A biostimulator may help areas that have lost fullness look less hollow.
Consultation-led aesthetic medicine · Brighton & Hove · By appointmentConsultation-led · Brighton
COLLAGEN · VOLUME · SUPPORT
BiostimulatorsSculptra · Radiesse · Juläine
If your face looks less full than it used to, biostimulators can help restore some of that fullness gradually.
At a glance
Volume & support.
Built gradually.
I look at the whole face before deciding where added support could help.
Sculptra, Radiesse and Juläine have different properties and their own evidence.
PLLA develops over weeks and months; Radiesse can also provide some early support.
Quick overviewYour appointment at a glance
- Consultation
- Your first visit is a consultation. Treatment takes place at a separate appointment after a cooling-off period. We discuss the product, alternatives, risks and the change you want.
- Appointment
- Usually 45–60 minutes, including photographs, skin preparation and injections. Numbing and technique depend on the product and area.
- Preparation
- Bring previous treatment records and details of medicines, supplements and any reactions. Preparation instructions are confirmed before treatment; do not stop prescribed medicines yourself.
- Recovery
- Swelling, bruising and tenderness can affect the early appearance. Massage instructions differ: Sculptra uses the clinic’s five-minute, five-times-daily, five-day routine; Juläine and Radiesse have separate advice.
- Course & review
- The result is built in stages. At one visit, I use no more than 1.5 ml of Radiesse or one vial of Sculptra; Juläine has its own plan. We allow time for the response before considering more.
- Fees & booking
- See current Radiesse and Sculptra fees; Juläine pricing is confirmed separately. The fee covers one treatment visit; a scheduled review is not included. Start with a consultation.
Your questions, answered
Your questions about
biostimulators
What collagen biostimulators can restore, how the products differ, and what gradual results and recovery involve.
odNOVA guide
- 1 You
- 2 Piotr
- 3 Clinical
- 4 In depth
Choose a question
What are collagen biostimulators?Piotr answers
Piotr
Biostimulators are injectable treatments that encourage your tissue to make collagen, helping restore support and fullness gradually. Collagen is part of the structure that gives skin and soft tissue their strength.[11][12]
The products have different properties. I choose between them according to the area we want to treat and the kind of change you would like.
How is this different from dermal filler?
Hyaluronic-acid filler is a gel that can provide a more immediate, localised change in volume or shape. With a biostimulator, part of the result develops through your own tissue response over time.
Radiesse also has a gel carrier, so it can provide some immediate support. Another important difference is correction: the enzyme used to dissolve HA filler does not dissolve PLLA or CaHA.
What if my main concern is skin quality?
If your main concern is hydration or surface texture, we can discuss skin boosters, polynucleotides or microneedling. Those options address different concerns from lost facial volume.
How is the product chosen for my treatment?Piotr answers
Piotr
The choice depends on the change needed, the area being treated and the volume already present. Sculptra and Juläine produce a gradual change through your tissue response. Radiesse can also provide some immediate support from its gel carrier.
Previous injections and your response to them also matter when choosing the product and amount.
Compare the three products
Sculptra and Juläine contain poly-L-lactic acid (PLLA); Radiesse contains calcium hydroxylapatite (CaHA) in a gel carrier.
Sculptra has a longer history of clinical use. Juläine is newer, so its published follow-up is shorter.
Sculptra
Established product with longer clinical follow-up. The intended later change develops gradually.
I consider it for fullness lost across the face, including faces that have become noticeably thinner. Early studies of facial fat loss involved people with HIV. We cannot assume that someone having cosmetic treatment will get the same result.[2]
Sculptra: timing and early fullness →Radiesse
Radiesse contains tiny calcium hydroxylapatite (CaHA) particles suspended in a carboxymethylcellulose gel.[15] The gel can provide early support and is gradually absorbed. The particles stimulate collagen production, so further change develops through the tissue’s response.[17]
Radiesse: clinical studies →Juläine
Newer, product-specific evidence for nasolabial folds. Longer follow-up is needed to understand how long the improvement lasts.
