Aesthetic medicine · Bodywise Heidelberg
Dr Michael Pees assesses your skin, the treatment goal and the specific product. Research evidence, alternatives, risks and costs are discussed before a decision is made.
Medical assessment
Exosomes and other extracellular vesicles are being discussed in aesthetic medicine as possible carriers of biological signals. However, the term does not describe a single standardised treatment: the origin, manufacture, processing, composition and use of the available products can differ considerably.
At Bodywise, Dr Michael Pees therefore assesses more than the desired treatment goal. Before a decision is made, the skin and tissue, previous treatments, relevant medical information and the specific product and its documentation are also assessed. Only then can it be discussed whether exosome injections appear justifiable, which alternatives may be considered and where the limitations of the procedure lie.
Treatment at the first visit is not guaranteed. Consultation, examination, informed consent and a clearly reasoned treatment decision come first.
The basics
Exosomes are very small, membrane-bound particles released by cells. They belong to the larger group of extracellular vesicles. These vesicles can carry proteins, lipids and nucleic acids, among other substances, and can thereby participate in communication between cells.
In commercial settings, however, the term “exosomes” is often used more broadly than the scientific evidence clearly supports. A product name alone does not establish whether a preparation actually consists predominantly of defined exosomes. Information on the source, manufacture, purification, characterisation, accompanying substances, sterility, storage and intended use is therefore relevant to the medical assessment.
A preparation containing exosomes is therefore not automatically comparable to another product. Statements about the effects or safety of one preparation cannot readily be applied to all products.
Individual findings
In aesthetic applications, a possible improvement in skin quality is being discussed. Depending on the initial findings, aspects such as skin texture, hydration, elasticity or fine superficial lines may be relevant. Whether such an approach is appropriate for the particular concern must be assessed individually.
Exosome injections are not a procedure for targeted volume enhancement and do not replace hyaluronic acid filler treatment. They also do not specifically reduce the activity of selected muscles and therefore serve a different purpose from expression line treatment. Nor should it be assumed that every change in skin quality can be achieved with this procedure.
Evidence and limitations
In recent years, initial clinical studies on exosome- or vesicle-based applications have been published. They described short-term changes in various skin parameters, including hydration, elasticity, wrinkles, pores, pigmentation and overall skin appearance.
However, the strength of this evidence is limited. Many studies involve small groups, short follow-up periods and different products, source materials, concentrations and routes of application. Much of the data concerns topical use or combinations with microneedling or fractional laser procedures. These results cannot automatically be applied to direct injections.
There are therefore no generally applicable standards for exosome injections regarding the product, amount, number of sessions, intervals or duration of effect. A firm promise of success or lasting results would not be medically appropriate. Treatment should only be considered after a transparent assessment of the available evidence and product-specific information.
Product-specific assessment
The label “exosomes” alone does not establish what a preparation actually contains. The following points are particularly relevant to an informed decision:
If the origin, composition, sterility or permitted use cannot be adequately verified, injections should not be performed. The medical assessment therefore concerns both the patient and the product being used.
Alternatives
Hyaluronic acid fillers are used to compensate for volume changes or support contours. Botulinum toxin temporarily reduces the activity of selected muscles. Polynucleotides are discussed as a distinct group of substances for treating skin quality. Exosomes and extracellular vesicles follow a different biological concept and are not interchangeable with these procedures.
Which approach may be medically and aesthetically appropriate depends on the actual findings. The consultation may also lead to the conclusion that another method is more suitable or that an injection treatment is not recommended.
Consultation
A medical consultation may be helpful if you are interested in skin quality treatment and first want to understand how your findings should be assessed. An informed decision requires a willingness to consider the still limited and inconsistent evidence as well as possible alternatives.
The procedure is not suitable if you expect a reliable volumising effect, a defined change in contours, an immediate result, guaranteed new collagen formation or a fixed duration of effect. Such promises cannot be derived from the current evidence.
Step by step
You describe your concerns, expectations, existing conditions, medication, allergies, previous aesthetic treatments and any previous reactions or healing experiences.
Dr Pees assesses the initial findings, skin quality, possible inflammation, previous treatments and factors that may weigh against an injection treatment.
The origin, composition, product documentation, intended use and available data are taken into account in the decision. The label “exosomes” alone is not enough.
You discuss whether the desired goal appears reasonably achievable with the procedure or whether another treatment or no treatment would be more appropriate.
Before treatment, the uncertain evidence, common reactions, relevant risks, aftercare and costs are explained. You can then take your time to decide.
If treatment is considered justifiable following the medical assessment, its scope is agreed in advance. Aftercare instructions and the appropriate timing of a follow-up assessment are discussed individually.
Results and progress
A visible change cannot be reliably assessed immediately after the injections. Early swelling or redness may initially affect the appearance. Whether skin quality improves over time varies between individuals and depends, among other factors, on the initial findings, the specific product and its application.
Current research does not establish a consistent onset of effect or a reliable duration. Nor can a standardised number of sessions be generally justified. Further treatments should not follow a fixed routine, but should only be planned after a renewed medical assessment.
