An Under-the-Radar Injectable, Renuva Is Gaining Momentum—with Before and Afters

“As a surgeon who operates on the face all the time, I’m tired of seeing fillers in there, causing scarring and other problems,” says Gabriele C. Miotto, MD, a clinical associate professor of plastic surgery at Emory University School of Medicine. She considers fat transfer “the gold standard for volumization,” but sees Renuva as the next best thing, since it eventually dissolves and is replaced by the patient’s own fat. (Fat transfer, aka fat grafting, is a surgical procedure that involves removing excess fat via liposuction—commonly from the abdomen or thighs—and reinjecting it into areas lacking volume and contour.)

In Dr. Miotto’s Atlanta practice, she’s seeing more young people transitioning from filler to facial fat grafting and Renuva. “I like offering fat transfer first—we can do it awake, under local anesthesia—and then for maintenance, we’ll do Renuva,” says Dr. Miotto, who is a consultant and trainer for the brand. Renuva works best where fat already exists, so blanketing depleted areas with a light layer of fat is sometimes a prerequisite for Renuva. Of course, there are patients who lack the constitution and downtime for surgery, and assuming they have at least a modicum of fat in the areas they’re targeting, they may choose to have Renuva instead of fat grafting to avoid the associated compression garments, discomfort, and aftercare.

What exactly is Renuva?

Renuva isn’t an exact dupe for fat. In fact, the treatment doesn’t contain any live fat cells. “We remove the cell components, because mature cells from one individual, when implanted into another, could cause an immune reaction,” explains Evi Chnari, PhD, senior director in research and development at MTF Biologics. Instead of fat cells, Renuva comprises an adipose-derived extracellular matrix—meaning: all of the materials surrounding and supporting human fat cells, including collagen, natural hyaluronic acid, and proteins. “These components are easily recognized by the recipient’s body, so their own fat cells can go into the scaffolding that Renuva provides, attach to it, revascularize it [by establishing a blood supply], and slowly turn it over into fat—the patient’s own fat,” says Chnari.

To be clear, Renuva is made from donated human tissue, which is a fact that could easily be sensationalized or fear-mongered—until we pause to recognize that donor tissue has long been used in medicine. (I’m a registered organ donor and you may be too.) MTF Biologics works with organ procurement organizations and processes tissue grafts—bone, ligament, cartilage, tendon, skin—for various medical indications, including orthopedic surgery, wound care, and plastic and reconstructive surgery (think: cartilage grafts for rhinoplasty and acellular dermal matrices, or ADMs, to reinforce breast surgery). Complying with standards set by both the Food & Drug Administration (FDA) and the American Association of Tissue Banks (AATB), MTF screens, cleans, and processes each donation without the use of radiation to maintain its integrity.

Regarding Renuva specifically, Chnari adds, “We’ve done the biocompatibility testing, we’ve removed any possible contaminants, and every lot that’s released is tested for sterility.”

Aiming to verify the company’s claims with an objective source, I reached out to Saranya P. Wyles, MD, PhD, a board-certified dermatologist and regenerative medicine researcher at the Mayo Clinic Center for Aesthetic Medicine and Surgery. Dr. Wyles uses Renuva in practice and has published research on adipose allograft matrix, but does not consult for MTF Biologics or receive funding for studies. Adipose allograft matrix is an unbranded way of referring to donated human fat matrix—the tissue to Renuva’s Kleenex, if you will. When it comes to injectable versions of this material (the kind without living cells ) in general, she confirms that they’re “aseptically processed” (meaning, in a sterile way) “without terminal irradiation” (which could degrade their quality) and derived from “donated deceased human adipose tissue, which is recovered and screened in accordance with AATB and FDA regulations and guidelines.” These types of products also need to meet certain international standards and be tested for sterility, biocompatibility, and endotoxins (substances found in the cell membranes of infection-causing bacteria).