Before booking: I explain your individual treatment plan and fee before you decide.
Juläine: the available evidence →Each product has its own treatment course and aftercare.
What can a biostimulator actually improve?Piotr answers
Piotr
A biostimulator may help a face that has lost fullness or support look less hollow and better supported. The change develops gradually, which can suit someone who prefers to build a result over time.
I assess your whole face before choosing an area. At odNOVA I use these treatments for appropriate facial areas, not the lips or immediate under-eye area. They do not remove excess skin or reproduce a surgical lift.
When might another treatment suit me better?
The studies on this page do not cover every facial area. Results measured in the folds between the nose and mouth do not tell us exactly what to expect in other areas.
A precise change in contour may suit hyaluronic-acid filler. Lines caused by facial movement need a different assessment, while substantial loose skin may be better addressed through a surgical opinion.
We start with what you want to change, then choose the treatment that fits.
Can this be combined with other treatments?
Yes, when the treatments address different concerns. I plan the order and spacing so your skin has time to recover and we can see what each step has achieved before adding another.
Would a biostimulator suit me?Piotr answers
Piotr
A biostimulator may suit you if your face has lost support and a gradual increase in fullness would help its shape.
Your health and any previous filler or biostimulator treatment affect that choice. Reactions to earlier injections need to be considered. Active infection, inflamed skin or a cold sore may mean treatment needs to wait.
Health and treatment history to tell me about
- Pregnancy or breastfeeding; active infection, inflamed skin or an active cold sore.
- Allergies, previous reactions to injectables, unusual scarring or a history of keloids.
- Autoimmune or inflammatory conditions, immune-system treatment, bleeding problems, medicines and supplements.
- Previous fillers or biostimulators, including the product, area and approximate date where known.
These details do not all mean the same thing. Some are reasons to defer; others need individual assessment or a different approach. Send the information requested before treatment and tell me about anything that has changed. Do not stop prescribed medicines on your own to prepare for an aesthetic appointment.
I do not offer these treatments to anyone under 18. When used to create a filling effect for cosmetic purposes, biostimulators are covered by England’s rules on cosmetic fillers. The law allows limited medical exceptions.[10]
I have had filler before. Does that matter?
Yes — bring any treatment records you have. The product, area and approximate date help me understand what may still be present. If those details are unclear, we may need further assessment before adding another material.
Is “collagen banking” in my twenties worth it?
Age alone is not a reason to have a biostimulator. If there is no clear concern that treatment can usefully address, I would not recommend injections simply to store collagen for later. Observation and skin-health measures may be more proportionate. The evidence on this page does not establish that treating a healthy face in its twenties prevents future facial ageing.
When will I see a change?Piotr answers
Piotr
With Sculptra, the result develops over weeks and months. The fullness immediately after treatment largely reflects preparation fluid and swelling; it can settle before the gradual tissue response becomes visible.
Radiesse can give some immediate support from its gel carrier, followed by further change as the tissue responds. With either approach, we assess the result after swelling has settled and allow time before deciding whether more treatment would help.[1][6]
For Juläine, the newer clinical evidence describes change over follow-up visits rather than a reliable date when every patient will first notice a result.[9]
How long might the result last?Piotr answers
Piotr
Published follow-up suggests around 12–18 months for CaHA and up to about 25 months for established PLLA treatments. The duration varies with the product, area, course and your response. Those figures should not be transferred to Juläine, whose longer-term evidence is more limited.[1][12]
Further treatment depends on the result that remains, how the tissue has responded and what you still want to change. The original amount does not automatically need to be repeated.
What did the longer Radiesse follow-up show?
Some Radiesse results were still visible at a later assessment. In one follow-up study, 40% of the treated folds were still rated as improved at least 30 months after the last injection. Participants had been offered another treatment between months six and twelve, so this does not show that one treatment usually lasts that long.[7]
If I do not like the result, what can be done?Piotr answers
Piotr
PLLA and CaHA cannot be dissolved with the enzyme used for hyaluronic-acid filler. This is an important part of the decision before treatment.
