In this live‑procedure video, Dr. Charles Pereyra treats a patient named Haley with a comprehensive facial that combines microneedling, topical mesenchymal stem cell (MSC) exosome solution, and layered platelet‑rich plasma (PRP). The session begins with a detailed skin analysis, noting acne, scarring, and discoloration, and a discussion of Haley’s aesthetic goals. After applying a potent numbing cream, Dr. Pereyra draws a small amount of the patient’s blood to prepare PRP. He then uses a portable NanoPen equipped with gold‑tip needles to create micro‑channels at adjustable depths, focusing deeper on the cheeks. An atomizer delivers a 100‑nm exosome solution evenly across the face, followed by sequential layers of hyper‑PRP and exosome spray, forming a mask that remains on the skin for up to 12‑24 hours. Throughout, Haley reports minimal sensation, describing a vibrating, cold, and tightening feeling. Dr. Pereyra explains the biological rationale—stimulating growth factors, inflammatory cascades, and sealing the active ingredients—to achieve tighter, more radiant skin, with visible tightening expected within days.
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So I am here with Haley. I'm gonna make Haley a little bit more comfortable here. We are taking a look at her face. She has a little bit of acne, some acne scarring, and we are going to use our new topical MSC exosome solution to make Haley even more beautiful and make her skin even more radiant. And so let's just dive in. First thing that we're going to do is just look at her skin. We've already chatted with the patient. We know some of her goals. We know what she's looking to achieve from this procedure, which is the most important, is setting the expectations and going through it. Looking at her skin here, I do a full skin analysis. This is the physician analysis part. You've probably already had the AI procedure done. If you've had a consultation with us, we do an AI skin health analysis first. And so we're seeing here she has some breakouts, a little bit of scarring here on the left lower side. Let's take a look at the other side of her face here. Also a little bit of acne, not horrible, no pustular acne really. There's none of these bolus infected areas, which otherwise we wouldn't do if it was super infected. Now I'm just going to lift up the chin here. Okay, and then a little bit of discoloration here on the forehead. So we're going to do the full facial with her today, but first we're going to numb her with this. This is a very powerful numbing cream to the point where she will likely not feel very much on her face. You're very lucky I did it without this and I cried.
Oh gosh.
We're gonna apply this solution right now, and then what we'll do after this, and she's— when she's numb, is we'll sterilely clean the face again, make sure it's clean. She's already washed her face.
What exactly does it feel like? I'm sorry, like the microneedling?
The microneedling will feel like little tiny, like Like this going in. You should feel even less than that because this numbing cream is— you can tell going all over your face. So I'm going to leave that on for a little bit. What we're going to do, we'll get a little bit of PRP from you, a little bit of blood.
You okay?
We don't have to do it if you don't want, but I don't care. We can do the whole thing for you.
Uh, might as well.
So we'll go through.
Do you inject the PRP? Where do you— do you inject it?
Um, the PRP we're going to also put with the exosomes together as like a mask to seep in with this atomizer. It's really cool. So we're going to use today for Haley is the NanoPen. This is a very new type of pen. It's portable. Um, it also comes with a gold tip kind of microneedling. So the gold tip microneedling is really important because it helps to stimulate the kind of growth factors and inflammatory response we want. And we're able to adjust the depth to the perfect depth that we want to use for Haley. So the gold tips along with the Nano Pen and the speed of this pen is going to allow us to create these channels into Haley's face, get this inflammatory cascade that we want, the healthier version of it. And then what we're going to do is apply an application of a hyper-PRP, so a different kind of platelet-rich plasma, along with a topical exosomal solution. This is going to allow some of the inflammation around Haley's skin and for the appearance of her skin to look much more vibrant, to look much more tight. She'll probably start to notice it in the next couple of days. This mask is going to stay on her face, um, so it's going to stay on her face probably for at least 24 hours to allow everything to seep in and create that nice barrier. All right, you ready? All right, we'll start wiping you off. So these are the sterile stem cell exosomes that we're going to be applying for the topical solution first. We do this in a layered system here. So what we'll do is we'll draw up 2 to 5 cc's initially, and we'll go ahead and apply it with our atomizer here. So what you're going to see is us going in and really sucking out some of the solution. Here we go. Here we go. And what we're going to do for Haley is introduce this with an atomizer here. And so this atomizer is going to allow us to get an even distribution of the cells once we do the microneedling here. So it's really important to be careful with the needle when you're doing this. Um, here we go. What we do is just release the needle here, put it into the sharps container here, and now we have exosomes ready to go for her procedure. So then the next step here we get to do is we get to use our microneedling pen. She's all cleaned up, she's alcoholed, ready to go, and this is already loaded and good to go. So the first step in the 4-step process is to create these micro pores with the gold tip needles on the Nano Pen. So we'll do a few passes on her face, get everything going. The next step after that is to apply the topical exosomal solution, then a layer of hyper PRP, followed by a little bit more exosomal solution, and then finally with the last layer of PRP, hyper PRP, to seal it all in. This will be a nice mask for her. She's going to be very, very happy with it. You tell me how you feel, okay? How is that?
