Use of Enzyme Preparations: Best Practices

The use of enzymes in the field of aesthetic medicine, dermatology and plastic surgery is a revolutionary approach in the treatment of any type of fibrosis, including post-traumatic and post-surgical fibrosis; atrophic, hypertrophic and keloid scars; rough neurotic scars; post-burn scars, scars after skin transplantation; fibrosis after liposuction and surgical interventions; fibrous cellulitis; post-acne scars, etc.

In the article estet-portal.com you can get acquainted in detail with the advanced data on the tactics of creating preparations containing enzymes (collagenase, lipase, lyase), the benefits of their use, features of application and administration technique from plastic surgeon, professor of plastic , Reconstructive and Aesthetic Surgery, Consultant Surgeon of the University "Tor Vergata" in Rome, Stefano Verardi (Italy).

What does the use of enzyme preparations in aesthetic medicine mean

SV: We use three types of enzymes: collagenase, lyase and lipase. Thus, each of these enzymes breaks down fat and connective tissue. In products, these enzymes are found in this combination, but in different proportions between them. We can use the product to correct hypertrophic, keloid scars and areas with excess fat. Thus, you can use enzymes to work with fat in the abdominal and thigh area, neck.

Thanks to enzymes, we can inject combinations of enzymes to change the contour of the human body.

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What is the essence of the work of enzymes in human tissues

S.V.: Enzymes are designed to break down certain components of biological tissues: for collagenase it is collagen, for lipase — fat. But you should not use only one enzyme: you must use at least 3 enzymes in one injection procedure. Because they work together with each other to fix the defect. The process of creating these enzymes is very laborious, they are made biologically.

We use some bacteria, for example, Staphylococcus aureus, which contains these enzymes and uses them to penetrate human tissues and cause a pathological process. So if you take the gene responsible for the synthesis of the enzyme and transfer it to another bacterium, for example, Escherichia coli, it will begin to synthesize the same enzyme. To do this, you must have a large company with zero contamination and millions of dollars.

What is the future of enzyme preparations

SV: This is a new technique and no one knows how it will develop in the future, but it is really promising. Nowadays some doctors are starting to use enzymes and the results are very good.

So there will probably be an expansion of this technique in the future.

It is expected that there will be 3 products that will differ in the activity of enzyme components: high, medium, low. No one knows the real concentration of each of the enzymes of the drug, because it is a company secret.

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Enzyme preparations against plastic surgery

SW: There are many patients who do not want to undergo surgery. Most of them also come to a plastic surgeon, but they prefer not to have plastic surgery, so they ask the doctor for some alternative treatment.

Enzyme preparations — worthy alternative to plastic surgery.

This is a good alternative to plastic surgery, because, for example, to remove a double chin, the surgeon must perform an expensive major operation and make a facelift with the removal of excess tissue, and enzymes allow you to get a comparable result without invasive intervention.

Which contraindications to the use of enzymes should be emphasized

S.V.: The only contraindication is the lack of qualifications of the doctor and the fear of using enzymes. Because if you don't use the right proportion and technique, you may not get good results. But a surgeon who is afraid and very limited in performing some therapeutic manipulations can use low doses of enzyme preparations.

So far I have not had any allergic reactions, but I cannot rule out this undesirable phenomenon.

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Describe your tactics for working with enzyme preparations

SV: I only use enzymes for scar correction, excess skin correction and fat correction.

This is practically what we call "body profilometry"; (contouring) in plastic surgery. You can change the abdominal region in the supra- and sub-navel, some people have excess fat, especially in the sub-navel, which is between the navel and the suprapubic line. There, enzymes can be used in a higher concentration, injections should be done once a month. You will have to wait because 3-4 weeks after the injection is enough to get the full effect and decide if the next procedure is necessary.

To see a very good modification, you must complete 2-4 treatments.

You should make a fold of the leather and then go horizontally and vertically under the skin, and in the central part go down in three different layers. So you will have a 3D effect because you will see fat reduction and skin contraction. By the way, other popular non-invasive methods can only reduce fat, not excess skin.

Thank you for staying with estet-portal.com. Read other interesting articles in the "Cosmetology" section. You may be interested in Enzymatic peels – great alternative to acids

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Enzymes in aesthetic medicine

In our medical practice we use three types of enzymes: collagenase, lyase and lipase. Each of this enzymes change the aspect of fat and connective tissue inside the site of use. In addiction we can have these three enzymes combined in several different proportions among them.

We may use them to correct scares, keloids and local fat deposits. So we can use them to modify the aspect of the abdominal region, thighs and necks. Because of that we are able to inject these enzymes’ combinations to modify the contour of the human body.

How do enzymes work in human tissues

The contraindication consists only in the doctor`s inability and fear of using enzymes. Because if you do not use the right proportion and technique you may not reach a good result. But doctors who are afraid and very restrictive in performing some therapeutic manipulations can start using the low-dose enzyme preparations.

It is very difficult to produce these enzymes because they are made by biological engineering.
Producers use some bacteria, for example, the Staphylococcus aureus which contains one of this enzymes and is able to use it to enter human tissues causing a disease.

If you take the gene that is responsible for the synthesis of this enzyme and transpose it into another bacteria, for instance the Escherichia coli, this will start to produce the enzyme in large quantity. But to do this you should drive a big company at zero contamination. So there are lots of problems to solve and and millions dollars to invest.

What is the future of enzyme preparations

It is a new technic and nobody knows which will by the future of this technic, but it is really promising. Nowadays several doctors are starting to use it and the results are very promising. Maybe in the future there will be also an increase of the application of this new technique.

These enzymes at the moment come to the market it 3 different portions and combinations: high, medium, low. Nobody knows the real concentration of each of them in the drug which come in the aesthetic medicine market because it is still considered a secret of the producer.

Enzymes vs plastic surgery

There are many patients who do not want to undergo to surgical operations. These patients mainly ask their doctor to do on them alternative treatments. But most of them still comes to visit plastic surgeon also if they prefer not to perform any surgery. The use of enzymes is a good alternative to plastic surgery, because for example to remove the double chin surgeons should perform an expensive major operation and make a lifting to remove the excess tissue.

What are the contraindications to focus on

Any enzyme is dedicated to reduce the quantity of its proper target: for collagenase this target is the collagen, fore lipase is the fat, etc.

But we are not using only one of these enzymes. Any commercial combination is using at least 3 enzymes in each injection procedure. Because enzymes are cooperating during each procedure and each of them promotes the healing and gives its proper contribute to correct the defect.

Up to now I did not face any allergic reaction, but I cannot exclude any side effect.

Describe your working with enzyme preparations

At the moment these enzymes have been used only for scar correction, excess of skin correction and adipose tissue correction.
So it is still a bit more less to that we call "body prophilometry" (body contour) in the language of plastic surgery.

Using them we can divide the abdominal region in supra-umbilical and under-umbilical, some people have the access amount of fat especially in under-umbilical region, which is between the umbilicus and suprapubic area. There enzymes can be used and injected in the part of the abdomen which is our target and then wait for a month or two watch the result and make a second procedure.

In this way you should make the injections once a month until you do not reach your target. Between each procedure you have to wait, because after the injection, it well take 3-4 weeks to reach the full effect and make a decision about any next procedure.

To see a very good modification you should perform usually a maximum of 2-4 treatment sessions. Before any procedure the doctor must design over the skin area a sort of net which will be help him to make injection in the proper way and in the right place. Doctors have to remember that they should have in their mind will have a 3D image of the area they are going to inject. Because enzymes do not treat only fat excess but also the skin excess which will result in a contemporaneous contraction of the skin.