RENUVA the Filler that Stimulates your own fat

MTF,the worlds larges accredited tissue bank, has just introduced RENUVA!   This is an Allograft Adipose Matrix  or in plain English, adipose cellular material from the highest quality donors. The "remnants" of the fat cells (processed to keep the fat stimulation properties) have no imunogenic activity. Thus no skin test is necessary. No anesthesia is necessary! This could replace fat grafts in small volumes  and can be used to correct minor "dents". Of course this is being used in cosmetic procedures to replace certain fillers. Cheeks and hands  are two areas that have caught the attention of some of the early adopters of this new Biostimulator.

Cheek Volume Restoration


Individual results may vary.

Hand Rejuvenation


  In essence the material comes in a syringe and it is prepared by mixing or rehydrating it with saline. It is then ready for injection! The material tricks the body into making fat where it has been injected. Most studies demonstrate a forty percent volume retention long term in areas treated with RENUVA. As larger volumes become available surgeons and dermatologists will address "Larger targets" such as buttocks or even breasts! 

While Autologous Fat grafts will not be replaced by these Allograft Adipose Matrixes, they will add one more tool into our cosmetic and reconstructive group of options. The growth factors contained in the Renuva has even been shown to help heal certain types of wounds and soften longstanding scars much like those autologous fat grafts/ Call the office at 2390348-7362 to see if this could be benficial to your goals.

Quiz: Finding the Right Nonsurgical Procedure

Naples plastic surgeon Dr. Manuel Peña offers a number of nonsurgical options, enabling him to address many skin imperfections – including signs of aging – without surgical risks or lengthy recovery times. But how can you tell which cosmetic service is right for your specific concerns?

The short quiz below can help you start thinking about the treatments best for your needs, though nothing can replace a one-on-one consultation with Dr. Peña. Give us a call at 239-348-7362 to schedule a consultation and learn more. Located in Naples, Peña Plastic Surgery serves men and women living in Ft. Myers, Estero, Bonita Springs, and surrounding areas.

Dr. Peña offers many nonsurgical facial rejuvenation services at La Piel Medical Spa including age rejuvenation, hydrotherapy, and normalizing treatments for all skin types. Give us a call at 239-348-7362 to schedule your consultation, complete with a Visia Skin Evaluation, to learn how we can help you look and feel your absolute best. 

Hair Growth Stimulation Strategies

Androgenic alopecia (hair loss sensitive to Testosterone) is the most common type of hair loss in both men and women. Follicles are “ miniaturized” and hair gets thinner before it falls out. All the following treatments work better on recent hair loss and in areas that still have some active but miniaturized follicles.  If these methods are to work there will be results in 6-9 months usually at the most 12 months.  Occasionally the PRP injections will work even in  cases of autoimmune types of alopecia.

Topical treatments for alopecia have been around for over 20 years in the form of minoxidil (Rogaine).  This was originally a blood pressure medication and has been recently found to probably increase the circulation to the hair follicles.  This is in contrast with the oral agents such as finasteride (Propecia) that are 5-alpha reductase inhibitors (they block the conversion of testosterone to  dihydrotestosterone).  As you can imagine the side effects of these agents orally can be significant and they can include loss of libido difficulty with ejaculation and so forth.  Although topical compounds from these have been made the original minoxidil Rogaine formulations were now well received by the public probably because of the high percentage of propylene glycol used as a delivery agent.  A much better formulation 82M was developed which included minoxidil at seven percent plus tretinoin (which helps the absorption of the rest of the medications), a topical steroid most commonly betamethasone and an organic 5 alpha reductase inhibitor Oleanic Acid.

We have this available as a topical agent by itself or as a shampoo with or without some of the other delivery system such as the micro-needling and micro-needling with PRP.  In addition to this will also offer oral agents that are purely building blocks for the hair follicles.  Essentially vitamins that the body continues to stimulate and maintained good hair growth.

Now a little bit about what happens with the PRP  and with some of the other growth factor stimulation of the hair follicles.  The hair follicles have been found to be stimulated by several things from low level laser treatments that are springing up all over the place to increase the blood supply through minoxidil topically or by blocking the action of testosterone on the health follicles through some of the blocking agents (as a medication or an organic compound).  Most recently the stimulation of the follicles directly by platelet derived growth factors such as VEGF also known as  vascular endolthelial growth factor and several others found in the platelets have adirect stimulatory effect on the numbers of hair follicles that are active and the thickness of the hair they produce!.

                          Microneedling+ PRP

Individual results may vary.

Other Growth factors derived from fat cells have also been used with Microneddling and have been shown to have a stimulatory  effect on the hair follicles. These are producta available "Off the shelf" without requiring a blood draw ad platelet gel preparation. These substances combined with mechanical stimulaion caused by the micronnedling itself can lead to a "perfect storm" type  of effect.


