Polynucleotides: What They Do and How They Differ From Fillers

For patients researching modern skin treatments, polynucleotides have become one of the most talked-about developments in aesthetic medicine in recent years. The confusion many patients bring to consultation is understanding how they differ from dermal fillers, since both are injectables and both are often discussed in the same conversation. The answer is that they are designed to do very different things, which is why they are used for different reasons and often at different stages of a patient’s treatment plan.

Polynucleotides are short chains of purified DNA fragments, typically derived from salmon or trout, that are injected into the skin to support tissue repair and regeneration. Instead of adding a substance that fills space in the way a hyaluronic acid filler does, polynucleotides encourage the skin’s own cells to repair and hydrate over the weeks and months following treatment.

At McKeown Medical Glasgow, the polynucleotide product used is Ameela. It is a purified formulation designed for skin regeneration and is well suited to delicate areas such as the under-eye region, as well as broader use across the face and neck.

The end result is not a change in facial shape or volume, but a change in the quality of the skin itself. Patients typically notice improvements in skin hydration, elasticity, texture, and overall radiance, as opposed to the fuller or more defined appearance that filler produces.

Polynucleotides work very differently from traditional injectable treatments because they are designed to improve the quality of the tissue instead of adding volume. Once injected into the skin, they support the biological processes involved in tissue repair and regeneration.

Because the effect depends on the body’s own processes and not on an immediate visible change, results develop gradually. A course of polynucleotide treatment is recommended, with the exact number and spacing of sessions determined at consultation based on the individual’s skin quality and treatment goals. Maintenance treatments are then typically discussed once the initial course is complete.

Dermal fillers are made from hyaluronic acid or other volumising substances and are used to restore volume, define contour, and support structure where tissue has been lost or was never present in the desired proportion. Cheek filler, lip filler, and tear trough filler are examples of treatments that use dermal fillers to change the shape or volume of a specific area.

Polynucleotides do not add volume. They improve the biological quality of the skin, which produces a different kind of visible improvement: skin that looks more hydrated, feels smoother, and has better elasticity. Where filler might restore the shape of a cheek that has lost volume, polynucleotides would improve the texture and quality of the skin covering that cheek.

For many patients, the two treatments are complementary rather than alternative. Filler restores structure where structure has been lost, and polynucleotides improve the quality of the skin that covers that structure.

Polynucleotides suit patients whose primary concern is skin quality rather than facial shape or volume. Typical presentations include thinning or crepey skin around the eyes, neck, and hands, loss of hydration and radiance that no longer responds to skincare alone, and early signs of ageing where adding volume may not be necessary.

They are also used for patients who want to focus primarily on improving skin quality without changing facial structure or volume. Because the effect is regenerative rather than corrective, polynucleotides can form part of a broader skin health plan alongside topical skincare, energy-based treatments, and, where appropriate, filler.

Filler remains the more appropriate treatment when the underlying concern is volume loss or structural change rather than skin quality. Patients who want more defined cheekbones, fuller lips, or softening of the tear trough hollow are better served by dermal fillers chosen and placed for that specific purpose. Polynucleotides will not address a hollow cheek or a thinning lip, because those changes are structural rather than tissue-quality issues.

Because polynucleotides and fillers address different aspects of ageing, the right choice depends on what a patient is actually trying to change.

For some patients, a combination of these approaches may be appropriate, tailored to the individual pattern of change.

It is quite common for someone to come in asking about polynucleotides having read about them online, when the underlying concern is actually a filler issue rather than a skin quality issue. Someone asking for polynucleotides under the eyes, for example, may in fact have volume loss in the tear trough, which may be more appropriate to address with appropriately placed filler rather than with a regenerative treatment

The opposite pattern is also common. Some patients arrive asking for filler in an area where the underlying issue is thinning skin quality. In these situations, adding volume may not address the problem and, in some cases, can produce a less natural result. Addressing the skin with polynucleotides first, then reassessing volume, often delivers a more balanced outcome than filler alone would.

A third group of patients present with both concerns and arrive expecting to choose between the two treatments, when a combined plan sequenced across several months delivers a better result than either treatment used alone.

None of these is a wrong starting point. The consultation exists to work out which pattern applies, and to match the treatment to what is actually happening in the tissue, not to what the patient came in asking for.

Every consultation for skin quality and volume concerns at McKeown Medical Glasgow begins with a structured examination. The medical team looks at the skin itself, the underlying volume distribution, and the pattern of change the patient has noticed before recommending any approach. For some patients, polynucleotides alone are the right answer. For others, filler is more appropriate. In some cases, a combination delivers a more balanced result than either treatment used in isolation.

Are polynucleotides safe?

Polynucleotides have been used in aesthetic medicine for several years and are considered a well-established treatment. As with any injectable, treatment should only be performed by a qualified medical practitioner in a properly regulated clinical setting, and full consultation and consent processes apply.

How many polynucleotide sessions are needed?

A course of treatment is recommended, with the exact number and spacing of sessions determined at consultation based on individual skin quality and treatment goals.

When will I see results?

Because polynucleotides work by supporting the skin’s own regenerative processes, results develop gradually rather than immediately. Progressive improvement is typically seen over the weeks and months following treatment.

Can polynucleotides replace filler?

Not in the conventional sense, because the treatments are designed to do different things. Where volume loss is the underlying issue, filler remains the appropriate treatment. Where skin quality is the concern, polynucleotides may be more suitable. Many patients benefit from both.

Is there any downtime?

Polynucleotide treatment involves multiple small injections, and mild redness or swelling at the injection sites is common for a short period afterwards. Most patients return to normal activities the same day, though full aftercare guidance is provided at consultation.

Dr Darren McKeown (GMC 6128508), MB ChB Glasgow (2005), is renowned for his expertise and artistry with dermal fillers. A Full Member of the British College of Aesthetic Medicine (BCAM), the UK’s leading professional body for aesthetic medicine doctors, and a peer-reviewed medical author, he is passionate about treatments that stand up to scientific scrutiny. Above all, he genuinely cares about helping each patient feel their most confident, natural self.