Conscious Cosmetology: Dr Yulia Shvets's Combined Protocols

Yulia's first meeting with a patient is not about choosing a treatment from a price list; it is about diagnostics. She assesses the condition of the skin, lifestyle and medical history and, if needed, orders tests.Next comes an individual strategy for preventing age-related changes. Yulia is skilled in modern device-based and injectable techniques, but the key, in her words, is knowing how to combine them properly.Below are the four combined protocols Yulia uses most often, and the scientific evidence she relies on.

This protocol is for a defined facial contour, expression lines and better skin quality. Each technique works on its own level: ultrasound on the deep framework, biorevitalization on hydration and dermal structure, botulinum therapy on facial expressions.What the research says

• In a series of clinical cases, combining microfocused ultrasound with skin booster injections (hyaluronic acid, amino acids, PDRN) in one session proved safe and effective for lifting and rejuvenating facial skin. Ultrasound creates precise, controlled micro-injuries, and boosters enhance recovery, remodelling and collagen production [1].
• In a controlled study in women aged 30-55, ultrasound combined with hyaluronic acid almost doubled skin hydration (from 28 to 55 points) and reduced the depth of fine wrinkles [4].
• The order matters: if both treatments are done in one visit, hyaluronic acid is usually recommended after ultrasound, not before it [2].
• A retrospective analysis of 101 patients showed that the safety profile of microfocused ultrasound combined with botulinum toxin and fillers matches the profile of each procedure on its own [3].

Who it suits: loss of contour definition, first signs of sagging, expression lines, dull and dehydrated skin.

This protocol makes RF microneedling possible even for those who were previously advised to postpone it: patients with pigmentation and a tendency to redness. Exosomes are applied in the same session and speed up recovery.What the research says

• In a comparative study of RF microneedling for the under-eye area, adding exosomes after the procedure further reduced pigmentation, increased dermal thickness and reduced the visibility of blood vessels. Mild redness and swelling resolved within 48 hours [5].
• In patients with dark skin (phototypes IV-V), who are at high risk of post-inflammatory hyperpigmentation, combining RF microneedling with exosomes showed a safe and measurable improvement in texture [6].
• Exosomes are described as extracellular nanovesicles with anti-inflammatory and anti-pigment properties; microneedling with them improved pigmentation, inflammation and skin texture [7].
• Hyaluronic acid in skin boosters activates fibroblasts via CD44 receptors and the TGF-β signalling pathway, stimulating collagen synthesis and matrix remodelling [8].

Important: data on exosomes so far come mainly from small studies, and the quality of products on the market varies. Choosing a specific product is therefore the doctor's responsibility.

Who it suits: acne scars and uneven texture, enlarged pores, reduced skin density, especially with pigmentation, rosacea or a tendency to redness.

A surgeon removes excess skin but does not change its quality. A course of LDM ultrasound therapy and biorevitalization before surgery prepares the tissues so that the result is more pronounced and recovery is easier.What the research says

• Dual-frequency LDM ultrasound modifies cell signalling, with anti-inflammatory and anti-fibrotic effects. In a multicentre study after rhinoplasty, patients who received LDM for 5 days in a row saw swelling and bruising resolve significantly faster than with ice [9].
• A review in the Journal of Surgery describes administering skin boosters (hyaluronic acid, polynucleotides, polylactic acid) before facelift and blepharoplasty. The aim is to optimise the skin microenvironment before the surgical trauma, since surgery corrects structure but not dehydration and texture [8].
• A 2025 randomised double-blind split-face study in patients before a facelift confirmed the idea of preparing the skin bed: on the prepared side, healing went better, and the skin contained more collagen, elastin and hyaluronic acid [10].

Who it suits: patients planning a face or neck lift or blepharoplasty. The timing of the course and of the last session before surgery is agreed with the surgeon.

This combination restores metabolic processes in the scalp tissues and hair follicles. RF microneedling with exosomes improves tissue nutrition and regeneration, and PRP therapy adds the patient's own growth factors.What the research says

• A systematic review of 30 studies (687 patients) showed that PRP increases hair density and thickness in men and women with androgenetic alopecia without serious side effects [11].
• A meta-analysis of 17 groups from clinical studies recorded an increase in hair density from an average of 141.9 to 177.5 hairs per cm² after PRP [12].
• In a split-scalp study, adding fractional RF microneedling to minoxidil gave a significantly greater increase in hair count after 5 months (from 44 to 73 versus 46 to 63) and in hair thickness [13].
• In 16 patients (men and women), five sessions of RF microneedling with exosomes significantly increased hair count, density and thickness [14].
• In a clinical observation of 72 patients after microneedling with exosomes, moderate or marked improvement was seen in 73% [15].

Who it suits: thinning hair, androgenetic and diffuse alopecia, after stress, childbirth or illness, once the cause of hair loss has been identified.