AestheFill
AestheFill®
Collagen Regeneration Filler
AestheFill® is a collagen-stimulating injectable formulated with PDLLA (poly-D,L-lactic acid) as its active ingredient.
Unlike hyaluronic acid fillers, which add volume immediately, AestheFill® is designed to stimulate your own collagen production within the skin over a period of months. For this reason it is also referred to as a collagen booster or a biostimulator (biostimulatory filler). Because the change develops gradually, it is an option worth considering for wrinkles, skin laxity and loss of firmness when a sudden change in facial shape is not desired.
At AFRODE CLINIC in Omotesando, Tokyo, treatment is performed by Dr. Shotaro Michishita, Director of the clinic and a certified AestheFill training physician, who assesses suitability and plans the injection sites and volume during consultation. AFRODE CLINIC operates on a referral basis, but AestheFill® treatment may be booked without a referral.
* Results and their duration vary between individuals. No specific outcome is guaranteed.
Concerns
Who May Wish to Consider AestheFill
- You have begun to notice hollowing or shadowing around the cheeks, such as nasolabial folds or tear-trough (mid-cheek) lines
- You feel a loss of firmness and elasticity in the skin, but wish to avoid treatments that noticeably change your facial shape
- You are uncomfortable with repeated hyaluronic acid injections, or concerned about an unnatural result
- You would prefer a gradual change over time rather than a sudden difference
- You want to address age-related changes early, in a way that is unlikely to be noticed by others
- You would like to address overall skin texture and laxity together, not only individual lines
* Suitability is determined by the physician at consultation. This treatment is not appropriate for everyone.
What is AestheFill
What Is AestheFill®?
AestheFill® is an injectable product whose active ingredient is microspheres of PDLLA (poly-D,L-lactic acid). PDLLA is a lactic-acid-derived polymer that has long been used in absorbable surgical sutures, and it is broken down and absorbed by the body into water and carbon dioxide over time.
Whereas hyaluronic acid creates contour with the injected material itself, AestheFill® is designed so that your own collagen is produced at the treated site. This is why it is classified as a collagen booster or biostimulator. The change develops gradually over several months, while the product itself is progressively broken down and absorbed.
Rather than adding significant volume, it is more often chosen with the aim of restoring firmness and elasticity from within the skin, and of softening the heaviness and shadowing along the facial contour — that is, a change accompanied by a difference in skin quality.
Important Notice: Treatment Using a Medication Not Approved in Japan
Treatment with AestheFill® is elective (self-pay) care using a medication that has not received approval under Japan’s Pharmaceuticals and Medical Devices Act. In accordance with the Japanese medical advertising guidelines, we provide the following information.
- Unapproved status: This product has not been approved as a medication in Japan.
- Route of acquisition: The product is imported under the physician’s responsibility, following the procedures required by Japanese law.
- Availability of approved equivalents in Japan: No medication with the same ingredient and the same indication has been approved in Japan. (For the treatment of wrinkles and facial contour, other approved medical devices such as hyaluronic acid fillers do exist in Japan.)
- Safety information from other countries: The product is approved and in clinical use in a number of countries and regions, including South Korea and Taiwan. The adverse events listed under “Possible Side Effects and Risks” below have been reported.
* This treatment is elective care and is not covered by Japanese public health insurance. The full cost is borne by the patient.
* Before treatment with an unapproved medication, the physician provides an individual explanation and treatment proceeds only with your consent.
Mechanism
How It Works
AestheFill® is reconstituted with sterile water for injection and then injected into the deep dermis and subcutaneous layer. Once injected, the PDLLA microspheres are reported to stimulate the surrounding fibroblasts, prompting them to produce collagen. This process advances in stages over several months, while the product itself is gradually broken down and absorbed.
STEP 01
Injection
Reconstituted PDLLA microspheres are injected into the deep dermis and subcutaneous layer according to your areas of concern. A temporary fullness from the diluent may be visible immediately afterwards; this settles within a few days.
