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Carey and Pickarts ultrasound study found an average increase in collagen density of ~28% at 12 weeks, with top responders reaching 51%

It's the same as if an anti-biotic was unsuitable for a patient, we don't just prescribe it." This is largely due to the strict code of conduct that physicians must operate by

Poor technique, like vigorous shaking, using the wrong solvent, or ignoring sterility, can cause foaming (which risks oxidation), precipitation (insoluble aggregates), or rapid degradation from bacterial byproducts

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More specifically, the amino acids which are replaced appear to be the 2nd, 8th, 15th, and 27th amino acids