Option #1 oral supplements to stimulate

Option #2 oral supplements plus a topical agent such as 82M which come by a high percentage minoxidil with tretinoin and betamethasone along with oleanic acid (to block testosterone from becoming dihydrotestosterone). The Shampoo 82 S  has pure organic agents

Option #3 addition of micro-needling using 82M or another off-the-shelf hair growth stimulation with the growth factors derived from fat cells.


Option #4 is the most aggressive which includes micro-needling with PRP and any of the additional oral or topical agents post procedure.  Both option #3 and #4 are spaced about 4-6 weeks apart and include a series of 3 treatments for maximum stimulation.  Expect significant improvement proximal 6 weeks after the second treatment.  Yearly treatments are recommended for maintenance of maximal stimulation of growth.*  Not all treatments will work on everyone and sometimes we have to try different ones to maximize  hair growth.






*Individual results may vary. Consult with Dr. Peña to see if you are a candidate.

Hair Growth Stimulation using Microneedling and PRP

The more we learn about our body's ability to stimulate healing and regenerate itself,  the more we find innovative ways to restore the failing parts of her body.  Platelet rich plasma also known as PRP is a highly concentrated suspension of our own bodies healing triggering bodies known as platelets.  They contain a myriad of hormones or 'factors' that begin and stimulate the process of 'wound healing' and repair in many different ways.  For hair stimulation the epithelial growth factors are the most valuable.  The stimulate the hair follicles in 2 ways.  First is  to increase the circulation to the follicles  at critical moments in the development of the hair thus making the hair thicker (up to forty percent)  and 'waking' up some of the hair follicles that were in the resting or dormant phase. 

The Platelet Rich Plasma (PRP) is made by drawing your blood and centrifuging or spinning this blood to concentrate the platelets and remove the red blood cells.  This allows only the stimulating platelets without the remaining parts of the blood which can have an irritating the effect.

So what is the process to get the platelet gel to the targeted hair follicles.  One way to admisnister it is to inject the scalp or any other area in which you want to stimulate hair growth at a level where these hair follicles are (between 2 and 3 mm deep)  or we can use a micro-needling device which essentially pokes tiny needle holes to the same level.  The needle holes themselves will stimulate a similar response from the hair follicles and this is only augmented by the application of the platelet gel that trickle down into these holes while they are still open.  This is usually combined with an injection of the remainder of the platelet gel deep to the hair follicles after the micro-needling.Thus the term Microneedling with PRP

                                 Microneedling with PRP

Individual results may vary.

This process is not only for male pattern baldness but also useful for the thinning hair experienced by more and more women these days.  Recent studies have  shown this to be highly effective in treating alopecia areata which appears to have an autoimmune component.  The process is repeated an average of 3 times about 6 weeks apart.  We start seeing significant improvement at the 3-4 month stage after the initial treatment.  And it is recommended that once a year  another session of micro-needling plus PRP is used as a booster to keep the hair growth.*  We often combined this with topical applications which work in many different ways.  The most common affect is to block the testosterone effect on the hair follicle itself and other parts of these formula help keep the scalp cleaned by turning over the new cells and clearing the path for the hair follicle growth.  Please call La-Piel Spa at 239-352-5554 for your evaluation and to get you started on stimulation of your own lush beautiful hair.

*Individual results may vary. Consult with Dr. Peña to see if you are a candidate.


Have you heard of Smartphone Face? It’s become a buzz term as more and more fashion magazines and bloggers draw attention to the phenomenon. It refers to the premature aging and sagging of neck and facial tissue brought about by having the head constantly bowed while looking at a smartphone – and it is becoming more and more common.

Is your smartphone aging you prematurely? Call Naples cosmetic surgeon Dr. Manuel Peña to learn how we can help

There are a few things that factor into the premature aging brought about by smartphone use:

  • Over activity of your platysma muscles (neck muscles) cause skin in the neck to sag
  • Gravity pulls facial skin and tissue from bowed heads earthward

These factors combine to rapidly age the face and loosen the skin, and are exacerbated the more this position is maintained. The only way to avoid smartphone face is to improve the posture and keep the neck and head erect. But since this postural position is unlikely to sweep the nation, smartphone face is very likely something that’s here to stay.

What can be done about Smartphone Face?

Fortunately, there are treatments that can be used to counter the effects of constant smartphone use. Naples plastic surgeon Dr. Manual Peña can help you determine which will best address your condition during your initial consultation. Options that may be discussed include:

Some medical spa treatments may be useful as well, particularly when used proactively to counter the effects of smartphone use. These can be discussed as appropriate during your visit to our Naples cosmetic surgery office.

To schedule your consultation at Peña Plastic Surgery, please use our online contact form or call us at 239-348-7362. Dr. Peña is a board-certified plastic surgeon serving Naples, Ft. Myers, Bonita Springs, and all surrounding areas of Florida.