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What are Collagen Biostimulators (with studies)

Disclaimer - This blog is not a medical blog, nor does the author have any training in the area and any doubt or clarification about aesthetic treatments should always be clarified with a specialized Doctor.

For those who don't know, a small part of my work at Studio involves managing social networks and some of my clients are, precisely, doctors in the field of aesthetic medicine. Now this implies that I constantly do research on topics in this area, namely the treatments in vogue today.

One of these treatments is precisely that of collagen biostimulators. And it was about these that I watched last week, at the invitation of a brand, a presentation by some doctors who explained this topic a little better.

But what exactly are collagen biostimulators and what are they used for? Below are answers to some of the most common (and not so common) questions about one of the most sought after cosmetic procedures nowadays.

Note - I did not perform any aesthetic procedure on myself, so all information shared here is the result of research and information collected from brands / laboratories.



1- What are the main active ingredients?

Many popular dermal fillers are made with a substance that occurs naturally in the body and has unique moisture-retaining properties. When injected, these fillers add volume and structural support that smoothes and plumps the skin. They offer immediate results without a long-term commitment. An example of these fillers is the well-known Hyaluronic Acid.

Collagen-stimulating fillers, also known as biostimulators, don't just provide volume – they help the body produce new collagen. These products contain ingredients that stimulate the body's natural collagen production process to restore firm, youthful skin. Results are gradual but longer lasting than mentioned above.

There are currently 3 collagen biostimulators:

  • Polylactic Acid which is a potent biocompatible and resorbable product, that is, it is easily absorbed by the body, without harm, in a safe way. The procedure smoothes tissue damage caused by natural aging, correcting skin thickness and redefining facial contours. It can also be used in areas other than the face, such as the neck, décolleté, arms, abdomen, legs and buttocks.

  • Calcium Hydroxyapatite, which in addition to being an injectable collagen biostimulator, can be used as a filler. It is indicated when volume replacement, lifting effect and contour definition are desired. In addition to the face and neck, it can be performed on other areas of the body, such as the lap, buttocks, hands, arms and belly.

  • Polycaprolactone is a water-based filler and biostimulator with polycaprolactone microspheres, which promotes instant filling and gradually stimulates collagen production. The goal of treatment is the improvement and prevention of sagging and correction of lines and furrows. You can also use it to redefine facial contours for a natural rejuvenating effect.

2- In what areas can they be used??

The treatment can be used in places where you would normally place fillers: lips, puppet lines, cheekbones, chin.

In addition, certain collagen biostimulators can also be used for areas of the body such as buttocks, thighs, hands and décolleté and neck.

3- How many sessions are needed?

A dermal filler procedure can take around 30 minutes. Depending on the area and desired result, more than one session may be necessary, namely when applied to the body.

4- When can you see results?

Collagen biostimulators, unlike other dermal fillers, are a gradual treatment. While there may be a slight improvement in volume shortly after the injection, real results may take weeks. The product needs time to trigger collagen production in the body and restore the skin's underlying structure. This process usually takes four to 10 weeks, with optimal results occurring after three months.

5- How long do results last?

Depending on the collagen biostimulator and the treated area, the result can last up to two years. The lasting benefits of collagen growth will continue to be seen over time. As the body absorbs the product, it also produces its own new collagen to naturally stimulate the skin, even after the filler has dissolved. Retouches will be needed to maintain the results indefinitely.



I also leave some studies on the different collagen biostimulators that have been done so far:

Polycaprolactone: how a well-known, futuristic polymer became an aesthetically innovative collagen stimulator

" The long-term efficacy and duration of action as well as the safety of PCL (Polycaprolactone) filler are confirmed in clinical studies and daily clinical practice worldwide over 10 years. Volume restoration, remodeling and rejuvenation effects provide long-lasting natural results and improved skin quality. The rate of adverse events is low and no unexpected adverse events were reported. (...)

There are differences between collagen stimulators with regard to their effectiveness, duration of action and safety, but no standardized clinical study has been carried out so far to compare them. As an additional perspective, large clinical trials are expected to investigate the effect of PCL filler in other aesthetic applications, including combination treatment and body applications, both of which are current trends in aesthetics, to optimize treatment and enable global rejuvenation.."

- Source

Safety of poly-L-lactic acid (New-Fill®) in the treatment of facial lipoatrophy: a large observational study among HIV positive patients

"This prospective observational study examined the safety of poly-L-lactic acid for the correction of facial lipoatrophy in HIV patients. This was a large study involving over 4,000 courses of treatment, and 15,000 PLLA injection sessions were used to treat patients with severe facial lipoatrophy. A quarter of the patients required five treatment sessions and 82% of the sessions required the use of two vials of PLLA. The subjective efficacy of the treatment was reported as “satisfied” or “very satisfied” by most patients and physicians. The product was well tolerated and the incidence of immediate and non-immediate AEs was acceptable. (...) Less than 3% of PLLA treatments were discontinued due to an adverse event, despite the large number of injections performed, and no new adverse events of PLLA were described. We have demonstrated under real conditions that, in the hands of trained physicians, the treatment of ARV toxicity-induced facial lipoatrophy with poly-L-lactic acid (New Fill®) is feasible, efficient and safe in clinical practice."

- Source

A cross-sectional analysis of adverse events and litigation for injectable fillers

"Of a total of 1748 adverse events included, swelling was the most common complication, followed by infections. The use of calcium hydroxyapatite and nasolabial sulcus injections were significantly associated with intra-arterial injection and necrosis; Inadequate informed consent was the most common factor cited in litigation. (...)

To the best of our knowledge, this study is the most comprehensive analysis of reported complications from filler injections. Although swelling and infection were the most commonly reported events, of the serious complications reported to the FDA, Radiesse® was significantly more likely to result in vascular compromise, and nasal dorsum injections were significantly associated with blindness. Injectors need to have a thorough understanding of filling complications and their proper management. An analysis of disputes involving fillers showed that alleged deficiencies in informed consent were a commonly cited factor. Better communication with patients can improve their understanding of the procedure and potentially reduce litigation."

- Source

Use of calcium hydroxylapatite (Radiesse®) for facial augmentation

"Finally, Radiesse® can be considered an effective soft tissue filler in view of its general advantages. Many published research shows that calcium hydroxyapatite is safe and well tolerated when used properly. Most of the desirable properties of a dermal filler can be achieved with Radiesse®, including acceptable longevity, biocompatibility, low rate of side effects, and reasonable cost-effectiveness."

- Source

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