If you are unhappy with the result, contact me for an assessment. Early swelling, excess correction and an inflammatory lump are different problems; depending on the cause, we may monitor it, treat inflammation or arrange specialist care. Some problems take time to resolve, and complete correction cannot be promised.
How much is used at one visit?Piotr answers
Piotr
At one visit, I use no more than 1.5 ml of Radiesse or one vial of Sculptra. I build the result in stages and reassess before adding more. Juläine has a separate individual plan; these amounts do not apply to it.
I can suggest how many appointments may be useful, but photographs, your examination and how you feel about the change guide what comes next.
What if I don’t respond?
People respond differently. I allow enough time for the result to develop before assessing whether more treatment would help. We may continue, adjust the plan, consider another treatment or stop. I would not automatically add more product if you have not noticed a change.
Can I be treated at the first consultation?Piotr answers
Piotr
No. Your first visit is a consultation. We discuss what you would like to change, and I assess your face and explain the treatment, alternatives, recovery, risks and cost.
Treatment takes place at a separate appointment, after a cooling-off period so you have time to consider your decision. A deposit secures your treatment appointment. I send you preparation instructions beforehand.
What happens at the appointment?Piotr answers
Piotr
A treatment appointment usually takes 45–60 minutes. We confirm the plan, take clinical photographs and prepare your skin before the injections. I mainly use a cannula. I also use a needle when needed. Before you leave, we go through the aftercare for the particular product you have received.
Can I work or attend an event afterwards?
You may feel well enough to work while swelling or bruising is still visible. For an important event, the treatment date needs to allow time for recovery and for the gradual change in fullness to develop.
Will biostimulator treatment hurt?Piotr answers
Piotr
You may feel stinging, pressure or tenderness. I explain the numbing and injection method appropriate for the product and area. I check how you feel throughout, and you can ask for a pause.
What should I do afterwards?Piotr answers
Piotr
Follow the written aftercare for the product you have had. Swelling, tenderness and bruising can affect the early appearance, so give the area time to settle before judging it.
Massage advice differs between products. I explain whether you should massage, how to do it and for how long; do not apply the instructions for one product to another.
If you have any questions, you are always welcome to contact me. For increasing pain, unusual colour changes or other urgent warning signs, seek help immediately rather than waiting for a routine reply.
Will I need to massage the area?
- Sculptra
- At odNOVA, the clinic protocol is gentle massage for five minutes, five times a day, for five days.
- Juläine
- Juläine has its own separate manufacturer massage instructions, which you will be shown and given in writing.
- Radiesse
- Radiesse does not have the five-day massage routine used with Sculptra. I will explain whether you should massage the area after your treatment. Do not massage or press on it unless I have advised you to.
Your individual written aftercare takes priority over this general summary.
Can I contact the clinic while I am healing?
If tenderness and swelling are settling, that is different from a new or worsening symptom. You can contact me if you are unsure. I may be unable to answer immediately while I am with a patient.
For unusual pain, skin colour changes or other urgent symptoms, use the help guidance below rather than waiting for a routine reply.
What are the risks?Piotr answers
Piotr
Swelling, bruising and tenderness are common short-term reactions. Less common problems include infection, persistent unevenness, lumps or delayed inflammatory nodules. Some require further treatment.
An injection can also obstruct a blood vessel, potentially damaging skin; facial injections can very rarely affect sight. I explain the risks relevant to your product and treatment area, how I reduce them and what symptoms need urgent attention. The guidance below distinguishes ordinary recovery from changes that should not wait.
Separate temporary effects from complications
Early recovery
Injection-site discomfort, swelling, redness and bruising. Their extent and recovery time vary.
Unwanted result
Asymmetry, too little change or excess correction. How often these occur is not reliably established. These need assessment; another vial is not an automatic solution.
Lumps and inflammation
Small lumps can sometimes be felt beneath the skin without being visible. In two studies with twelve-month follow-up, nodules were reported in about 1–1.7% of treated people: 1 of 97 in the Sculptra study and 1 of 60 in the Juläine study.[14][13] The Sculptra nodules were mild but still present at the end of follow-up; the Juläine nodule settled without treatment. Other studies with different protocols and longer follow-up reported higher rates, as explained below. Inflammatory lumps, including granulomas, can also occur.