Safety
The injections may cause temporary redness, swelling, tenderness, small bruises, itching or a feeling of tightness. The severity and duration of these reactions depend on the treatment scope, skin response and product.
In addition to the general risks of injection treatment, there are product-specific uncertainties. Reports have described infections, allergic or inflammatory reactions, persistent nodules or granulomas and isolated cases of tissue damage following injectable applications, among other effects. Possible long-term risks have also not yet been conclusively clarified.
Suitability and reasons to avoid treatment
Treatment should not take place if there is an acute infection or inflammatory skin change in the intended area, if relevant medical information remains unclear or if the origin, composition, sterility or use of the product cannot be adequately verified.
Pregnancy and breastfeeding, known hypersensitivities, immune system conditions, current or previous tumours, medication affecting blood clotting or immune responses, and previous unusual reactions must be discussed in advance. These do not automatically exclude treatment in every case, but individual medical assessment is essential.
Dr Pees may also advise against treatment if the desired goal does not appear reasonably achievable with the procedure or if the uncertainties outweigh the possible benefits.
After treatment
Aftercare depends on the product used, the treated area and individual progress. You receive specific instructions on what to do after treatment and which reactions to expect. General rules found online do not replace this product-specific guidance.
If you experience unusual or worsening symptoms, contact the practice early. A follow-up assessment may be useful to medically evaluate reactions, possible changes and the next steps.
Costs and transparency
from 250 Euro
The treatment scope and total costs are agreed in advance.
View the full price overviewBodywise publishes a price from 250 Euro for exosome injections. The actual amount depends on the intended product, the treatment scope and the amount of material required. After examination and treatment planning, Dr Pees explains the expected total costs before you decide whether to proceed with treatment.
Medical services are billed according to the German Scale of Medical Fees (GOÄ). Whether private health insurance covers the costs depends on the individual policy and the reason for treatment.
Medical responsibility
Dr Michael Pees is a specialist in surgery. For many years, he worked as a senior doctor in aesthetic surgery in Heidelberg and the surrounding region. His surgical training and many years of clinical responsibility shape his assessment of findings, anatomical factors, risks and appropriate therapeutic limits.
At Bodywise, Dr Pees provides consultation, examination, assessment of the indication, informed consent and medical treatment. Particularly with a procedure that remains varied and continues to develop, critical assessment of the product, evidence and individual suitability is an essential part of the treatment decision.
Frequently asked questions
Exosomes are small, membrane-bound particles released by cells that may participate in cell communication. They belong to the extracellular vesicles. For commercial products, how the particles were manufactured, purified and characterised is crucial.
No. Source material, manufacturing processes, composition, concentration, accompanying substances, sterility and intended use can differ considerably. Statements about one product cannot automatically be applied to another.
There are early clinical findings suggesting possible short-term improvements in various skin parameters. However, the studies are heterogeneous, often small and have only short follow-up periods. A substantial proportion of the data concerns topical or combined applications rather than direct injections.
No. They involve different products and biological concepts. The two procedures must be assessed separately in terms of their goals, products, evidence, risks and individual suitability.
Exosome injections are not a hyaluronic acid filler. Defined volume enhancement or a targeted change in contours should therefore not be expected.
A generally applicable course of treatment has not been sufficiently established scientifically. Whether another session is appropriate should be decided based on progress, the product and medical assessment.
Temporary redness, swelling, tenderness, itching or bruising are possible. Less common reports concern infections, allergic or inflammatory reactions, nodules or granulomas and tissue damage following injectable applications.
Bodywise publishes a price from 250 Euro. The product, treatment scope, material requirements and expected total costs are agreed before treatment.
Your consultation
Further information
Medical assessment of skin texture, elasticity and fine lines.
Learn more
Information on restoring volume and how the procedures differ.
Learn more
Information on medical assessment of expression lines.
Learn morePatient reviews
Selected Google reviews about consultations and treatment at Bodywise – Dr. Michael Pees. Translated from German.
Google reviews
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A very pleasant atmosphere in pleasant surroundings. Dr. Pees gave me knowledgeable advice that was easy to understand.
I am very satisfied with the result of my treatment. I would be very happy to recommend the practice.
Dr. Pees is a knowledgeable and empathetic doctor with more than 30 years of professional experience. This is also reflected positively in his thorough, open and individual advice and care. I felt very well looked after by Dr. Pees and can recommend him without reservation.
I visited Dr. Pees again today for injectable treatments. Such a wonderful doctor; I would not go to anyone else. He deserves more than just 5 points.
I can really only recommend him.
Dr. Michael Pees gave me excellent advice, and solutions to my problem were found quickly.
Thank you ❤️
Personal consultation at Bodywise
Whether exosome injections are justifiable for your concern cannot be decided from the name of the procedure alone. The individual findings, realistic goals, specific product, its documentation and the balance of possible benefits, alternatives and risks are decisive.
If you would like a medical assessment, you can arrange a consultation at Bodywise in Heidelberg. During the discussion, Dr Michael Pees considers which treatment may be appropriate for your findings and whether it would be preferable to advise against injections.
