A hot, new beauty treatment driving tens of millions of dollars in sales around the globe is now aiming for the US market. Its unusual ingredient: skin from dead Americans.

Each year, tens of thousands of Americans donate bodily tissue upon their deaths, generally by checking a box at a motor vehicle department or through an authorization made by a loved one. Over the past few years, tens of millions of dollars' worth of donated skin has traveled from American tissue banks to biotech companies in South Korea, the beauty capital of the world. There, among other uses, it is turned into injectable beauty treatments.

The maker of the market-leading Korean brand said last week it has signed a distribution contract to introduce its skin-derived injection to the US market next year. It isn't clear whether the product can be sold in the US without approval from federal regulators.

Business Insider traced the tissue supply chain to understand how donor tissue from, say, San Antonio can end up for sale at a clinic in Seoul — and how much money is being made along the way.

People who donate tissue "have no idea of how much money is changing hands in the course of all of this," Ana Iltis, a professor at Wake Forest and former president of the American Society for Bioethics and Humanities, told Business Insider. "With tissue donation, there's a lot of money at stake."

Donors and their families can't be paid for organ or tissue donations under US law.

A K-beauty trend

For decades, American plastic surgeons have used products made from human tissue for skin grafts and reconstructive surgeries. That practice includes aesthetic uses — such as cartilage for a nose job or skin for a breast augmentation — though many doctors prefer to use the patient's own tissue for such procedures.

Now, skincare treatments made from human tissue can be purchased for a few hundred dollars and administered at a med spa or dermatology clinic in under an hour. In South Korea, a mecca for cutting-edge beauty treatments, at least 10 biotech companies are making or planning to introduce skin-derived injections.

They are the latest generation of a treatment known among beauty obsessives as "skin boosters." Get your algorithm just right, and your social-media feeds will soon be full of before-and-afters showing off the purported benefits of these products. They depict patients, typically women and sometimes young ones, going from dull to dewy, fine-lined to smooth.

This year, the skin-derived injections are projected to generate $75 million in sales in South Korea, according to analysts at Yuanta Securities.

No brand is bigger than Re2O, which one dermatologist on Instagram called "the Love Potion No. 9 for cells." It accounts for between 60% and 70% of sales in the category, according to L&C Bio, its manufacturer.

Re2O notched the equivalent of more than $17 million in sales in the first half of this year, helping swing the company to an operating profit of about $11 million after a loss of about $326,000 in the same period last year, L&C Bio said. It has expanded the product line with Re2O Fine, marketed for more delicate skin, and is planning to launch a human fat-derived filler next year.

The company said it sold 700,000 units of Re2O as of September. It is available in Singapore and China, and has been approved in the United Arab Emirates, Peru, and Thailand.

Last week, L&C Bio said that it has signed a contract to deliver at least $60 million of Re2O to the US over the next five years. The company also said it may explore acquiring US tissue banks with its US distribution partner.

L&C Bio's plan to introduce Re2O to the US could spark a regulatory showdown. L&C Bio has said Re2O falls into a category of products such as skin grafts that don't require approval from the US Food and Drug Administration.

Some products that manufacturers claim qualify to be sold under this category don't actually meet the applicable criteria, the FDA told Business Insider. The agency said it wouldn't discuss any specific products under investigation.

"Products derived from donor skin that have been decellularized, dried, and ground into a powder for injection as a cosmetic 'skin booster' may raise significant questions" and may have to go through a more complex regulatory approval process, the agency said.

L&C Bio said it wouldn't comment on its discussions with regulators.

Re2O's biggest competitor, CellREDM, came onto the South Korean market in late 2025. It has been such a success that in the quarter ended June 30, operating income for its maker, Hans Biomed, soared to over $3 million after barely eking out a profit in the year-earlier period.

The tissue business

"In the human tissue business, access to raw materials is the lifeblood of the industry," L&C Bio's founder and CEO, Whan Chul Lee, said in Korean in a February interview with a South Korean news outlet.

For his company and its competitors, that lifeblood flows from the United States.