Affected blood supply
Vascular occlusion can injure skin and, in severe cases, affect vision or cause neurological injury. The actions below should not wait for a routine appointment.
Why the risk figures need their study context
The product, treated area, injection method and length of follow-up affect which complications a study records. A controlled trial and a report from one practice can also give us different kinds of information. Figures from older studies in people with HIV-related facial fat loss do not tell you how likely a complication is after cosmetic treatment today.
Sculptra cheek study: One of 97 treated people (1.0%) developed mild, palpable nodules 180 days after the last injection. They were still present at the end of the twelve-month study.[14]
Older Sculptra protocol: A five-year US study followed 867 people and used a 5 mL preparation. Nodules or papules in the folds between the nose and mouth were reported in 165 of 867 people (19%); the overall rate across treated facial areas was 28.5%. These figures combine nodules and papules, not granulomas, and are not an estimate of current odNOVA risk. The study also reported one serious treatment-related foreign-body granuloma. That is not a count of all granulomas.[14]
Radiesse follow-up: Among 102 people followed for three years in the extension study, there were no reports of nodules or granulomata (0 of 102). This does not establish zero risk. Participants had been offered another treatment between months six and twelve.[7]
Juläine follow-up: One of 60 people (1.7%) developed a mild nodule that settled without treatment; the study did not establish when it first appeared. Separately, two of 60 (3.3%) had temporary lumps that settled in one and seven days. No confirmed granuloma diagnosis was reported.[13]
These are separate study results, not a direct comparison between products. The products, treated areas, preparation methods and follow-up periods differed.
The six study records keep the actual observations and their limits together. Lack of an event in a small trial does not establish that it cannot happen.
What about lumps and nodules?
Firm lumps can occur, including delayed inflammatory reactions. Their frequency in current cosmetic practice is not reliably quantified by the studies on this page. Older PLLA studies involved people with HIV-associated facial lipoatrophy and different treatment protocols; their figures are not a personal risk estimate. CaHA observations are also area- and study-specific. A new, persistent, red or painful lump needs clinical assessment rather than self-treatment.
The Radiesse product information also records delayed inflammation reported after infections, vaccinations or dental procedures. The timing can help explain the history of a new swelling, but it does not prove what caused it.[15]
For the reported figures and who they apply to, open the clinical study records.
When should I ask for help?
Symptoms that need action
Use the urgent contact route in your written aftercare for increasing or disproportionate pain; skin that becomes white, grey, dusky, mottled or cold; or a firm, red or painful swelling, including one appearing weeks or months later. These changes need prompt clinical assessment. Any sudden visual change, severe eye pain or double vision after treatment requires immediate assessment at the nearest Emergency Department; do not wait for a clinic reply. Call 999 for sudden facial or limb weakness or speech difficulty.
What does treatment cost, and what is included?Piotr answers
Piotr
The Fees page lists current prices for Radiesse and Sculptra. I explain the proposed product, amount and cost before treatment; Juläine pricing is confirmed separately.
The number of appointments varies from person to person. I assess your progress before recommending further treatment and explain the fee before you decide to proceed.
The fee covers the treatment appointment. A routine review is not usually needed. If you need a review, it can be arranged.
What do the studies actually show?Piotr answers
Piotr
Clinical studies have found improvements in facial fullness and folds, with results that develop and persist differently between products. In a trial of 233 adults, PLLA improved nasolabial folds, with improvement recorded up to 25 months after the final treatment.[1]
In a separate split-face trial of 117 people, 79% had greater improvement on the CaHA-treated side than on the side treated with a collagen implant at six months. That is a comparison between treatments, not a 79% reduction in fold depth.[6]
The studies below include the treatment course, follow-up and limitations, including the newer Juläine studies.
Does the research include people with darker skin?
