BLOG

Doctors' Point

While the term “human-derived” tends to draw the most attention when it comes to Lituo, its true essence lies in utilizing human-derived extracellular matrix (ECM) to optimize the environment that forms the foundation of the skin. It is neither a treatment that adds volume, like hyaluronic acid, nor a treatment that lifts the skin, like a thread lift.

 

Therefore, it is important to determine whether the expected results align with the treatment goals. Furthermore, just because a product is derived from humans does not mean it is absolutely safe; as with any injection treatment, there are risks such as redness, swelling, bruising, and infection. When undergoing this procedure, it is important to receive a thorough explanation regarding the product’s quality control system, the physician’s experience, and the indications and risks involved, and to choose the treatment only after you are fully informed and satisfied with the information provided.

 

“Is it true that Rituo is derived from humans?” “How is it different from animal-derived collagen?” “Is it safe?”—These are questions we hear very frequently during consultations at cosmetic surgery clinics. In the field of cosmetic surgery, interest is shifting from mere “additive rejuvenation” to a “nurturing approach” that improves the skin’s underlying environment, driving the expansion of the skin booster market. Among these products, Lituo—which focuses on human-derived extracellular matrix (ECM)—is gaining attention as a new option that applies concepts from regenerative medicine.

 

Important Notice: Since I was unable to locate relevant materials or references, this article is based on my general knowledge. It does not include any citations supported by academic literature. For the latest information or specific applications, please consult a reputable medical institution for an examination or counseling session.

What Is Lituo? — A Skin Booster Using Human-Derived ECM

Rituo is a skin booster that utilizes human-derived extracellular matrix (ECM). Its key feature is that, rather than injecting actual cells, it removes cells, DNA, RNA, and blood components from human tissue as much as possible, retaining only the ECM that supports the skin’s foundation.

 

ECM contains a variety of components that form the skin’s “skeletal framework,” all in a natural balance, as described below.

• Collagen
• Elastin
• Laminin
• Fibronectin
• Proteoglycan
• Glycoprotein

 

In other words, Rituo is an approach that aims not to “replace cells” but to “create an environment that facilitates the skin’s natural regenerative abilities.”

What Does “Human-Derived” Mean?—The Significance of Decellularization

"Human-derived" refers to raw materials that come from human tissue. However, it does not mean "inserting another person's cells as-is."

 

At Rituo, the decellularization process—which removes cells, nucleic acids, and blood-derived components that could trigger an immune response, and extracts and processes only the ECM—is a key pillar of our operations. The goal is to minimize foreign body reactions while preserving the tissue’s natural three-dimensional structure as much as possible.

Why It’s Gaining Attention in Cosmetic Surgery—The Concept of Improving the “Foundation of the Skin”

Conventional skin boosters and injectable formulations (such as hyaluronic acid, PN/PDRN, and polylactic acid) each have distinct roles. The reason Rituo is gaining attention in the field of cosmetic surgery is that its ECM can provide a “microenvironment created by a combination of multiple components”—something that is difficult to replicate with a single ingredient.

 

The design philosophy—which addresses multifaceted skin concerns such as firmness, elasticity, fine lines, and pores by addressing the “foundation”—aligns with the trend toward “nurturing” treatments in cosmetic surgery.

What About Safety?—Manufacturing Controls and General Risks

When people hear the term “human-derived,” many become concerned about infectious diseases or immune reactions. To ensure safety, the following control measures are generally implemented in a layered manner.

• Strict Donor Eligibility Screening
• Infectious Disease Screening
• Decellularization and Washing Processes
• Quality Control by Production Lot

 

Even so, there are no “absolutes” in medicine. With injectable treatments, common risks such as redness, swelling, bruising, pain, infection, and allergy-like reactions may occur. Before the procedure, be sure to receive a full explanation of the risks, alternative options, downtime, costs, and aftercare, and proceed only after you fully understand and agree to them.

Differences from Animal-Derived Collagen

Collagen preparations derived from cattle and pigs have been used for a long time, but there have been periods when allergy testing was recommended due to immune reactions caused by heterologous proteins.

 

Rituo is based on human-derived ECM and is designed to minimize foreign body reactions. However, it would be simplistic to assume that “human-derived” automatically means “superior.” The optimal solution varies depending on individual concerns, goals, treatment site, and skin condition.

Differences from Rejuran (PN/PDRN)

Rejuran is a polynucleotide (PN) preparation derived from salmon DNA. Rituo, on the other hand, is based on an ECM-derived approach. In other words,

• Rejuran = Nucleic Acid-Derived Support
• Creating a “Scaffold” Derived from Litou-ECM

The choice isn't about which is better, but rather depends on "what your skin is currently lacking." Depending on the combination of concerns—such as the epidermal barrier, dermal density, dryness, fine lines, pores, and redness—you may consider using a single treatment or a combination of treatments.

Differentiating Between Hyaluronic Acid and Other Treatments (Treatment Strategies in Cosmetic Surgery)

Hyaluronic acid is primarily used for adding volume and providing physical “support” against wrinkles. In contrast, Rituo aims to enhance the skin’s texture—including firmness, elasticity, and skin texture.

 

In cosmetic surgery, treatment plans are sometimes designed to optimize both facial contours and skin texture by combining “structure (hyaluronic acid)” and “environment (Rituo).”