Roughly 90% of all the human tissue used in South Korea is imported, according to South Korea's Ministry of Food and Drug Safety. Less than 4% of South Korean adults are registered to donate organs, and even fewer donate tissue. Korean biotech companies have turned primarily to the US, where well over half of adults are registered donors.

Cadaver skin is collected in the US by organ procurement organizations, known as OPOs, and tissue banks. In the transplant system, skin is treated as a tissue, not an organ.

After tissue is collected, its route can vary. A nonprofit OPO often transfers it to an American tissue bank. The tissue bank pays a fee to the OPO, depending on factors like the amount and quality of tissue recovered. The fee covers the cost of the tissue recovery as well as a margin that supports other programs offered by the OPO.

Tissue banks — which can be nonprofit or for-profit entities — supply donor skin to Korean biotech firms.

Much of the US skin supplied to South Korea is used for more traditional medical purposes, like skin grafts for burn victims. L&C Bio makes such therapeutic products and says it prioritizes supply for them.

L&C Bio spent more than $25 million on donor skin from US tissue banks between 2023 and 2025 and $3.8 million in the first half of this year, according to corporate filings. The company told Business Insider that a quarter of its skin supply is used to make Re2O.

Organ distribution is coordinated by a public-private partnership with the federal government. Tissue is handled differently. It is distributed through commercial relationships.

The more traditional business aspects of the tissue industry have been a subject of debate since the federal law governing America's organ recovery and distribution system was enacted in the 1980s. In a system that relies on altruism, money changing hands could affect public trust, Jerold Mande, who helped write the National Organ Transplant Act, told Business Insider.

There is little data on American attitudes toward tissue donation. A survey of more than 1,000 families of donors in the US published in a 2010 academic journal found less than 30% said they thought it was acceptable for donated tissues to be processed and distributed by for-profit companies.

Revenue from tissue, primarily skin and bone, drove 93% of American OPO profits between 2013 and 2017, or a total of about $107 million per year in profit at 51 OPOs, according to a study in the medical journal Transplantation. The Association of Organ Procurement Organizations called the study outdated, said the money collected for tissue helps fund other life-saving work, and objected to the study's use of the word "profit."

"Reimbursed funds go directly back into the organization, supporting organ procurement as well as aftercare programs for donor families such as bereavement support and grief counseling," said Jenny Daigle, a spokesperson for the Association of Organ Procurement Organizations. Organizations must have a margin and reserves to remain financially stable, she added.

Human tissue donations help millions of people in the US each year, including skin for burn victims, bone for cancer survivors, and eyes for the visually impaired, Daigle said.

Regenerative Biologics, a Florida tissue bank, provides all the skin for Re2O, L&C Bio confirmed to Business Insider.

Regenerative's CEO, Sandy McCann, said her tissue bank acts as an intermediary, supplying skin collected by other organizations, and provides L&C Bio only with skin from donors who have given consent for international and cosmetic use. If other American tissue banks have skin that they can't use, "many times we can place it where someone can," she said.

Regenerative had just over $16 million in annual revenue in 2024 and 2025, according to reports filed with a Florida regulator.

By reviewing South Korean government records and images of product packaging, Business Insider identified two other US tissue banks, South Texas Blood and Tissue and RTI Surgical, that supply tissue for skin-derived injectable beauty treatments made by Korean companies.

South Texas Blood & Tissue supplies skin used to make South Korea's No. 2 brand, CellREDM. The tissue bank is based in San Antonio, sometimes called "Military City, USA" because of the large military base there. Educational materials on the tissue bank's website say that donor skin "heals patients suffering from burns or other traumatic wounds, and in reconstructive surgeries, including those wounded during military service."

South Texas Blood & Tissue said each of its tissue donors helps an average of 75 recipients. International distribution and commercial use are longstanding practices in the tissue industry, the group said. Tissue donor families have the option to decline cosmetic, international, or research use, the group added.

"Our top priority is to serve as good stewards of these tissue donations, and to ensure that all tissue we recover has the greatest impact possible," it said.