Yes. One CaHA study specifically enrolled 100 people with darker skin types and followed them for six months after treatment of the folds beside the nose and mouth. That gives direct evidence for this product and area; it does not establish the same findings for every biostimulator or every part of the face.[16]
Research and results
Read each finding with the people studied, the comparison and the follow-up beside it. Improvement against a collagen implant is not the same question as benefit over no treatment, or a comparison with a modern HA filler.
How durable is the correction?
A randomised, evaluator-blinded trial treated 233 adults with moderate-to-severe nasolabial folds: 116 received PLLA and 117 received a human-collagen implant.
Improvement
Investigator-rated global improvement favoured PLLA over the collagen comparator; a stand-alone PLLA responder percentage is not separately reported.
The study supports nasolabial-fold correction in this trial population. It does not establish the same result in another area, or show that a particular technique is best for your face.
Read the full study record
- Result & endpoint
- In a 233-participant trial (116 PLLA, 117 collagen), some PLLA-treated nasolabial folds remained improved for up to 25 months after the last treatment.
- Onset & duration
- Gradual over weeks, unlike the immediate collagen comparator. PLLA improvement was reported up to 25 months after the last treatment; the collagen comparator was followed only to month 13. Separately, of the 106 PLLA participants who entered the extension, 95 completed it; 105 received no further treatment and one was treated again at month 19.
- Satisfaction
- Not reported as a validated satisfaction measure.
- Adverse effects
- Injection-related events and occasional nodules consistent with the material class.
- Limitations
- The comparator was human collagen, not a modern hyaluronic-acid filler. The trial measured nasolabial folds, not every facial area; a stand-alone responder percentage is not cleanly extractable. Most participants were white women with Fitzpatrick skin types II–III. The upper follow-up bound is not a personal-duration promise.
- Study design & reference
- Randomised, evaluator-blinded trial with a collagen comparator
Does it work, and does it last?
Pivotal four-centre split-face randomised trial — 117 subjects, CaHA on one side against a human-collagen implant on the other; 102 entered extended follow-up.
Improvement
At six months, 79% of subjects had greater improvement on the CaHA-treated side than on the collagen side.
In the extension, 40% of folds were still graded improved at least 30 months after the last CaHA injection. Optional retreatment was allowed between months 6 and 12, so this is not persistence measured from the original treatment alone.
Read the full study record
- Result & endpoint
- Clinician-graded improvement in nasolabial-fold severity, compared within each patient against a collagen implant.
- Onset & duration
- In the extension, after optional CaHA retreatment to both folds between months 6 and 12, 40% of folds evaluated at least 30 months after the last CaHA injection were graded improved or better.
- Satisfaction
- Not reported as a validated satisfaction measure; global-improvement grading was the endpoint.
- Adverse effects
- Mostly bruising and swelling, resolving in about two to three weeks. Across the extended follow-up in 102 patients, no nodules, granulomas or infections were reported in this trial; a trial of this size cannot establish how often uncommon events occur.
- Limitations
- The comparator was collagen; a single fold is not diffuse volume; the long-term finding is not untreated persistence from the original split-face injection alone, because retreatment was offered between months 6 and 12; the findings are product-specific.
- Study design & reference
- Randomised split-face trial and extension with a collagen comparator
What changed at six months?
The authors reported a one-grade or greater improvement in fold severity in 23 of 32 women on the right (71.9%) and 22 of 32 on the left (68.8%). These are two sides of the same participants.
This prospective, uncontrolled study used up to three sessions. Four participants did not complete follow-up. [9]
Read the study details
Patient ratings: 21 of 32 (65.6%) rated themselves better or much better at six months on the Global Aesthetic Improvement Scale.
Safety: reported reactions were mild to moderate and resolved; no serious adverse events were recorded. This small sample cannot exclude uncommon risks.
Limitations: no control group, manufacturer support and only six months of follow-up. The paper contains inconsistencies in other outcome counts and follow-up timing. It does not establish equivalence to Sculptra or long-term duration.
What changed twelve months after the final treatment?