Who Is This For? — Suitability and Precautions

• I want to improve my skin's firmness and elasticity.
• Concerned about fine lines and visible pores
• “I want to aim for a more natural-looking rejuvenation rather than an ”over-the-top” look
• I'm concerned about age-related loss of elasticity and dryness

 

On the other hand, if you’re looking to achieve significant volume enhancement or clearly defined contours right away, other options—such as hyaluronic acid—may be more effective. Let’s discuss your priorities during your consultation and work together to design the most efficient plan.

Treatment Process and Downtime (From the Front Lines of Cosmetic Surgery)

The procedure primarily involves an injection-based process, and the final results depend on the treatment area, depth, dilution, and layer selected. As for downtime, temporary side effects such as redness, swelling, bruising, and tenderness may occur. While these symptoms typically subside within a few days to about a week, individual variations are inevitable.

 

Immediately after your procedure, please follow the instructions regarding makeup restrictions and sun protection. At our cosmetic surgery clinic, we tailor your schedule to accommodate your life events (such as photo shoots, business trips, and ceremonies).

How to Interpret “Before & After” Photos—Accurately Assessing "Changes in Skin Texture"

Rituo is a treatment designed to enhance skin texture rather than dramatically alter facial contours. When evaluating “Before & After” photos, it is important to comprehensively assess factors such as skin brightness, pore appearance, firmness, fine lines, how well makeup applies, and the lighting conditions in the photos.

 

Be sure to standardize the photography conditions (lighting, distance, angle, facial expression) and pay attention to the timing of the evaluation (when the inflammatory swelling has subsided).

Points to Check at a Cosmetic Surgery Clinic

• Is there an explanation regarding the origin, manufacturing control, and lot control of the drug product (policy on the handling of human-derived materials)?
• Presentation of Indications, Contraindications, Adverse Reactions, Complications, and Management Strategies
• Comparison with Alternative Treatments (Hyaluronic Acid, Rejuran, Lasers, etc.)
• Clarification of Downtime, Number of Sessions, Costs, and Aftercare
• Explanation of How to Present "Before & After" Images and Shooting Conditions

Frequently Asked Questions (FAQ)

Q. It sounds a little scary when I hear “human-derived.”

A. This treatment does not involve implanting whole cells; instead, it uses ECM from which cellular components have been removed through decellularization. Although safety measures are in place, the risk is not zero, so it is important to provide a thorough explanation and obtain informed consent beforehand.

Q. Do other people's cells enter my body?

A. No. We use the ECM rather than the cells themselves. It is designed to reduce the risk of an immune response.

Q. Can I feel the effects after just one session?

A. Results vary from person to person. We may aim for gradual improvement by combining several sessions with optimized skincare and lifestyle habits.

Q. How is it different from animal-derived collagen?

A. Lituo uses human-derived ECM, which has a different immunological profile than animal-derived ECM. However, it is not possible to definitively determine which is superior; the choice depends on the intended use and the treatment site.

Q. Can it be used in combination with hyaluronic acid or Rejuran?

A. Since the objectives differ, there are some procedures designed to produce synergistic effects when performed in combination. A cosmetic surgery clinic will evaluate each case individually and develop a plan specifying the appropriate sequence, layers, and treatment areas.

From a Cosmetic Surgery Perspective—Common Misconceptions

• "Human-derived does not necessarily mean safe or effective" (Results vary depending on individual differences, indications, and technique.)
• "ECM does not equal volume enhancement" (it primarily involves optimizing the texture of the environment)
• Planned maintenance is more realistic than a "one-time fix."

 

Please note that this article is a general explanation based on common knowledge and is not supported by scientific literature. For more details, please refer to the guidelines provided by each medical institution.

Summary

Rituo is a skin booster that utilizes human-derived extracellular matrix (ECM) to target the skin’s “foundation.” While safety is ensured through processes such as decellularization, risks do exist, as this is a medical procedure. It is important to understand the respective advantages of animal-derived collagen, Rejuran (PN/PDRN), and hyaluronic acid, and to choose the optimal solution based on your specific concerns and goals.

 

In cosmetic surgery, an approach that addresses both facial contours (structure) and skin quality (environment) is effective, and combining these treatments may be considered as needed. Ultimately, you should develop a treatment plan that you feel confident about after going through a thorough process of explanation, comparison, and informed consent. Please note that no relevant materials or literature were found, and the content of this article is based on general knowledge. For highly individualized decisions, please consult with a plastic surgeon during an in-person consultation.

 

Summary: Re2O is a skin booster that utilizes human-derived extracellular matrix (ECM) to restore the skin’s natural environment. While it is expected to improve skin quality—including firmness, elasticity, fine lines, and pore appearance—it is not intended for treatments aimed at adding volume or lifting the skin. Each formulation—such as hyaluronic acid and Rejuran—has its own distinct characteristics; rather than focusing on which one is superior, it is important to select the appropriate one based on the condition of your skin and your specific goals.

 

In cosmetic medicine, combining multiple procedures as needed—rather than relying on a single treatment—can sometimes lead to more natural and satisfying results. When considering Rituo, it’s important not to base your decision solely on the term “human-derived.” Instead, you should accurately understand the product’s characteristics, risks, and expected effects, and develop a treatment plan tailored to your needs after receiving a thorough consultation at a reputable cosmetic surgery clinic.

 

▷ Rituo Re2O (Bunaju) Treatment Page

▷ Counseling Appointment Page