RTI, a Florida tissue bank that does business as Evergen, said it transfers a small amount of unprocessed donor skin to DOF, a tissue bank in South Korea that manufactures the skin-derived injection product Juveacell. RTI added that it is "dedicated to honoring the generosity of donors and their families."

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• Today's tip to get better at work: Get better at handling disagreements at work.
• Jeff Bezos wrote about his '"disagree and commit" strategy in a 2016 Amazon shareholder letter.
• Make your case, but once a decision is made, commit to the decision, even if you disagree.

Get better at: Disagreements

Today's move

In an era where leaders want to move quickly, you don't want to be the one slowing everyone down.

Jeff Bezos, the billionaire founder of Amazon, wrote about the phrase "disagree and commit" in a 2016 Amazon shareholder letter under a section labeled "High-Velocity Decision Making," and it's been making a comeback.

While Bezos popularized the phrase, it echoes a management philosophy that goes back to the 1980s, when Andy Grove ran Intel. Richard S. Tedlow, Grove's biographer, previously told BI that the concept of disagreeing and committing "was the essence of how he felt you should comport yourself at Intel."

Why it works

The idea behind "disagree and commit" is to defend your argument and make a clear case. However, if the team rallies around a different decision, you have to commit to it too. Bezos argued that the use of "disagree and commit" could "save a lot of time."

"If you have conviction on a particular direction even though there's no consensus, it's helpful to say, 'Look, I know we disagree on this but will you gamble with me on it? Disagree and commit?'" Bezos wrote.

The former Amazon CEO has even used it himself, such as when his team green-lit an Amazon Studios project that he didn't think would succeed. Instead of continuing the back-and-forth, he disagreed but committed to the plan.

Try it today

The next time you disagree with a coworker, make the case for your idea and give it your all.

Once the decision is made, though, ask yourself if there's anything you can do to help it work better.

The bottom line

You don't need to agree with every decision at your job, but everyone benefits if there's an expectation that once a decision is made, everyone rallies behind it and tries to make it work.

Source

This insight is drawn from Business Insider's reporting about the origins of the "disagree and commit" phrase that Jeff Bezos popularized, and why it's making a comeback. Read the full story in Business Insider from Ana Altchek and Tim Paradis here.

Has this framework for disagreements worked for you? Tell us what you think of this advice in the comments below.

Donald Knierim planned his retirement around student-loan forgiveness.

He spent most of his career designing financial data systems for major companies. At the age of 60, he took a pay cut and moved to the public sector, working for Metra, Chicago's commuter railway. His primary draw to the job was lower stress, and an added bonus was that it qualified for the Public Service Loan Forgiveness program, which erases student debt for government and nonprofit workers after 10 years.

Knierim had a $62,000 balance remaining on the student loans he took out to send his kids to college. If all went according to plan, a decade at Metra would wipe that clean.

In November 2025, the now-71-year-old logged on to his Federal Student Aid dashboard. It read "Congratulations! You've satisfied your obligation, and no additional payments are required for this loan." That tracked — Knierim said he had never missed a payment, always verifying that his payments were counting toward his forgiveness progress. So he put in his notice and retired.

Months later, he received an update: 15 payments that had previously counted toward forgiveness were changed to "non-qualifying." The notice said his payments were below the amount required under his income-driven repayment plan, but did not specify the proper amount. That means he has at least another year and a half of payments — about $470 monthly — to achieve PSLF.

"If I have to restore that payment, it's going to put my wife and me in a bad situation," Knierim said. "We're too tight in retirement to be shelling out money for stuff that we can't afford."

Since 2023, Business Insider has heard from student-loan borrowers whose loan forgiveness was rescinded. Over the past few months, issues with PSLF have become more widespread, with borrowers reporting challenges in receiving accurate payment counts. Some had their payments toward forgiveness removed after the Department of Education said it was correcting accounts following Biden-era coding errors.

An Education Department spokesperson said that the agency "remains committed to ensuring that every qualifying payment is properly credited to a borrower's account."