In a study of 60 people treated with Juläine, 40 of the 54 assessed at twelve months (74.1%) had at least a one-grade improvement in the folds between the nose and mouth. Participants received up to three treatment sessions.
Short-term reactions: Swelling was reported in 22 of 60 people (36.7%). All reported treatment-related reactions had resolved by the analysis.
Lumps and nodules: Two people (3.3%) had temporary lumps that settled within one and seven days. Separately, one person (1.7%) developed a mild nodule that resolved without treatment. The study did not establish when that nodule first appeared.
The study was funded by the manufacturer and had no comparison group. These findings describe this treatment course and follow-up, rather than predict your individual result.[13]
Read the full study record
- Design and participants
- Prospective, uncontrolled study at two European sites. Sixty people were treated; 54 were assessed at twelve months after the final injection. There was no comparison group.
- Treatment and follow-up
- Up to three treatment sessions, two to four weeks apart. The reported twelve-month outcomes were measured after the final injection. Twenty-four-month results were not reported in this analysis.
- Result and endpoint
- Forty of 54 people (74.1%) had at least a one-grade improvement on the Wrinkle Severity Rating Scale in the folds between the nose and mouth. This is a follow-up assessment, not a guarantee of how long an individual result will last.
- Patient assessment and satisfaction
- Twelve months after the final injection, 45 of 54 people (83.3%) rated their appearance as improved, much improved or very much improved. In a separate study-specific questionnaire, 42 of 54 (77.8%) were satisfied or very satisfied with the result. That satisfaction questionnaire was developed by the sponsor and was not validated.
- Adverse effects
- Among 60 treated people, 81 adverse events were recorded in 43 people; 74 events related to the device or procedure were recorded in 37 people. These are event counts and patient counts, and the categories can overlap. Swelling affected 22 of 60 people (36.7%). Two people had temporary lumps (3.3%), which settled in one and seven days. One person had a separate mild nodule (1.7%) that resolved without treatment; its onset was not established. All reported related reactions had resolved by the analysis.
- Funding and limitations
- Nordberg Medical AB funded the study, data collection and analysis, and participated in study design and manuscript preparation and review. The study had no comparison group and mainly included women. These results cannot establish superiority to another product or exclude uncommon or later harms.
Did PLLA improve facial lipoatrophy in the group studied?
One randomised, open-label study of 100 adults with HIV-associated facial lipoatrophy: 50 received PLLA from week 0 and 50 after a 24-week delay.
Improvement
At week 48 in the immediate-treatment group, patients assessed facial-lipoatrophy severity as reduced in 83% and clinicians in 91%.
This shows that gradual stimulation can reduce lipoatrophy severity in one specific patient group. It is not an individual-response promise and does not transfer to a course of treatment here.
Read the full study record
- Result & endpoint
- Subjective severity grading by clinician and by patient at week 48. This was not a modern routine cosmetic-treatment population.
- Onset & duration
- The study reported outcomes to week 48. It does not establish a personal onset or a duration figure for cosmetic treatment.
- Satisfaction
- Patient-judged severity was recorded; no validated satisfaction measure is reported.
- Adverse effects
- Injection-site nodules were the characteristic effect, at approximately 10% at 48 weeks. That is an observation from this protocol, not a universal modern aesthetic rate.
- Limitations
- HIV-associated facial lipoatrophy rather than a healthy cosmetic population; open-label; the severity judgments were subjective; the week-48 result comes from the immediate-treatment subgroup alone.
- Study design & reference
- Randomised, open-label study in HIV-associated lipoatrophy; limited transfer to cosmetic treatment
How safe is it in ordinary practice, and where do nodules happen?
An uncontrolled practice series reviewed 1,000 patients treated for a range of facial applications during a 52-month period.
Improvement / persistence
More than 80% of patients reported some persistence at 12 months.
A series like this describes what one practice observed. It does not establish your personal risk, and it is not evidence about how often severe complications occur.
Read the full study record
- Result & endpoint
- Patient-reported persistence and events observed in one clinician's practice.
- Onset & duration
- Persistence was self-reported at 12 months; the series does not establish a duration figure beyond that report.
