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[5 min read] Biostimulator fillers in primary care

Minimally invasive and non-invasive cosmetic interventions are the best option for primary care practitioners looking to expand their portfolio of services. Injectables, such as Botulinum toxin injections, dermal fillers, and biostimulators, top the list of popular treatments.

The latter is becoming increasingly fashionable. Therefore, it has the potential to make one primary care practice stand out among others.

For further information on this topic, you may be interested to learn more about the HealthCert Professional Diploma program in Aesthetic Medicine.

The advance in aesthetic medicine in recent decades has made cosmetic procedures much less invasive, safer, and more affordable. Plastic surgery is no longer a synonym for aesthetic interventions.

Due to all that, many more people are considering treatments, such as biostimulator fillers. Adding such services allows primary care practitioners to expand their patient base and increase patient satisfaction while making additional profit.

To achieve this, doctors require adequate training. Also, the facilities for cosmetic procedures must meet all the criteria for safe treatment and high-quality outcomes.

What are biostimulator fillers?

Biostimulators do not differ much from other dermal fillers, such as hyaluronic acid when it comes to application. However, biostimulator injections work differently. They boost the natural production of elastin and collagen within the skin and underlying facial tissues for several months after application.

The results are not always instantly visible, but the rejuvenation effects of biostimulator fillers are thorough and far-reaching.

Types of biostimulator fillers

Not all biostimulator injections are fillers. For example, PRP (Platelet-rich Plasma) and PRF (Platelet-rich Fibrin) are also biostimulators. However, they lack the re-volumising effect of dermal fillers.

The two most popular active ingredients in biostimulator fillers are:

  1. Calcium hydroxylapatite (CaHA), and
  2. Poly-L-lactic acid (PLLA)

CaHA is a component of collagen. Its absorption into the skin promotes natural collagen production. In addition to these long-term effects, CaHA fillers also restore volume and improve the appearance of facial contours immediately after injection.

PLLA fillers lack this immediate skin-lifting effect. However, their application results in the longest-lasting improvements (up to two years). It usually takes three consecutive treatments to enable maximum results.

*The CaHA and PLLA fillers are currently available under different brand names.

Treatment outcomes

The efficacy, tolerability, and safety of biostimulators are comparable to Hyaluronic Acid. The boost of collagen production that results from Biostimulation is long-lasting. The results are best visible in facial rejuvenation. More so in less mobile areas, such as nasolabial folds.

Unlike Hyaluronic Acid, the effects of biostimulator fillers are not fully reversible. Therefore, the suggestion is to avoid their application in delicate areas where complications are more likely to occur. That includes the lips and the periocular region.

The comparison between biostimulator fillers and Hyaluronic Acid is necessary to understand their possibilities and limitations. Everything shows that the two treatments work best together for pan-facial rejuvenation. So, both procedures should be available at the same primary care facility.

Qualification and facility requirements

Doctors in primary care with adequate knowledge of facial anatomy and training in injectable cosmetic techniques can apply biostimulator fillers in a well-equipped procedure room or doctor’s office.

– Dr Rosmy De Barros

Read another article like this one: Treating hyperhidrosis with Botulinum toxin


  • Goldie K, Peeters W, Alghoul M, et al. Global Consensus Guidelines for the Injection of Diluted and Hyperdiluted Calcium Hydroxylapatite for Skin Tightening [published correction appears in Dermatol Surg. 2019 Feb;45(2):327]. Dermatol Surg. 2018;44 Suppl 1:S32-S41. doi:10.1097/DSS.0000000000001685
  • Schierle CF, Casas LA. Nonsurgical rejuvenation of the aging face with injectable poly-L-lactic acid for restoration of soft tissue volume. Aesthet Surg J. 2011;31(1):95-109. doi:10.1177/1090820X10391213
  • Christen MO. Collagen Stimulators in Body Applications: A Review Focused on Poly-L-Lactic Acid (PLLA). Clin Cosmet Investig Dermatol. 2022 Jun 21;15:997-1019. doi: 10.2147/CCID.S359813. PMID: 35761856; PMCID: PMC9233565.
  • Felix Bravo B, Bezerra de Menezes Penedo L, de Melo Carvalho R, Amante Miot H, Calomeni Elias M. Improvement of Facial Skin Laxity by a Combined Technique With Hyaluronic Acid and Calcium Hydroxylapatite Fillers: A Clinical and Ultrasonography Analysis. J Drugs Dermatol. 2022;21(1):102-106. doi:10.36849/JDD.2022.6333

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