Knierim said that even if he could land a new public service job, he wouldn't be able to take it. Caring for his wife, who is facing serious health issues, is a full-time job. He has reached out to his servicer and filed multiple complaints with Federal Student Aid, requesting his payments to be returned to a qualifying status. Meanwhile, he has not made the new payments his servicer said were due, which has lowered his credit score by more than 200 points. He recently received a notice that his account is delinquent and at risk of default, putting him at risk of seizure of federal benefits, like the Social Security he relies on to stay afloat.

Now, he's asking for the initial communication he received from his student-loan servicer to be honored.

"I thought I was done, they gave me that notification that I was done, and then they clawed it back," Knierim said. "I didn't know where that came from, or what to do."

An error-riddled student-loan forgiveness program

There are a few reasons a borrower might get their PSLF notices rescinded. An internal Education Department memo from 2023, reviewed by Business Insider, said that servicer MOHELA erroneously discharged loans for 64 student-loan borrowers "due to inadequate staff training." The memo recommended that MOHELA send notices to affected borrowers explaining what had happened.

In 2023, one borrower received a notice that his loans had been discharged under PSLF. Nine months later, he received a notice that the forgiveness was a mistake, and his payments were restarted. Between those two notices, the borrower said he had bought a home and paid for his son's preschool. The reversal required him to reconfigure his family's budget.

More recently, the Trump administration removed some PSLF borrowers' qualifying payments, with the Education Department citing Biden-era code errors that "resulted in inaccurate payment counts for some borrowers."

Bonnie Latrielle, an official in the Education Department's Federal Student Aid office under former President Joe Biden, said PSLF errors often arise during communication between the Education Department and servicers; servicers report qualifying PSLF payments to the department, and the department matches that information with a borrower's employment records to determine if the borrower is PSLF eligible.

"Those are all things that are outside of the borrower's control," Latrielle said.

Knierim said his servicer told him that some of the payments he made toward the Temporary Expanded PSLF program — a Biden-era program that allowed payments previously deemed ineligible to count toward forgiveness — did not qualify because they were below the required amount. He said he did not receive any further explanation as to why his payment amounts did not qualify, despite following his servicer's guidance on reaching forgiveness.

"I have a flawless payment history," Knierim said. "I have never missed a payment, and I paid what they told me to pay."

From relief to repayment

The Education Department has a "stated policy of holding borrowers harmless," Latrielle said, and borrowers have the right to submit complaints to the department's ombudsman if they have been harmed by their servicer.

However, amid staffing cuts in the department as part of the Trump administration's plan to dismantle the agency, it has stopped monitoring servicer performance and routine borrower complaints. Latrielle said a growing number of states have student-loan ombudsmen and a borrower bill of rights, offering resources and protections for borrowers within the state. Borrowers can also file lawsuits against their servicer if it violates state law, Latreille said.

Knierim, with the help of his daughter, an attorney, sent a letter to his servicer offering to pay the shortfall in his monthly payments. He said the letter was never acknowledged. He does not want to resume payments or switch repayment plans if doing so could further complicate his progress toward forgiveness. Still, his account is also inching toward default, and finding a resolution is becoming more urgent.

In September, eight state student-loan ombudsman offices, including those from Massachusetts, California, and Illinois, where Knierim lives, sent a letter to the Education Department and congressional leaders calling for stronger oversight of PSLF. They cited an example of a public service worker who had more than the required number of payments for forgiveness, but his progress tracker was reset to zero.

"Borrowers have received no clear explanations for individual reductions, making it difficult to verify the accuracy of the new totals, even though these retroactive adjustments can delay forgiveness by years," the letter said.

Knierim is still searching for clarity on where his student-loan forgiveness stands. He said he recently spoke with a Federal Student Aid representative who told him that a "reconsideration request" for the payment denial is in progress. That process could take up to two months, Knierim said he was told, and in the meantime, he's seeking to put his loans on forbearance until he gets a final answer.

"I kept getting different answers," Knierim said. "I can't go back and work. I have no recourse here."