STEP 02
Fibroblast Stimulation
The PDLLA microspheres act on the surrounding tissue, and collagen production by fibroblasts is reported to be stimulated. The change appears through this process rather than immediately after injection.
STEP 03
Gradual Change and Absorption
The change generally becomes apparent over three to six months, and the product itself is broken down into water and carbon dioxide and absorbed. Nothing remains permanently in the tissue, unlike non-absorbable fillers.
Comparison
AestheFill® Compared with Hyaluronic Acid Fillers
Both AestheFill® and hyaluronic acid address wrinkles and hollowing through injection, but their purpose and the way the change appears are different. Neither is superior to the other; they are chosen according to the goal, and are sometimes combined within one treatment plan.
| AestheFill® (PDLLA) | Hyaluronic acid filler | |
|---|---|---|
| Primary aim | Stimulates your own collagen production to restore firmness and skin quality | Adds volume and creates contour with the injected material itself |
| How the change appears | Gradually, over several months | Visible immediately after injection |
| Character of the result | Subtle; unlikely to be noticed by others | A clearer change in facial shape |
| What happens to the product | Broken down into water and carbon dioxide and absorbed | Broken down and absorbed; can also be dissolved with an enzyme |
| Ease of adjustment | Cannot be dissolved or reversed once injected | May be adjusted or removed with hyaluronidase in some cases |
| Best suited to | Those prioritising a natural change and improved skin quality | Those who wish to clearly fill a hollow or reshape a contour |
* AestheFill® cannot be dissolved with an enzyme after injection. Please discuss the result you have in mind thoroughly at your consultation beforehand.
Timeline
How the Change Develops and How Long It Lasts
With AestheFill®, the result is not complete on the day of injection. Because the appearance changes with time, it is important to understand the expected course before treatment.
| Time after treatment | What is generally expected |
|---|---|
| Immediately to a few days | Fullness from the diluent may make the area look temporarily fuller. Swelling, redness or bruising may also occur. |
| 1 to 2 weeks | The diluent is absorbed and the initial fullness settles. During this period the change may feel minimal. |
| 1 to 2 months | Collagen production progresses, and many people begin to notice a change in firmness. |
| 3 to 6 months | The period in which the change is most apparent. Additional treatment is considered at this stage if required. |
| Thereafter | The reported duration is generally in the region of one to two years. This varies with lifestyle and the individual course of ageing. |
Depending on the extent of your concern and the area treated, treatment may not be completed in a single session; a plan of several sessions spaced a few months apart may be proposed. The number of sessions and the interval between them are determined individually at consultation.
Downtime & Aftercare
Downtime and Aftercare
Swelling, redness or bruising may occur at the injection sites. In most cases these resolve within a few days to about two weeks, though bruising varies considerably between individuals and may need to be covered with make-up for a period.
| Washing your face / showering | Permitted from the same day |
| Make-up | Permitted from the same day (please avoid rubbing the treated areas) |
| Bathing, sauna, strenuous exercise, alcohol | Please avoid activities that increase circulation on the day of treatment, as they may worsen swelling and bruising |
| Facial massage and sleeping face-down | Please avoid strong pressure on the treated areas for a period after treatment |
| Combining with other treatments | If you are considering laser, radiofrequency or HIFU treatments, please discuss the timing with us in advance |
Benefits & Limitations
Benefits and Limitations of AestheFill®
We believe it is important that you understand not only what can be expected, but also the situations in which this treatment is not the right choice, and the points that require care.
