dried preparation that is reconstituted with sterile water 48 hours before injection. After injection of the poly-L-lactic acid, a foreign body reaction occurs over several weeks to months, presenting itself as a volumetric expansion. It is important to note that there is no visual endpoint at the time of injection, and a waiting period of at least 4 to 6 weeks after initial product placement is recommended before subsequent injections.

Collagen Stimulation with Subcision

Subcutaneous incision following Collagen Stimulation injection is the treatment of depressed scars.  After outlining, anaesthetising, and sterilizing the affected areas, a 22-gauge needle or a tribeveled 18-gauge hypodermic needle is inserted into the superficial fat with the bevel up just adjacent to the scarred area. The needle is turned so that the bevel is perpendicular to the skin surface, and the needle is moved back and forth in a fanning motion to break up the fibrous tissue that is depressing the scar. Audible rasping and popping is observed as the underside to the dermis is released from its subcutaneous attachment. Collagen Stimulation would be injected during subcision procedure which restores lost facial scar volume.  Following the procedure, patients can expect bruising for up to 1 week.

There is also the option of using traditional fillers, but in the arena of facial fillers and volumizers, Collagen Stimulation is one of a few stimulatory products as opposed to the traditional immediate fillers like collagen or hyaluronic acids. Collagen Stimulation does not take up space and create immediate results but rather causes the growth of fibrous tissue or collagen by the body, which then results in gradual volume restoration.

A clinical study by Dr Ayham Al-Ayoubi of more than 400 patients at our clinic has shown that the improvements obtained with Collagen Stimulation have lasted for up to 4 - 5 years. Treatment usually consists of 2 to 4 sessions lasting up to half an hour; usually four weeks apart with no 'downtime'.

Compared with having conventional line fillers every 6 months, Collagen Stimulation is very cost effective and your requirement for the product may diminish after the first course of treatment.

What are possible side effects of Collagen Stimulation ?

In capable hands, with the right training and experience, this is a very safe and effective procedure. Over time the technique has evolved to optimise the effects and reduce problems.

Immediate side effects may include injection-related events at the site of injection, such as minimum redness, slight tenderness or discomfort, some bruising and rarely swelling.

All of these side effects usually last only for a day or two.

A delayed appearance of small bumps under the skin in the treated area could rarely occur. Generally these bumps are not visible and may only be noticed when pressing on the treated area.

This rare side effect is usually an effect of the product being injected too superficially causing a lump of product or collagen to form, but vigorous massage usually prevents this.

Collagen Stimulation Clinical Safety

The safety of injectable Collagen Stimulation in humans has been assessed in patients in investigator-initiated clinical studies.

Collagen Stimulation has been found to be well tolerated with no serious adverse events reported.

The most common device-related adverse event was the delayed development of palpable, non-visible subcutaneous papules (very rare) that occurred at the site of injection.

Post Collagen Stimulation treatment information

To ensure the success of the gradual, long lasting effect of Collagen Stimulation , it is important that patients comply with the aftercare instructions provided.

Over the following days after a treatment session the patient should massage the treated area twice a day (morning and night) up to 5 minutes using an appropriate cream, such as aloe vera gel, to reduce friction. Within the first 24 hours of the treatment an ice pack wrapped in a cloth can be applied for a few minutes at a time to the treated area to help reduce any swelling. If there are no problems after the treatment, then the patients may apply makeup a few minutes afterwards, if they want. Also excessive sun exposure or exposure to a UV lamp must be avoided for up to three days after. 

In summary

Collagen Stimulation is designed to go one step further and close the gap between surgical and non-surgical cosmetic procedures. As it lifts sagging skin by restoring volume, it is the answer for men and women seeking an alternative to more invasive treatments such as plastic surgery.

We pride ourselves in being the leading clinic in Collagen Stimulation treatment in the UK and Europe. Dr Ayham Al-Ayoubi is a leading Collagen Stimulation Training Surgeon and he is an internationally recognized expert in the procedure with more than 5000 cases of Collagen Stimulation treatments performed at our clinic.

Dr Ayham Al-Ayoubi has invented and developed his own advanced Collagen Stimulation techniques including Collagen Stimulation for treating facial asymmetry, deep acne scars, traumatic scarring, Double V and Tear Duct technique which has now been adopted by numerous plastic surgeons and cosmetic doctors worldwide.

Patients travel from all over the UK and from around the world to have Dr Ayham Al-Ayoubi perform Collagen Stimulation treatment at the London Medical and Aesthetic Clinic, which is one of the leading training centres for Collagen Stimulation treatment in the UK and Europe.