It's not bad.
I'm gonna focus on the areas of pigmentation, but really get as much of the total area as we can.
It honestly just feels like it's like vibrating.
The cheeks we always go a lot deeper on because the cheeks are thicker. You get nice puffy cheeks there.
Yeah.
I still can't feel it.
No, we're going to the deepest setting here. I did a little bit.
Right now we're spraying or atomizing. We are atomizing the exosomal solutions on with this particleizer. And they're 100 nanometers, remember. So all these are seeping directly in, they're creating a nice film around the face. It's kind of like airbrushing in a way. Feels cold. Mm-hmm. Feels good. So we have this first solution on. We're gonna let this seep, right? And then while this seeps, what we're going to do is we'll do the rest of solution once this dries and we fit putting on some of the PRP. So that's what we're gonna do. We're going to drop this PRP here. We're gonna be careful only to get the supinate of this, so the really nice liquid gold part that we talked about earlier. The gold is the only thing you want. And that is it for this one. Then we'll just get a little bit of more. What we're doing is going in here and we are getting a little bit of this beautiful golden PRP. This is going to go directly onto Haley's face, creating a nice mask healing response. That's really all you need. Now for some ladies, we can do intradermal injections of this PRP and really kind of get everything going for you. These are patients with deep, deep lines. We can go underneath the skin with the solution subdermally, just like you would with the filler, and we can actually plump it up with the PRP itself. Much better than doing just filler, in my opinion. Little spray of exosomes, the last layer of exosomes.
All right, that is it for that.
We're gonna let that dry real quickly, air this in, and then we're gonna seal it again with PRP. You've never had a facial like this, I can promise you that. So we just finished our topical MSC exosomal stem lift procedure with Haley. We did a nice number of microneedling her face with the gold tip pen very, very deeply, um, with the Nano Pen. How did it feel?
I really didn't feel anything at all.
That's always good to hear.
Truly.
How do you feel right now?
It's feeling like tight but also rejuvenated. It feels cold. It feels really good.
Nice. Yeah, sometimes it's a fresh feeling to have the exosome solution sprayed on afterwards with the atomizer. And also, as it starts to really seep in, it almost will pull the face back, so you'll notice a little bit of tightening. In the next couple days. I can kind of see it tightening already.
Yeah, I can definitely feel the tightening through here.
Yeah, it's good. It helps your skin. It's like giving your skin a nice— like, it's like taking your skin and cleaning out everything. So we're going deep, we're kind of flushing out the pores, and then what we're doing with these channels is you have micro channels all over your face that these gold tip pens created. And now those stem cell exosomes and those PRPs, like, really seeped it in. The reason why we do it in layers— so we'll do it with a little bit of exosomes, PRP, exosomal, PRP— is because we want to make sure it's sealed in. The PRP is very viscous filled with growth factors, and it seals and it really creates a mask. So she'll have that mask on her face for at least 12 hours and really keep it nice and tight.