What can be expected
- Designed to stimulate your own collagen, producing a gradual change
- The product is broken down and absorbed, leaving nothing permanently in the tissue
- Little immediate visible change, so it is unlikely to be noticed by others
- Addresses skin firmness and texture as well as hollowing
- Each session is relatively short, with limited disruption to daily life
Points requiring care
- There is no immediate effect; several months are needed before the change is noticeable
- Unlike hyaluronic acid, it cannot be dissolved and reversed with an enzyme after injection
- Not suited to substantial volume augmentation or a distinct change in facial shape
- Side effects such as swelling, bruising and nodules may occur
- It is elective care using a medication not approved in Japan, and the full cost is borne by the patient
- Depending on the extent of your concern, several sessions may be required
Flow
The Treatment Process
| 01 Booking | Please book online or through our contact form. AestheFill® treatment may be booked without a referral. |
| 02 Consultation and examination | We listen to your concerns and goals, and the physician examines the condition of your skin and facial contour. We explain whether the treatment is appropriate, how it compares with other options, the risks involved and the cost, and proceed only once you are satisfied. |
| 03 Preparation | Make-up is removed and the injection sites are confirmed and marked. Anaesthesia is discussed according to your wishes and the area to be treated. |
| 04 Injection | AestheFill® is injected according to the plan. The injection itself usually takes approximately 20 to 30 minutes, depending on the area and extent of treatment. |
| 05 After treatment | We check the treated areas and explain how to spend the rest of the day and what to be aware of. You may apply make-up and return home directly. |
| 06 Follow-up | The change develops over several months. Please contact us if any symptom concerns you, or if you wish to discuss additional treatment. |
Contraindications
Who Should Not Receive This Treatment
If any of the following applies to you, treatment may not be possible, or particularly careful assessment may be required. Please tell us at your consultation if you think any of these may apply.
- You are pregnant, breastfeeding, or may be pregnant
- There is infection, inflammation or a skin condition at the intended injection site
- You have a tendency to keloid formation, or have previously developed nodules or granulomas after an injectable treatment
- You have an autoimmune or connective tissue disease
- You have a history of allergy to any component of this product
- You are taking anticoagulant or antiplatelet medication (bruising may be more pronounced)
- A non-absorbable (permanent) filler has previously been injected into the intended treatment area
- You have impaired wound healing, for example due to diabetes, or a serious systemic illness
- You are a minor (consent from a guardian is required)
* Even if none of the above applies, we may advise against treatment based on the findings at examination.
Side Effects & Risks
Possible Side Effects and Risks
The following side effects and risks have been reported in association with this injectable. The physician explains them in detail before treatment.
- Swelling, redness, bruising or an unusual sensation at the injection sites (usually resolving within a few days to about two weeks)
- Pain, tenderness or itching
- Nodules or lumps (rare; overseas data report 6 cases among 16,000 treatments, approximately 0.04%)
- Asymmetry, surface irregularity or granuloma
- Infection (a general risk associated with injection procedures)
- Allergic reaction
- Very rarely, skin injury or visual disturbance associated with vascular occlusion
If you experience severe pain, a change in skin colour, visual disturbance or any other symptom that differs from the expected course, please contact the clinic without delay.
* The above lists the principal risks and is not exhaustive. Full details are explained by the physician at consultation.
Pricing
Fees (tax included)
| Treatment area | Fee (tax included) |
|---|---|
| Nasolabial folds | JPY 110,000 |
| Tear-trough / mid-cheek lines | JPY 79,200 |
| Eye area | JPY 78,100 |
* This is elective care and is not covered by Japanese public health insurance; the full cost is borne by the patient.
* Detailed pricing is confirmed at your consultation.
Our Approach
AestheFill® at AFRODE CLINIC
Treated by a certified training physician
Dr. Shotaro Michishita, Director of the clinic, is a certified AestheFill training physician and also instructs physicians at other clinics. He plans each treatment around the characteristics of the product.
A preventive medicine perspective
AFRODE CLINIC is built around preventive medicine. Rather than treating injection as an end in itself, we consider your lifestyle, nutrition and skin condition, beginning with whether the treatment is necessary at all.
Omotesando, by appointment only
Treatment takes place in a private setting within walking distance of Omotesando Station, by appointment only. The clinic operates on a referral basis, but AestheFill® may be booked without a referral.
