In this episode, Dr. Elizabeth Roche explains that biostimulators are injectables that coax your body to make collagen for gradual tightening and volume. She contrasts them with hyaluronic acid fillers that give instant results. Options include Sculptra, a poly-lactic acid that builds firmness over a series with results often lasting two years, and Radiesse, calcium hydroxylapatite that provides an immediate lift while stimulating collagen. Natural choices like PRP/PRF and lab made PDGF add growth factors. Common areas are cheeks, temples, neck, chest, hands, and buttocks. Risks include infection and nodules, so candidates should avoid certain conditions and choose an experienced injector.
John Maher: Hi, I am John Maher. I’m here today with Dr. Elizabeth Roche, founder of the Elizabeth Roche MD Med Spa in Bergen County, New Jersey, a medical aesthetics center committed to providing people with the most advanced procedures available to restore youth while preserving the beauty and functional health of your skin. Today our topic is Biostimulators. Welcome Dr. Roche.
Dr. Roche: Thank you, John.
What Are Biostimulators?
John: So, Dr. Roche, tell me about Biostimulators and a little bit more about what they are.
Dr. Roche: Sure. So, biostimulators are injectable treatments that stimulate your body to respond and make collagen. And in prior podcasts that we talked about, the importance of collagen and collagen production, so this is another way of keeping your collagen stimulated and tight and creating new collagen.
John: So, you also work with fillers or hyaluronic fillers. Are these biostimulators related to that or different?
Dr. Roche: The HA fillers are a different category. The hyaluronic acid fillers are the traditional fillers that many people are familiar with. They provide immediate volumization, immediate results. They are the fillers that fall into the family of Juvederm and Voluma and Restylane fillers, and Evolysse has a Form and Smooth. These are all immediate fillers and they’re great for someone who wants immediate changes and they’ve been in practice for a long, long time. They’re more of a gel-like form.
The biostimulatory type of fillers are a little different. For someone looking for a gradual change, they may ask for a biostimulatory type filler because it happens over weeks or months. They are injected and they stimulate collagen, and the collagen then forms volumization and tightness of the skin, so a little bit different. And these products are known as Sculptra, Radiesse, also natural platelet growth factors and PRP/PRF, and platelet derived growth factors as well.
What Is Sculptra?
John: So, let’s talk a little bit about each one of those. Let’s start with Sculptra. What is that?
Dr. Roche: So, I like to tell patients to think of it as absorbable suture materials that have been ground up. So they’re made from something called poly-L-lactic acid, and it’s a powder form, and we reconstitute this powder, we put it in some sterile water, some local anesthetic in it, and then make it into an injectable that…think about what a suture does, it stimulates your body to heal.
So, we’re putting this in almost like fertilizer. We put it in under the skin, and it’s going to stimulate your body to create collagen, and in doing so, you get tightness of skin. And then depending on how many sessions you have, you may get some volumization from it as well. It is a treatment that is gradual, so some patients love that effect. It helps with sagging skin, it helps with hollows. If you have hollow cheeks or temples, it’s a great treatment for that subtle, but over time, ultimate beauty look.
How Long Does Sculptra Last?
John: How long do the effects of Sculptra last?
Dr. Roche: Once you get to the end point, which may take, as I said, a couple of sessions, it can last over two years. What I usually tell patients to do though is, maybe once a year, and let’s say they had come in and had two vials per session over four sessions, and they got to their goal over a four or six month period of time. Then to maintain that, maybe just treat yourself to one vial for your birthday each year. Just saying that, look that you’ve achieved, we continually age, so we need to do something to prevent that.
What Is Radiesse?
John: The next bio-stimulator that you mentioned was Radiesse. What is that?
Dr. Roche: So, Radiesse is kind of a combination of an immediate filler and also a biostimulatory. It’s something called calcium hydroxyapatite. And it’s not as much of a biostimulator as Sculptra is, but what’s nice about it is that you do get some immediate filling effect. So if you have, let’s say, hollow or sunken cheeks, we inject it, you get that nice “wow” effect, and as that is wearing off, your body’s collagen stimulation is occurring. So, you kind of get this transition period of the product is going away, but your body’s also making new collagen to fill in that area. So, that is also a really nice kind of combination product that we offer.
How Long Does The Radiesse Last?
John: And how long do the effects of Radiesse last?
Dr. Roche: It’s probably around two years as well. It all depends also on all of these things of where you are in your aging process too. When we inject a younger patient, it tends to last longer, or someone who’s older, they need more kickstart to their collagen to begin with. And also it may not last as long. And also lifestyle, if you are out in the sun and not protecting your skin and doing things that can harm your skin and collagen, it may not last as long as someone who’s doing things to prevent the aging process, like wearing sunscreen and using the right products.