Have a story to share about student loans? Contact this reporter at asheffey@businessinsider.com.

After 20 years of balancing her corporate leadership roles with motherhood, Trisha Daab was ready for a break.

"Life had felt like sprinting a marathon for as long as I could remember," Daab, 47, told Business Insider. "I had no idea how tired I was until I stopped working."

In her year off, she tap danced, volunteered at a food bank, traveled to Disneyland and Alaska, and spent more time with her kids. By the end, she had decided she couldn't go back to her old life.

"My job often demanded that it came first — never-ending to-do lists, urgent emails, travel, and always chasing the next promotion," Daab, who's now a travel writer and substitute teacher, said. "Stepping away helped me realize my priorities had shifted."

Now in their 30s and 40s, many millennial women are skeptical of corporate and instead becoming business owners, content creators, and mothers, prioritizing more flexible work schedules. Instead of striving to get to the top, they're inverting Sheryl Sandberg's mantra of the 2010s — and leaning out.

Sandberg, Meta's former COO, told Business Insider that the corporate exodus is due to women feeling undervalued at work.

"This is not the women who are saying, 'I don't want to do it,'" Sandberg, 57, said. "It's the women saying, 'I don't want to do it because I'm not wanted, I'm not getting the same opportunities and the same support, and I face an unfair burden at home.'"

Even Lean In, the organization founded by Sandberg and named after her 2013 bestselling book, is noticing a recent shift in women's ambitions in the workforce.

According to the organization's 2025 Women in the Workplace report, published in December 2025, which surveyed 9,500 US employees across 124 organizations, women were less likely to say they wanted a promotion compared to men. This was true when filtered to include only millennials, who made up roughly one-third of participants.

When asked why, over 28% of millennial women said "personal obligations" made it hard for them to take on more — compared to 17% of millennial men.

Annie Wright, a licensed psychotherapist who works with Silicon Valley leaders, has also observed more of her millennial female patients shifting their ideas about what constitutes a fulfilling career.

"I'm watching them make more person-centered choices than necessarily career-only-driven choices," she told Business Insider. "I don't think many millennial women are becoming less ambitious. I think they're just becoming less willing to confuse ambition with self-erasure."

The rise and fall of the have-it-all girlboss

Let's, for a moment, remember what is now referred to as the "girlboss era" of the 2010s.

It was a time of She-E-O-led startups, of crushed velvet sofas and the words "I Want It All" aglow in cursive neon lettering. Of earnest enjoyment of "Fight Song" and T-shirts with earnest phrases like "feminist" and "woman up."

Of a future that was female, tinged millennial pink — until a series of public reckonings punctured the fantasy. Leaders of several companies stepped down amid allegations of toxic workplace cultures, exposing the facade of the girlboss promise.

Then came the remote work culture of 2020. Suddenly, many women had time to breathe, whether that meant not rushing to day care pickup, having more time to work out or see friends, or simply not being "on" all the time.

For some, the slowly creeping requirement to return to the office dealt the final blow.

Misty Heggeness, a professor at the University of Kansas specializing in gender economics, described the influx of new RTO policies by some companies as having a "chilling effect."

"That does disproportionately disadvantage women in general," Heggeness told Business Insider, "just because women are more likely to carry an invisible load of work within families."

The working mom paradox

After the birth of her first child, Kendra Rothermel switched from full-time to part-time work as an office manager while her husband remained at his full-time job. "As we grew our family, it made sense for me to have a more flexible schedule," Rothermel, 34, told Business Insider.

When she had her third baby, his clubfoot diagnosis meant frequent orthopedic appointments. Even part-time work wasn't flexible enough, so she eventually started her own venture helping small businesses with operations and marketing.

Rothermel said she was partly inspired by watching other working moms do the same.

A recent analysis of job-market data by Matthew Nestler, a senior economist at KPMG, found that labor force participation between December 2023 and May 2026 decreased among college-educated women with children under 5. Meanwhile, participation increased for women without children and most groups of men, including fathers.

