Re2O in Daegu: layering in the dermis, and why embossing appears

Filler is gathered in one place to build a shape. Re2O is the opposite. The target is dermal density, so the result is set by how evenly it is laid across an area. The same total volume placed in few points heavily and in many points lightly are two different treatments.

So “across how many points is it divided” is a more precise consultation question than “how many cc”. What depth is being targeted comes next.

What gets called “a feel for the needle” lives here too. Dermal thickness differs across the face. In a study measuring 30 fixed cadavers with a 3D scanner, facial skin was 2.1 ± 0.4 mm and superficial fat 5.2 ± 1.9 mm — a standard deviation of 36% of the mean. Injecting at a consistent depth therefore means changing where the needle stops, person by person and site by site.

Embossing is the name for the small raised beads visible after treatment. Liquid entering the dermis briefly expands that layer, and this is what you see.

So embossing is closer to evidence the product reached the dermis. Conversely, skin that stays perfectly smooth raises the possibility that the material went deeper than intended. Deeper is not necessarily wrong, but it is a different plane from the one aimed at.

One thing we should say plainly: we could not find any study measuring, in hADM, how many hours or days embossing takes to settle. We can describe what we observe clinically, but that is practice experience, not a trial result.

Where skin is thin, such as around the eyes, the same volume shows longer and more clearly. If you have something important in the diary, it is safer to set the treatment date around it.

The Re2O trial is small at 20 subjects over 20 weeks, but it compares the two sides of the same face under double-blind randomisation, which makes the result readable. The paper does not name the product; identity was confirmed against the trial registration number (NCT07155278).

Here is where things are often conflated. The 175-completer non-inferiority trial cited widely in Korean material is a Chinese product not distributed here. In it, nasolabial improvement rates were 88.4% against 85.4% at three months and 70.9% against 69.7% at six months, holding up against a crosslinked collagen filler — a good result, but not Re2O’s result. We have repeatedly seen those numbers used without distinguishing the products, and we could not find anywhere that sets out the distinction.

There is animal data too. Micronised hADM retained 113.5% of its volume at eight weeks in mice, against 85.1% for hyaluronic acid and 17.7% for a collagen-PMMA mixture. But that is an eight-week value in mice and cannot be read across as duration in humans.

hADM is made from donated human skin with the cells removed, leaving only the matrix. You should know this before treatment. In a survey of 1,034 adults, 69.8% said they would decline cadaver-derived tissue for cosmetic use — though we verified that figure from a National Assembly forum presentation and could not reach the underlying data.

Regulation is also moving. The MFDS gave notice in July 2026 of an amendment to the Rules on Human Tissue Safety, and as of September 2026 it has not been promulgated. This is not written to recommend or discourage the class, but because it is information you need in order to decide.

Checking authenticity is easy. You may ask to see the box and the vial before treatment — we do that on request.

Sessions are another matter. Three sessions four weeks apart is the usual guidance, but we could not find a trial comparing those intervals or that number. More fundamentally, no per-session dose is defined in the papers, the trial registry or the manufacturer’s material. We checked four sources and found it in none.

So we set sessions by the state of the skin rather than by the calendar. We do not fix a three-session package first and then fill it.

• Across how many points it is divided — this sets the result more than the total.
• What depth is being targeted — it should differ by site.
• Whether embossing is explained beforehand — unexplained, it is mistaken for a complication.
• Which product the quoted figures belong to — the 175-completer trial is a product not sold here.
• Whether the origin of the material is stated first — matrix from donated human skin.
• The box and the vial — you can check them before treatment.
• What decides the next session — the calendar, or the skin.

We treat Re2O as a treatment aimed at dermal density, and nothing wider. If the goal is to restore lost volume, a product that works in a different plane is the right answer — because using a dermal product on a fat-layer problem is a design in the wrong plane.

We divide the injection densely and change the depth by site. With dermal thickness varying by 36% of the mean, we do not run the same hand across the whole face. And we explain embossing before treatment, not after — experiencing it knowingly and experiencing it as a surprise are entirely different things.

Which treatment suits you can differ with skin condition, how much change you want and what you have had before. We do not recommend treatments that are not needed.

• Re2O in Daegu: which skin it suits · Where the evidence stands
• Pain, anaesthesia and bruising · Five things to check before booking
• The scope of hADM evidence · hADM and PN
• When embossing shows · Needle or cannula
• Re2O product page · Cellredm

Dr Lee Chi-Hak, Director, Miso Clinic

4F Bombom Building, 125 Dongdeok-ro, Jung-gu, Daegu (Kyungpook National University Hospital station, exit 1)

+82 53-428-2700 · www.clinicmiso.co.kr

• Any defined per-session dose — absent from the papers, the trial registry and the manufacturer’s material.
• Any measurement of how long embossing takes to settle in hADM.
• Any trial comparing session number or interval (three sessions four weeks apart).
• Duration in humans — the 113.5% figure is an eight-week value in mice.
• Large-scale human data for cosmetic use — the Re2O trial is 20 subjects over 20 weeks.
• Any published human trial of Cellredm.
• Any primary study of a reversal agent for this material.
• National adverse-event tallies for hADM in Korea.
• The underlying data behind the 69.8% refusal figure — verified only to the forum presentation.
• Any study validating our practice of varying depth by site — it is clinical judgement.