Planning your visit
If You Are Travelling to Tokyo for This Treatment
One point matters more here than with most aesthetic treatments: the result develops over months, not days. You will leave Japan before you see it. That is normal for this product, and it changes how the trip should be planned.
| Before you travel | Send us the enquiry form below with your goals, medical history and current medication. We will tell you whether the treatment is likely to be appropriate, and what it would cost, before you book flights. |
| Consultation | Examination and discussion with the physician: whether AestheFill® suits your concern, how it compares with hyaluronic acid, the risks, and the fact that this is elective care using a medication not approved in Japan. Consent is taken before anything proceeds. |
| Treatment | The injection itself usually takes about 20 to 30 minutes. You may apply make-up and return to your day. No hospital stay, no second visit required for the treatment itself. |
| The days after | Swelling, redness or bruising may appear and usually settles within a few days to two weeks. Plan the treatment early in your trip rather than the day before an important occasion, and avoid bathing, sauna, alcohol and strenuous exercise on the day. |
| Flying home | There is no requirement to remain in Japan. We do ask that you allow a margin rather than flying within hours of the injection. |
| Months afterwards | The change appears gradually, most visibly between three and six months. You may write to us by email at any point in that period; we will advise, and if further treatment is worth considering, plan it around your next visit to Japan. |
| Language | Consultation and consent are conducted in English. Please tell us in advance if you would prefer another language so that we can arrange interpretation. |
Because the product cannot be dissolved once injected, we would rather decline a case than treat someone whose expectations do not match what this product does. If what you are looking for is an immediate, visible change in facial shape during your stay, hyaluronic acid is the more honest answer, and we will say so.
FAQ
Frequently Asked Questions About AestheFill®
Q1. What kind of treatment is AestheFill?
It is an injectable treatment in which a product containing microspheres of PDLLA (poly-D,L-lactic acid) is injected into the deep dermis and subcutaneous layer with the aim of stimulating your own collagen production. Rather than adding volume with the material itself, as hyaluronic acid does, it aims to restore firmness and elasticity from within the skin over several months. It is also known as a collagen booster or a biostimulator.
Q2. How does it differ from hyaluronic acid injection?
Hyaluronic acid adds volume with the injected material itself, so the change in shape is visible immediately. AestheFill, by contrast, aims for your own collagen to be produced at the treated site, so the change develops gradually over several months. The result is subtle and unlikely to be noticed by others, but it is not suited to a distinct change in facial shape. It also cannot be dissolved and reversed with an enzyme, as hyaluronic acid can.
Q3. When will I see a result, and how long does it last?
Most people begin to notice a change one to two months after injection, with the change generally most apparent between three and six months. The reported duration is in the region of one to two years. The degree of change and its duration vary between individuals, and no specific result is guaranteed. Immediately after treatment, a temporary fullness from the diluent may be visible; this settles within one to two weeks.
Q4. How much downtime should I expect?
Swelling, redness or bruising may occur at the injection sites, usually resolving within a few days to about two weeks. Washing your face, showering and wearing make-up are permitted from the same day, but please avoid bathing, sauna, strenuous exercise and alcohol on the day of treatment. Because bruising varies between individuals, we recommend avoiding appointments immediately before an important occasion.
Q5. Is the treatment painful? Is anaesthesia used?
Sensitivity to the injection varies between individuals. If you are concerned about discomfort, or depending on the area treated, anaesthesia can be discussed; please raise this at your consultation. Some pain or tenderness may remain after treatment, but this usually settles within a few days. Please contact the clinic if severe pain persists.
Q6. What side effects and risks are involved?
Reported effects include swelling, redness, bruising, pain and itching, as well as nodules or lumps, asymmetry, surface irregularity, granuloma, infection and allergic reaction. Nodules are rare: overseas data report 6 cases among 16,000 treatments, approximately 0.04%. Very rarely, skin injury or visual disturbance associated with vascular occlusion may occur. The physician explains these risks in detail before treatment.
Q7. How many sessions will I need?
