Prof Patrick Treacy Research in Medicine

Contributions to Regenerative Medicine

Pioneering Regenerative Protocols in Aesthetic Medicine. Dr Patrick Treacy has contributed to the early clinical development of regenerative treatment strategies designed not only to restore aesthetic appearance but also to stimulate tissue repair, reduce inflammation, and improve long-term skin health. Among these contributions was the development of the HELPIR technique, a landmark protocol in aesthetic medicine addressing one of the most serious complications of injectable treatments — vascular occlusion leading to tissue ischemia and dermal scarring. Through early regenerative protocols such as HELPIR and the DUBLiN Facelift, he explored how growth factors, stem-cell-derived signalling molecules, and supportive regenerative therapies could be integrated to stimulate tissue recovery and improve complication management and aesthetic rejuvenation. The clinical protocols and research associated with these developments received international recognition and multiple professional awards. Medicine is gradually moving away from a purely disease-centred paradigm toward one that emphasises biological optimisation and restoration of physiological function. Dr Patrick Treacy has been particularly influential in integrating photobiomodulation with other regenerative modalities, including platelet-rich plasma (PRP), stem-cell-based therapies, and laser-assisted treatment strategies.

Photobiomodulation and Mitochondrial Medicine

An important component of regenerative medicine involves understanding how cellular energy systems influence healing and tissue regeneration. Among the most significant advances in this area has been the development of photobiomodulation (PBM), also known as low-level light therapy. Photobiomodulation uses specific wavelengths of light to influence biological processes within cells. Within cells, mitochondria function as the body's energy generators, producing ATP, which powers nearly every biological process. When specific wavelengths of red or near-infrared light are absorbed by cytochrome c oxidase within the mitochondrial respiratory chain, cellular respiration increases and ATP production rises. This enhanced cellular energy supports tissue repair by improving microcirculation, reducing oxidative stress, modulating inflammatory pathways, stimulating fibroblast activity and collagen production, and accelerating wound healing. Early in the development of regenerative aesthetic protocols, Dr Patrick Treacy began integrating photobiomodulation into multi-modal treatment strategies such as the HELPIR protocol and the DUBLiN Facelift, anticipating what is now widely understood in modern regenerative medicine: that supporting mitochondrial function is central to restoring tissue health and improving long-term healing outcomes.

The HELPIR Technique

One of the most important developments arising from my work in regenerative medicine was the creation of the HELPIR protocol, a multi-modal regenerative strategy designed to manage some of the most serious complications in aesthetic medicine—particularly vascular occlusion and tissue ischemia following dermal filler injections. The HELPIR technique integrates several complementary regenerative therapies, including:

• Platelet-rich plasma (PRP)
• Stem-cell–derived regenerative factors and exosomes
• Photobiomodulation using low-level laser therapy
• Hyperbaric oxygen therapy in severe vascular occlusion cases

PRP provides a concentrated source of growth factors such as PDGF, VEGF, TGF-β, and EGF, which play a central role in angiogenesis, collagen synthesis, and cellular regeneration. Low-level laser therapy influences mitochondrial activity within cells, particularly through stimulation of cytochrome c oxidase in the mitochondrial respiratory chain. By combining these biologically active treatments, the HELPIR protocol aimed to restore physiological balance within injured tissues, stimulate regeneration, and minimise permanent tissue damage following vascular compromise. The HELPIR technique received international attention and several professional awards.

Treacy P. Aesthetic Complications and Other Interesting Cases. Austin Macauley Publishers; 2022.

The DUBLiN Lift

Closely related to this work was the development of the DUBLiN Facelift, a regenerative rejuvenation procedure that shared several biological components with the HELPIR protocol. While HELPIR was designed primarily as a rescue protocol for complications, the DUBLiN Facelift was conceived as a proactive regenerative treatment aimed at improving tissue health and promoting long-term skin rejuvenation. The technique integrates growth factors from platelet-rich plasma (PRP) together with stem-cell-derived exosome solutions, supporting tissue regeneration, improving dermal quality, and reducing inflammatory processes associated with ageing. These biological approaches address what is now widely recognised as inflammaging, the chronic low-grade inflammatory state that contributes to progressive tissue degeneration over time.

An additional key component of the protocol was the use of photobiomodulation (PBM). By stimulating mitochondrial cytochrome c oxidase and increasing ATP production, photobiomodulation helps accelerate healing responses, improve microcirculation, and reduce oxidative stress in damaged tissues. Together, the HELPIR protocol and the DUBLiN Facelift represented early clinical exploration of regenerative aesthetic medicine, integrating biologically active therapies, cellular signalling molecules, and light-based mitochondrial stimulation to promote tissue repair rather than simply replacing lost volume.

Treacy P. Aesthetic Complications and Other Interesting Cases. Austin Macauley Publishers; 2022.