Because millennials are generally having kids later than previous generations did, Heggeness said parents, moms in particular, are more likely to be parenting young children just as their work responsibilities are ramping up.

"If they were going to lean out, now would be the time," she said, whether it's to save on childcare costs or introduce more flexibility.

Add to the list aging parents. The costs of childcare and eldercare, sometimes unaffordable even with the intense work commitments required to afford them, have prompted some women to leave their full-time jobs for more flexible or minimum-wage work.

To Sandberg, it's a sign that companies are not adequately adjusting to meet women where they are, whether that's offering more flexible hours, longer parental or bereavement leave options, or better healthcare coverage.

"We're at a critical moment in time for women, because what a lot of women are seeing is that commitment to them in leadership pulling back," Sandberg said. "Then what's happening to them is their ambition is pulling back. And that's a loss. It's a loss for our economy. It's a loss for our companies. It's a loss for our children."

The allure of going at it alone

Not all women who are leaning out are doing so because they are overworked. Some, like Heigi Jeong, 30, have dreams beyond corporate America.

"While I wouldn't say I loved the work, I liked it," Jeong, who made $173,000 working in product design, told Business Insider. "It was my dream job as an immigrant, and it was sustainable."

Still, Jeong was pulled toward her other ambitions: writing a book and being a content creator. She was also intrigued by the idea of being her own boss.

"When I'm working for myself, I entirely choose the role I will play," Jeong said. "I wanted to experience it myself and have my own take rather than constantly wondering 'What if I quit?'"

Three months after quitting, she enjoys not feeling as rushed as she used to, even if the price is an inconsistent income.

Both Heggeness and Wright have noted a growing interest in entrepreneurship and self-employment among women. A 2024 Census working paper found that the share of women business owners under 45 rose between 2012 and 2020, with the biggest increase among women ages 25 to 34. It also found that newer women-owned employer businesses were disproportionately owned by women under 35.

The creator economy opened another path. More than 200 million people worldwide now identify as content creators, though that broad figure includes far more than full-time influencers. Some Gen Z and millennial consultants are even leaving MBB and Big Four firms to build audiences and businesses online — trading the girlboss crown for a bubble headband.

In a 2023 Vogue article, writer Daisy Jones wrote that the newest iteration of girlboss swaps grind culture with the similarly perfectionistic "soft life" defined by travel and lucrative brand deals. Pantsuits were exchanged for sweatpants; speaking engagements and spread-thin multitasking gave way to self-care and supplement stacks.

"In some ways, the career woman appears to have been replaced by the health-conscious woman," Jones wrote, "the one who prioritizes her vitamin intake, hydration, and sleep cycle over endless meetings and salary increases."

Content creation doesn't come without its own costs. Plenty of influencers report feeling financially insecure or overworked, unable to take a day off without losing money.

Still, if they're going to burn out or worry about their job security, some figure they might as well enjoy their autonomy to create their own schedules.

"For some women, there's been a paradigm shift in values," Wright said. "Promotion or success now looks like more availability, presence, and freedom."

When everyone leans out

Sandberg, who herself stepped down as Meta's COO in 2022 to pursue philanthropy and early-stage investing ventures, said she supports women's career choices, whatever they may be.

"I think being at home with your children is great," she said. "Going back to school, great. Starting a company, great. Going part-time, great. Anything you want to do is great."

Part of the issue, she said, is that without female leaders, there are simply fewer people to advocate for the very policies that make other women more excited to move up in a company, be it egg-freezing coverage, lactation rooms, or more competitive maternity leave options.

It's why she feels companies need to do more work to assess why women are leaning out enough to jump ship entirely. "It's easy to overly characterize the words 'lean in,'" she said. "What I mean by them is very clear: I think women should make decisions based on believing in their own abilities, based on believing that they should and can have the same opportunities as men."

It's just a shame, she continued, if the decision stems from not feeling valued enough in the corporate world.

"I just hope that enough women want those senior leadership roles," she said, "that we get the environment for women that they deserve."