This depends on the extent of your concern, the area treated and the degree of change you are hoping for. In some cases a single session is followed by observation; in others, a plan of several sessions spaced a few months apart is proposed. Because the change takes time to appear, the need for further treatment is judged while following your progress. The number of sessions and the interval are advised individually at consultation.
Q8. How much does it cost? Is it covered by insurance?
Our guide prices are JPY 110,000 for the nasolabial folds, JPY 79,200 for the tear-trough area and JPY 78,100 for the eye area (tax included, per area, per session). Fees may vary according to the findings at examination and the volume injected. This treatment is elective care and is not covered by Japanese public health insurance, so the full cost is borne by the patient. Details are confirmed at your consultation.
Q9. Is this product approved in Japan?
AestheFill® has not been approved as a medication under Japan’s Pharmaceuticals and Medical Devices Act. We use product imported under the physician’s responsibility, following the procedures required by Japanese law. Overseas, it is approved and in clinical use in a number of countries and regions, including South Korea and Taiwan. The physician explains this — including that the treatment uses a medication not approved in Japan — before treatment, which proceeds only with your consent.
Q10. Can I book without a referral?
AFRODE CLINIC operates on a referral basis, but AestheFill® treatment may be booked without a referral. If you are visiting us for the first time, please book online or through our contact form. An examination and consultation with the physician always take place before treatment, and suitability is confirmed before proceeding.
The physician responsible
Who You Will Be Seeing
Medical Director
Dr. Shotaro Michishita
Consultation, the injection plan and the treatment itself are handled by Dr. Michishita personally. He is a certified AestheFill® training physician and instructs physicians at other clinics in its use. If we think the treatment is not appropriate for you, he will tell you so directly, and explain why.
| 2015 | Graduated from The Jikei University School of Medicine |
| 2017 | Joined Jikei University Hospital, Department of Neurosurgery |
| 2019 | Founded Re.habilitation Co., Ltd. |
| 2021 | Left Jikei University Hospital |
| 2021 | Medical Director, AFRODE CLINIC |
| Certified AestheFill® training physician |
Drawing on extensive experience as a neurosurgeon in end-of-life and palliative care, Dr. Michishita established AFRODE CLINIC with the philosophy of maximising the value of living. That background is the reason this clinic is careful about what it claims: he has spent his career close to patients for whom an unfounded promise would have cost something real.
The clinical content of this page has been reviewed by Dr. Michishita. Full team profiles →
Evidence
References
- Hyun MY, Lee Y, No YA, Yoo KH, Kim MN, Hong CK, et al. Efficacy and safety of injection with poly-L-lactic acid compared with hyaluronic acid for correction of nasolabial fold: a randomized, evaluator-blinded, comparative study. Clin Exp Dermatol 2015 Mar;40(2):129-135.
- Qiao J, Jia QN, Jin HZ, Li F, He CX, Yang J, et al. Long-Term Follow-Up of Longevity and Diffusion Pattern of Hyaluronic Acid in Nasolabial Fold Correction through High-Frequency Ultrasound. Plast Reconstr Surg 2019 Aug;144(2):189e-196e.
- Lin CY, Lin JY, Yang DY, Lee SH, Kim JY, Kang M. Efficacy and safety of poly-D,L-lactic acid microspheres as subdermal fillers in animals. Plast Aesthet Res 2019;6:16.
This page has been medically reviewed by Dr. Shotaro Michishita, Director of AFRODE CLINIC.
Booking Inquiry
Ask us before you travel
Tell us roughly when you will be in Tokyo, what you would like to address, and any medical history or current medication we should know about. A short message is enough — we reply in English by email, with an indication of suitability and cost, before you commit to travel dates.
AestheFill® may be booked without a referral. An examination and consultation with the physician always precede treatment.
You can also reach us at procurement@mwp.work or +81-3-5843-0130.
AFRODE CLINIC — BASE Jingumae B1F, 3-5-7 Jingumae, Shibuya-ku, Tokyo 150-0001, Japan (5 minutes from Omotesando Station, Exit A2)
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