- Satisfaction
- Reported at series level only, and not as a validated satisfaction measure.
- Adverse effects
- The commonest were redness and bruising. Nodules were mainly reported in the lips, and only two patients had nodules outside the lips in that series.
- Limitations
- An uncontrolled, self-reported, single-practice series with no blinding or comparator; it is not a universal frequency or safety guarantee, and its figures cannot be translated into a universal rate.
- Study design & reference
- Large practice series without a comparison group; useful for reported safety observations
An older three-year PLLA cohort involved HIV-associated and age-related lipoatrophy and additional treatment sessions; it does not establish a typical untreated duration for cosmetic treatment.[5]
These studies used different products and treatment courses. Their results help inform our discussion, but cannot predict your individual response.[12]
Question index
All your questions, by topic.
Open a topic and choose a question to go straight to its answer.
Browse all 29 questions
Treatments and alternatives7 questions
Suitability and previous treatment3 questions
Results and treatment plans5 questions
Consultation, appointment and fees4 questions
After treatment4 questions
Risks and seeking help3 questions
Research and evidence3 questions
References & sources
The references below link to the studies and guidance discussed on this page.
View all 17 references
- PLLA nasolabial-fold trial, durability to 25 months (RCT, n=233): Narins RS, Baumann L, Brandt FS, et al. (2010) ‘A randomized study of the efficacy and safety of injectable poly-L-lactic acid versus human-based collagen implant in the treatment of nasolabial fold wrinkles’, Journal of the American Academy of Dermatology, 62(3), pp. 448–462. DOI: 10.1016/j.jaad.2009.07.040. PMID: 20159311. Available at: View on PubMed (Accessed: 11 August 2026).
- PLLA for HIV-associated facial lipoatrophy, review of clinical studies: Barton SE, Engelhard P, Conant M. (2006) ‘Poly-L-lactic acid for treating HIV-associated facial lipoatrophy: a review of the clinical studies’, International Journal of STD & AIDS, 17(7), pp. 429–435. DOI: 10.1258/095646206777689116. PMID: 16820069. Available at: View the source (Accessed: 11 August 2026).
- PLLA HIV-associated facial lipoatrophy, 48-week follow-up: Carey D, Baker D, Petoumenos K, et al. (2009) ‘Poly-l-lactic acid for HIV-1 facial lipoatrophy: 48-week follow-up’, HIV Medicine, 10(3), pp. 163–172. DOI: 10.1111/j.1468-1293.2008.00667.x. PMID: 19245538. Available at: View the source (Accessed: 11 August 2026).
- Historical VEGA PLLA study: Valantin MA, Aubron-Olivier C, Ghosn J, et al. (2003) ‘Polylactic acid implants (New-Fill) to correct facial lipoatrophy in HIV-infected patients: results of the open-label study VEGA’, AIDS, 17(17), pp. 2471–2477. DOI: 10.1097/00002030-200311210-00009. PMID: 14600518. Available at: View on PubMed (Accessed: 11 August 2026).
- PLLA HIV-associated and age-related lipoatrophy, prospective three-year cohort: Levy RM, Redbord KP, Hanke CW. (2008) ‘Treatment of HIV lipoatrophy and lipoatrophy of aging with poly-L-lactic acid: a prospective 3-year follow-up study’, Journal of the American Academy of Dermatology, 59(6), pp. 923–933. DOI: 10.1016/j.jaad.2008.07.027. PMID: 19022099. Available at: View on PubMed (Accessed: 11 August 2026).
- CaHA nasolabial-fold pivotal split-face trial: Smith S, Busso M, McClaren M, Bass LS. (2007) ‘A randomized, bilateral, prospective comparison of calcium hydroxylapatite microspheres versus human-based collagen for the correction of nasolabial folds’, Dermatologic Surgery, 33(Suppl 2), pp. S112–S121; discussion S121. DOI: 10.1111/j.1524-4725.2007.33350.x. PMID: 18086048. Available at: View on PubMed (Accessed: 11 August 2026).
