Polynucleotides vs bio-remodelling

Bio-remodelling uses a very high concentration of hyaluronic acid that is stabilised without heavy cross-linking, so instead of staying where it is placed it disperses through the tissue over the following days. The effect is hydration and firmness across a whole area, plus a stimulatory effect on collagen and elastin production.

Polynucleotides are chains of nucleotides — purified DNA fragments, usually from salmon or trout — that act as a scaffold holding water in the tissue and appear to signal to fibroblasts, prompting them to behave more like younger, more active cells. There is no hyaluronic acid involved.

That difference has a practical consequence. Bio-remodelling gives you something that is measurably present in the skin from the day it is injected. Polynucleotides give you a change in how your own tissue behaves, which is slower to appear and, in my experience, holds differently.

Bio-remodelling tends to be the stronger choice where skin has lost firmness and bounce — the lower face, the jawline, the neck — and where someone wants a visible lift in skin quality within a few weeks. It suits skin that is dehydrated and slack more than skin that is thin and fragile.

Polynucleotides tend to be the stronger choice for thin, delicate or damaged skin: under the eyes, around a scarred area, skin that is reactive or has been over-treated. The under-eye is where the difference is clearest, because that skin is too thin to take a spreading hyaluronic acid product comfortably.

Where someone has both problems — and plenty do — they can be sequenced, and I would generally start with whichever addresses the thing that bothers you most.

Bio-remodelling is usually two sessions four weeks apart, with maintenance at around six months. Polynucleotides are usually a course of three sessions at two to three week intervals, then maintenance at six to nine months.

Both are given as a series of small injections at fixed points rather than as a general mesh across the face, and both take roughly twenty minutes. Bio-remodelling characteristically leaves visible raised blebs at each injection point which settle within a few hours to a day; polynucleotides leave smaller marks that settle faster.

Bio-remodelling shows itself at around four to six weeks. Polynucleotides build more slowly and are usually judged at eight to twelve weeks after the final session, which is a genuinely different amount of patience to ask for.

Polynucleotides are derived from fish DNA. The proteins that cause allergic reactions are removed during purification, so a fish allergy is not an automatic barrier, but it must be declared and assessed. They are not suitable if you avoid animal-derived products on ethical or religious grounds, and there is no equivalent that works the same way.

Neither is appropriate during pregnancy or breastfeeding, or over active skin infection or inflammation in the treatment area. Neither will change the shape of your face, so if what bothers you is volume loss or a heavy jowl, the honest answer is that you are looking at the wrong category.

Both require a practitioner who will assess your skin rather than sell you the one they have in the fridge. The Aesthetic Complications Expert Group and BAMAN both maintain guidance on assessment and consent that a good clinic will be working to.

Per course the two are broadly comparable, with the exact figures on the treatment pages. Deciding between them on price alone is the wrong axis, because they are not doing the same job.

The question I ask at consultation is what your skin is short of. If it is water and firmness across a broad area, bio-remodelling. If it is resilience in thin or damaged skin, polynucleotides. If you cannot tell from the mirror, that is what the £30 consultation is for — and it comes off the treatment if you go ahead.