Use of High Dose Hyaluronidase

Hyaluronidase, an enzyme that catalyses the degradation of hyaluronic acid within the extracellular matrix, had long been used in other areas of medicine to enhance drug diffusion. Among the physicians who advocated for a more proactive and structured approach was Dr Patrick Treacy, who emphasised that hyaluronidase should be regarded as an essential component of safe filler practice. At the International Master Course on Aging Skin (IMCAS) in Paris in 2005, he discussed the importance of hyaluronidase dosing as necessary to restore perfusion and dissolve the obstructing filler material. He further developed these ideas at the Las Vegas Aesthetic Conference in 2007. Lower doses of hyaluronidase were recommended for aesthetic corrections, such as overcorrection, superficial nodules, or minor asymmetries. By differentiating between therapeutic dosing for complications and emergency dosing for vascular events, he helped frame a more rational and safety-oriented approach to filler reversal. By 2012, physicians in Moscow who had adopted this approach reportedly began referring informally to the emergency management strategy as the "Treacy Protocol." A major step toward standardisation came with the publication of DeLorenzi's influential paper in 2017, which reinforced the concept that high-dose, repeated hyaluronidase administration is essential in managing vascular compromise.

Kroumpouzos G, Treacy P. Hyaluronidase for dermal filler complications: Review of applications and dosage recommendations. JMIR Dermatology. 2024;7:e50403. doi:10.2196/50403.

Methotrexate and Tissue Nodules

Adverse reactions associated with injectable aesthetic treatments have increasingly been reported in recent years. Many of these complications are centred on hyaluronic acid (HA) dermal fillers and poly-L-lactic acid (PLLA) collagen stimulators, which under normal circumstances rarely produce persistent side effects. Nevertheless, as injectable materials, these represent foreign bodies within the dermis, and in some individuals they may trigger immune-mediated reactions.

Some patients may develop Type I hypersensitivity reactions following either initial or repeated exposure to injected filler materials. These reactions may also be precipitated by immune system activation secondary to viral or bacterial infections. Delayed hypersensitivity reactions may also occur. These are typically T-lymphocyte mediated rather than antibody mediated. Clinically, these reactions manifest as induration, erythema, and oedema, sometimes resulting in the formation of persistent nodules. Hyaluronic acid fillers vary significantly in their elastic modulus (G'). In addition to HA fillers, several biostimulatory fillers are designed to induce collagen production, including Calcium hydroxylapatite (CaHA) – Radiesse® and Poly-L-lactic acid (PLLA) – Sculptra®. Calcium hydroxylapatite consists of synthetic CaHA microspheres suspended in a carrier gel, stimulating neocollagenesis with a typical duration of effect of approximately 15 months.

Treacy P. Treating COVID-19 vaccine-related nodules with methotrexate. PRIME Journal. November–December 2022. Published November 14, 2022.

The Retrobulbar technique vs the Supraorbital technique

Two principal methods have been proposed to deliver hyaluronidase in order to reverse vascular occlusion: the retrobulbar technique and the supraorbital technique. The retrobulbar method involves injecting hyaluronidase into the retrobulbar space behind the globe, typically performed by an ophthalmologist. However, this technique requires specialised expertise and carries risks including globe perforation, optic nerve injury, and retrobulbar haemorrhage.

In contrast, Dr Patrick Treacy has advocated the supraorbital approach, which involves injecting hyaluronidase into the supraorbital artery at the supraorbital notch along the superior orbital rim. In lectures to the Royal College of Ophthalmologists in London, Dr Treacy emphasised that physicians must understand the vascular anatomy of the face and orbit and should target proximal feeding vessels when distal embolised vessels cannot be directly accessed. The rationale is that perivascular hyaluronidase can diffuse across vessel walls and be carried forward by arterial flow. Dr Treacy has suggested that injection around the supraorbital artery is a relatively simple and safe technique that could be taught to physicians performing injectable procedures. Some fascinating work has been done by Ha Hong Nguyen at Viet Duc University Hospital, Hanoi, where cases of dermal filler–induced blindness have been treated using an angiography-guided intra-arterial approach, with direct catheterisation through the carotid circulation to the ophthalmic artery and delivery of hyaluronidase with thrombolytic agents, resulting in reported visual recovery in selected cases.

Treacy, P. (2023) 'Reversing dermal filler blindness', Aesthetic Medicine, June.

Books by Dr Patrick Treacy

Dr Patrick Treacy's writing reflects a distinctive intersection between scientific inquiry and lived medical experience. Throughout his career he has not only contributed extensively to clinical research but has also explored the deeper personal and philosophical dimensions of medical practice. His books often examine how the life of a physician is shaped not only by technical training but also by the experiences, challenges, and ethical decisions encountered throughout a medical career. Themes such as perseverance, resilience, professional purpose, and the responsibilities of physicians to their patients and society frequently appear in his work.

1. Behind the Mask: The Extraordinary Story of the Irishman Who Became Michael Jackson's Doctor (2015) – A memoir describing Treacy's career, experiences in medicine, and his association with Michael Jackson.
2. The Needle and the Damage Done (2021) – A reflective narrative exploring experiences in aesthetic medicine and the challenges of modern cosmetic procedures.
3. Pandemics (2024) – A book examining infectious disease outbreaks and their broader implications for society and medicine.
4. Don't Give Up on Your Dreams: Or They'll Give Up on You (2024) – A motivational and autobiographical reflection on resilience, setbacks, and pursuing one's purpose.
5. Destinations – A travel-influenced narrative drawing on Treacy's experiences around the world.
6. Prevention and Management of Aesthetic Complications (2022) – A medical text addressing complications in aesthetic procedures and their clinical management.

These narrative works are complemented by a substantial body of academic scholarship. Dr Treacy has authored more than 150 scientific papers, clinical studies, and medical publications, many of which focus on innovations in dermatology, regenerative medicine, laser therapies, platelet-rich plasma (PRP), stem cell applications, and the safety of aesthetic procedures.