Profhilo: the NAHYCO Bioremodeller from IBSA Pharma
What is Profhilo?
Profhilo is an injectable skin remodelling product developed and manufactured by IBSA Pharma in Switzerland. It received CE Class III certification as a medical device and is indicated for the improvement of skin laxity and overall skin quality in adults. Unlike conventional hyaluronic acid (HA) fillers, Profhilo does not add structural volume at a fixed anatomical location. Instead it functions as a bioremodeller: a product that triggers the body's own regenerative processes to produce new collagen, elastin, hyaluronic acid and to revitalise adipocytes in the dermis and hypodermis.
Profhilo contains 64 mg of ultra-pure hyaluronic acid in 2 ml (32 mg/ml), making it one of the highest-concentration injectable HA products available. It combines two molecular weight fractions: high-molecular-weight HA (H-HA, approximately 1100 kDa) and low-molecular-weight HA (L-HA, approximately 200 kDa). This dual-fraction approach is central to its mechanism of action.
NAHYCO Technology: Cross-linking Without Chemistry
The decisive innovation in Profhilo is the NAHYCO (NAive HYaluronic acid COmplex) technology. Most HA products on the market use chemical cross-linkers such as BDDE (1,4-butanediol diglycidyl ether) to create a durable gel network. BDDE residues remain in the tissue and raise questions about biocompatibility in sensitive patients.
NAHYCO uses a purely thermal process: H-HA and L-HA are combined under controlled temperature and pH conditions, forming a stable hybrid cooperative complex without any chemical cross-linking agent. The result is a product that is entirely free of BDDE and other synthetic cross-linkers while still exhibiting greater stability than uncross-linked HA, which degrades within one to two days. The thermal hybrid complex degrades gradually over six to nine months, releasing HA fragments that continue to stimulate fibroblasts throughout the resorption period.
Bioremodelling vs. Filling: a Fundamental Difference
Many patients and even some practitioners conflate Profhilo with dermal fillers. The distinction is clinically important. Fillers are placed with precision at a target site to restore or create volume, define contours and correct deep folds. The goal is a structural, localised result.
Profhilo works differently. Its high viscosity and spreadability mean it disperses approximately 2 cm radially from each injection point, integrating into the tissue rather than remaining as a discrete bolus. It does not lift, project or volumise in the conventional filler sense. Instead it creates a sustained bio-stimulation environment: H-HA provides a scaffold that retains water and interacts with cell-surface receptors (CD44, RHAMM), while L-HA fragments act as signalling molecules that upregulate fibroblast activity. Controlled clinical studies have demonstrated statistically significant increases in collagen types I and III, elastin fibres and adipocyte differentiation after two treatment sessions.
This means Profhilo addresses skin quality, hydration, firmness and fine surface texture rather than volume loss or deep anatomical contour. For patients with moderate skin laxity who are not yet candidates for surgical lifting, it occupies a unique position in the treatment ladder.
The BAP Injection Technique
The standard injection method for Profhilo on the face is the Bio Aesthetic Points (BAP) technique, first described by De Maio, Swift, Signorini and Fagien in 2017. The technique defines five injection points per half-face, selected anatomically to avoid superficial vessels, to achieve maximum HA diffusion and to minimise patient discomfort. Treatment of the full face therefore requires only ten injections, a significant reduction compared to the 30 or more microinjection points used in classical mesotherapy protocols.
Each of the five BAP points on the half-face is injected with a precise volume of Profhilo using a sharp 25 G or 27 G needle. Injection depth is mid-to-deep dermis. The BAP landmarks are defined by anatomical triangles that account for the location of the facial artery, angular artery, zygomaticofacial artery and other vessels. Adherence to the BAP technique reduces but does not eliminate the risk of intravascular injection, and practitioners must be trained in vascular complication recognition and management.
Treatment Protocol and Duration of Effect
The initial treatment course for Profhilo on the face consists of two sessions administered four weeks apart. In the first session the baseline biostimulation begins. The second session, timed to coincide with the early phase of HA degradation and peak fibroblast activity, reinforces and extends the biological response. Patients typically notice improvement in skin hydration and texture within two to four weeks of the first session, with the full remodelling effect visible six to eight weeks after the second session.
Histological studies confirm increased collagen density and improved dermal architecture persisting for six to nine months. After the initial course, a maintenance booster session every six months is recommended to sustain the effect. Annual re-evaluation is advisable to adjust the protocol to changing skin conditions and age-related changes.
Profhilo Body: Extending the Technology
IBSA has extended the NAHYCO platform to body applications with Profhilo Body. The product uses the same dual-fraction thermally cross-linked HA technology and is indicated for skin laxity on the neck, décolleté, hands, inner arms and inner thighs areas where skin ageing and collagen loss are pronounced but surgical correction is often disproportionate to the degree of laxity.
The injection points, volumes and technique for body applications differ from the facial BAP protocol. Practitioners require specific training for Profhilo Body. Clinical evidence for body applications is growing, with published case series and pilot studies demonstrating improvements in skin laxity scores, patient satisfaction and objective elasticity measurements.
Risks, Contraindications and Safety Profile
Profhilo has a favourable safety profile in published literature, consistent with its BDDE-free formulation. Common adverse events include injection-site redness, swelling and bruising, all of which typically resolve within 24 to 72 hours. Nodule formation is rare when the BAP technique and correct injection depth are observed.
Contraindications include known hypersensitivity to hyaluronic acid, active skin infections, inflammatory skin conditions at the injection site, autoimmune disease, pregnancy and breastfeeding. As with any HA product, inadvertent intravascular injection is the most serious potential complication. All practitioners must have hyaluronidase available and be trained in its use. Because Profhilo is HA-based it is fully reversible with hyaluronidase, which dissolves the HA complex enzymatically.
Costs and Where to Receive Treatment
Profhilo is not available for self-injection or over-the-counter purchase. It is a prescription medical device dispensed exclusively to licensed medical practitioners. In Germany, Austria and Switzerland treatment is offered by plastic surgeons, dermatologists and aesthetically trained general practitioners. A full two-session facial course typically costs between €600 and €1,200 depending on the region and practice profile. Subsequent booster sessions are priced individually.
Patients should verify that the treating physician holds specific training in injectable aesthetics and in the BAP technique. Purchasing Profhilo from unverified online sources carries serious health risks and is illegal in most EU jurisdictions.
Frequently Asked Questions
Sources and Further Reading
- De Maio M et al. (2017). Facial Assessment and Injection Guide for Botulinum Toxin and Injectable Hyaluronic Acid Fillers. Plast Reconstr Surg.
- Prasetyo AD et al. (2016). Hyaluronic acid fillers with cohesive polydensified matrix for soft-tissue augmentation and rejuvenation. Clin Cosmet Investig Dermatol.
- Callan P et al. (2016). Efficacy and safety of a hyaluronic acid filler in subjects treated for correction of midface volume deficiency. J Cosmet Laser Ther.
- IBSA Pharma. Profhilo Instructions for Use and CE Technical Documentation. 2022.
- Bertucci V, Solish N (2019). Evaluation of the NAHYCO Hybrid Cooperative Complex in Bioremodelling. J Drugs Dermatol.