What Is PRF?
John: Alright, the next treatment is PRF. What is that?
Dr. Roche: So, that’s platelet rich fibrin. There’s PRP, platelet rich plasma and PRF. So, what we do is we draw your blood and spin it in a centrifuge. So, the whole blood gets separated into red blood cells and then the plasma, and that’s called PRP, platelet rich plasma. From there, then we activate that plasma and it starts to make fibrin and we inject that in.
So, this is an all-natural product that comes from you. It’s really popular under the eyes or we also use it when we’re doing microneedling and we are creating these little channels in the skin, and we can put the PRP on or PRF after that treatment. So, someone who’s looking for just a completely natural approach, PRP or PRF is a great choice for them.
There’s also something new out called PDGF, which is similar to the PRF, but this is a manufactured form. It’s like a bundle of growth factors. So it comes from a company instead of from your own blood, and it’s totally pure, but it’s a concentrated form. So, you get more of those growth factors than you would in just spinning your own blood. So, this is another alternative that is becoming very popular.
What Is PDGF Plus?
John: And then there’s PDGF plus, what is the plus in that?
Dr. Roche: Yeah, that means that it’s from a manufacturer and it’s a concentrated formula, that the plus.
Where Can These Products Be Used?
John: Okay. What are some of the areas on your face where you can apply these products?
Dr. Roche: Sure, we can apply them hollow cheeks, cheekbones, temples. We can apply them in neck, the decolletage, hands. And we’ve also, especially with Sculptra, we’ve done buttocks augmentation. Or even if somebody has loose skin on their buttocks and they would like to have tightening of the buttock skin, we inject the Sculptra there as well. So, there’s multiple areas to use these, and a lot of overall kind of refresh, just a little bit sprinkled everywhere.
Are There Risks To A Stimulator Injection?
John: So, it sounds like these are fairly natural procedures where they’re stimulating that natural process, but are there any risks involved in having a stimulator injection?
Dr. Roche: Yes. With every injection, you always have to be careful about infection. You want to make sure that the skin is clean. You’re not injecting over an infected area. You want to make sure that a person doesn’t have a predisposition for keloid scarring or one of the skin diseases such as eczema, scleroderma, sometimes severe rheumatoid arthritis because they may create too much collagen.
So, you want to be very cautious in patients who have those conditions. Of course, with everything, pregnancy, breastfeeding, if you have sensitivities or severe allergies to many things, you may not want to put a biostimulatory product in. Another important consideration is there’s a possibility of forming nodules, and that can be part of how it’s injected in the depth that it’s injected at.
So, you want to be careful of how you choose your injector. You want to make sure that somebody has training and experience in using these products, especially the Sculptra and the Radiesse, because if it’s not injected properly, later on it could form nodules.
John: And you’re actually a trainer for Sculptra?
Dr. Roche: Yes, I am. So, I really take time to review the depth, the layer where it should be injected, and also if it’s injected in an area that it’s not going to take effect, that’s not good either. You have to know what layer you’re at. So it’s important that a person has proper training on these products and have some experience under their belt as well, instead of just starting out. That’s with everything too. You want to pick an experienced injector.
Summary Of Biostimulator Treatments
John: Can you summarize this for your patients who might be interested in a bio stimulator, but they’re not sure maybe which one to choose, or if it’s the right procedure for them for the results that they’re looking for? How do you summarize it for them?
Dr. Roche: So, a biostimulatory product is great for someone who wants a gradual effect. Someone who maybe is trying to preserve what they have and they don’t want to enter into an aging process and having to do rejuvenation, preservation is key. Somebody who is maybe a little bit new to the whole dermal filler world and is unsure about the traditional dermal fillers. Sometimes someone who has had the traditional dermal fillers and they just want to condition their skin.
So, there’s patients of all types that are interested in biostimulators. And I think it’s great if you can put a biostimulatory injectable in and do a treatment such as SkinTyte therapy. I actually have a really great protocol where I dilute it down or blend it down so that it’s very, very thin. I inject it in the neck or the decolletage, and then I take them immediately to either Ultherapy or SkinTyte.
And the combination of that, it creates a beautiful result. So, there are all different procedures, all different choices, and once again, when a patient comes in, I take the time and I speak with them to see what their goal is and what they feel comfortable with, and we come up with a treatment plan to see which is the right treatment for them.
John: Alright, that’s great information, Dr. Roche. Thanks again for speaking with me today.
Dr. Roche: Thank you, John. It’s good seeing you.
John: Yeah. For more information about the Elizabeth Roche M.D. MedSpa or other treatments that are available there, visit the website at elizabethrochemedspa.com or call 201-505-1020.