Biostimulation consists of stimulation of collagen production by the body, through the injection of exogenous substances such as calcium hydroxyapatite, poly-L-lactic acid or physical methods such as microneedling, radiofrequency, micro-focused ultrasound or laser.
Injectable methods are currently the most popular. They can be applied for volumizing and improving the texture of facial and body skin, sagging skin and cellulite treatment, often in conjunction with physical methods.
The injection of calcium hydroxyapatite (CaHA) is one of the most used techniques, the most used product being Radiesse® (Laboratorios Merz). This substance, composed of calcium and phosphate microspheres, exists naturally in human bones and teeth, having found its first use in orthopedic, otorhinolaryngological and dental applications.
In addition to the volumizing effect, CaHA stimulates the production of endogenous collagen (neocolagenesis) and elastin by stimulating fibroblasts in the skin. After a few months (12-24 in the majority of cases), the microspheres are completely reabsorbed through phagocytosis by macrophages naturally present in the tissues, maintaining the collagen network that provides structural support to the tissues and improves the quality of the skin.
Another substance used is Sculptra® (Galderma) or Lenisna® (VAIM CO.), Poly-L-lactic acid, the latter also containing hyaluronic acid. With a similar injection mode after dilution, they have a duration and effect similar to CaHA, and are still used as volumizers in certain procedures such as non-surgical gluteus augmentation. The degradation products are carbon dioxide and water, excreted through the lungs and urine.
Techniques with injectables have very satisfactory results, with immediate volumizing and a stimulating effect expected between 3 to 6 months, where more than one treatment session may be necessary. The expected duration of the therapeutic effect is estimated at 12 to 24 months.