- CaHA nasolabial-fold long-term extension: Bass LS, Smith S, Busso M, McClaren M. (2010) ‘Calcium hydroxylapatite (Radiesse) for treatment of nasolabial folds: long-term safety and efficacy results’, Aesthetic Surgery Journal, 30(2), pp. 235–238. DOI: 10.1177/1090820X10366549. PMID: 20442101. Available at: View on PubMed (Accessed: 11 August 2026).
- CaHA 1,000-patient practice series: Tzikas TL. (2008) ‘A 52-month summary of results using calcium hydroxylapatite for facial soft tissue augmentation’, Dermatologic Surgery, 34(Suppl 1), pp. S9–S15. DOI: 10.1111/j.1524-4725.2008.34237.x. PMID: 18547188. Available at: View on PubMed (Accessed: 11 August 2026).
- Completed Juläine/LASYNPRO product-specific study: Urdiales-Gálvez F, Benítez PA, Díaz I. (2026) ‘Clinical Outcomes of an Innovative Poly-L-Lactic Acid (LASYNPRO) in Facial Rejuvenation: Prospective, Multicenter Spanish Study’, Journal of Cosmetic Dermatology, 25(2), e70753. DOI: 10.1111/jocd.70753. PMID: 41715284. PMCID: PMC12921352. Available at: View the source (Accessed: 11 August 2026).
- Under-18 prohibition in England: GOV.UK (2021) ‘Botulinum toxin and cosmetic fillers for under 18s’. Available at: View on GOV.UK (Accessed: 11 August 2026).
- Qualified PLLA mechanism review: Haykal D, Haddad A, Cartier H, Avelar L. (2025) ‘Poly-L-Lactic Acid in Aesthetic Dermatology: A Decade Beyond Volume Restoration Toward Regenerative Biostimulation’, Aesthetic Surgery Journal, 45(10), pp. 1065–1072. DOI: 10.1093/asj/sjaf121. Available at: View the source (Accessed: 11 August 2026).
- PLLA and CaHA efficacy, durability and safety systematic review: Ferreira ACM, Silva LR, Espasandin I, Sant'Anna JF, Mourão CA, Tedesco AD, Vieira MG, Colaço ARA, Varela RM, de Paula Barbosa A. (2026) ‘Efficacy, Durability, and Safety of Collagen Biostimulators Based on Poly-L-Lactic Acid (PLLA) and Calcium Hydroxyapatite (CaHA) in the Face: A Systematic Review’, Aesthetic Plastic Surgery, 50(3), pp. 1291–1300. DOI: 10.1007/s00266-025-05412-8. PMID: 41184662. Epub 3 November 2025. Available at: View on PubMed (Accessed: 11 August 2026).
- Juläine nasolabial-fold study, twelve-month follow-up: Ribe A, Erhardt U, De Almeida Caramico K, Souton-Al Gburi É, Grimolizzi F, Hedén P. (2026) ‘Effectiveness, Patient Satisfaction, and Safety of a Next-Generation Poly-L-Lactic Acid Collagen Biostimulator for Nasolabial Fold Augmentation: 12-Month Results of a Prospective Multicenter Study’, Aesthetic Surgery Journal, sjag180. DOI: 10.1093/asj/sjag180. PMID: 42682196. Available at: View the source (Accessed: 7 October 2026).
- Sculptra US instructions for use (2023): clinical-study safety data, pp. 11 and 19–20: Galderma (2023), Sculptra US instructions for use. Available at: View the instructions for use (Accessed: 7 October 2026).
- Radiesse injectable implant instructions for use — composition and delayed-onset inflammation reports. View the instructions for use
- Marmur et al. (2009) — CaHA study in 100 people with darker skin types, six-month follow-up. PMID 19708876. View the PubMed abstract
- Merz Aesthetics — Radiesse mechanism of action. Manufacturer explanation of the gel carrier, its absorption and the collagen response. View the manufacturer information (Accessed: 8 October 2026).
This page provides general information. It does not replace individual assessment, consent or treatment-specific aftercare.