Biostimulator fillers seem to be on the rise and gaining popularity rapidly.

We are seeing many more enquiries for these fillers compared to years gone by, including from patients prepared to travel some distance who want to have the initial consultation and treatment on the same day, especially with poly-L-lactic acid. Due to Australian AHPRA regulations, we are not permitted to use drug names here.

Invariably, the answer to consultation for a new patient and treatment on the same day is a no. Why is that, especially if they are coming from some distance?

Read on to find out!

There are two main brands of biostimulator fillers on offer at Skin Essentials, brand S and brand R. The one we are discussing here, is brand S 

The aging process catches up with us all eventually, as seen in the loss of skin elasticity, sagging as well as (deep) lines, wrinkles and seemingly enlarged pores. The bulk of these skin changes are due to progressive collagen loss over the years: 

• we begin to lose around 1% of collagen production from our mid 20s
• for women, the menopausal process accelerates this through loss of oestrogen, with an estimated 30% collagen loss over 5 years
• thereafter, collagen loss continues at an accelated rate in women at 2% per year
• by age 70, it is estimated we’ve lost 80% of our collagen producing capabilities 

So in addition to bony changes with ageing, most prominent around our eyes, our jawlines and around our mouths, thinning and sagging skin due to collagen loss over time contributes in large part to the loss of youthful glow in most of us. 

This is why, beyond volume replacement, rejuvenation and maintenance should rightly shift to collagen induction and maintenance of healthy, supple skin in a variety of ways. 

So what is this brand of biostimulatory filler and how does it work? 

1. Full Face Rejuvenation 

• it is an injectable powder that is made up to form a solution that is injected into the skin where it stimulates collagen production
• it is usually an initial series of 3-4  treatments a month apart
• results are gradual, from around 6 weeks, look natural and last longer than most other injectables, as it is your own collagen. In studies, results lasted at least 25 months
• by inducing collagen production, this product works to restore some of the underlying structure of the face/ body that has become gaunt due to significant volume loss and improves skin radiance by thickening skin quality
• the added fullness, over time, improves the appearance of fine lines, wrinkles and folds. Bony areas can be softened and gaunt areas of the face, such as under the cheeks, and temples, can be rejuvenated also. 

2. No PillowFace 

• the initial course recommended is 3-4 treatments a month apart over areas of the face that need the volume and skin improvement
• thereafter, maintenance is recommended with a single session annually
• unlike hyaluronic acid based dermal fillers, which can look overfilled, this is not possible with biostimulatory fillers, which can only stimulate your own collagen production, done well 

3. Long Lasting Results 

• in studies, treatment with biostimulatory filler lasted at least 25 months, and likely longer.
• because it stimulates your own collagen production, with care to protect and maintain this collagen, the results are much longer lasting than many other treatments. 

4. Low Maintenance Treatment Option 

• initial treatment is a series of 3-4 monthly sessions with a significant cost depending on how many vials are used
• thereafter, maintenance is a single annual session
• this is a great option for the face, crepey skin in the neck as well as décolleté and hands 

Sold? Great, so why can’t you have it on the same day as the consultation, especially if you’re already familiar with it via Google? 

1. Adequate informed consent is key 

• Results depend on the injector and their skill but no outcome can be guaranteed as the medication relies on your collagen induction powers AND your compliance with instructions 
• training for biostimulator fillers is not as common as with hyaluronic acid fillers.
• they’re also more expensive than hyaluronic acid fillers, especially for the initial course of treatments in terms of time commitment, consistency and budget
• this is not a treatment to be having with a new injector (or a new patient whom I do not know well) 

2. Biostimulator Fillers are not reversible 

• unlike hyaluronic acid fillers, which can be reversed in the event of an adverse outcome, all biostimulatory fillers are not reversible in the event of an unexpected side effect or if you do not like the result 

3. There is some aftercare needed and some side effects are reliant on aftercare 

• with this biostimulatory filler, I advise people to massage the treated area 5 times a day for 5 minutes, for 5 days, firmly.
• I show them how to do this to distribute the filler evenly among the tissue where it was injected, unlike with hyaluronic acid fillers
• lack of attention to this, rarely, may lead to nodules that need to be surgically 

4. Results are gradual, over months 

• patients need to understand this
• they need to commit to the initial 3-4 sessions monthly and budget for it as delays will lead to a suboptimal result
• they need to understand aftercare and commit to it to minimise risk of adverse outcomes 

5. It needs preparation prior to injection

• because it is prepared as a powder, it needs to be diluted and prepared with adequate mixing at least 24 hours prior to injection, preferably slightly longer.
• at Skin Essentials, this usually means that we spend our time in consultation addressing your concerns, assessing your suitability for it, and then talking you through what is involved including aftercare and then giving you some time to think about it and decide without any pressure.
• should you decide to go ahead, you’ll be required to pay an upfront non refundable deposit of 50% of the cost of each session before we start preparing the solution and book you in to come in for it another day. 

At Skin Essentials, our focus and priority for all treatments remain your safety and ours, so for all these reasons and many more, we’d prefer to start with all new patients with an open mind, and not rush into treatments unless they are relatively simple and straightforward on the day we first meet you.