Dr Natalia Grigorovich answers four of the questions she hears most often in consultation about collagen biostimulators, including JULÄINE, the next-generation PLLA biostimulator available at Aestha Clinic.

Q1. What exactly is a collagen biostimulator, and how is it different from a dermal filler?

This is probably one of the questions I get asked most often, and the main difference is in how the two treatments work.

A dermal filler, usually made with hyaluronic acid, adds volume to the area where it’s injected, so the result is visible immediately. It can be used to restore volume, enhance certain areas or improve facial contours.

A collagen biostimulator doesn’t add volume in the same way. Instead, it stimulates your own fibroblasts, the cells responsible for producing collagen, to become more active. Depending on the product, this can be done with poly-L-lactic acid, calcium hydroxylapatite or polycaprolactone. Each works slightly differently, and the results develop gradually over time.

So, rather than giving you an immediate change in volume or shape, a biostimulator works on the skin itself, helping to improve its firmness, density and overall quality as new collagen is produced.

This can be particularly useful for patients from their late thirties onwards who are starting to notice changes in skin firmness and elasticity and want to improve these changes without adding unnecessary volume.

The two treatments can also be used together when appropriate. For example, a filler may be used to restore a specific area of lost volume, while a biostimulator can be used to support the quality and firmness of the surrounding skin.

There isn’t one treatment that is right for everyone. I look at your skin, facial structure and what you want to achieve before deciding whether a filler, a biostimulator or a combination of both is the most appropriate option

Q2. How soon will I see results from a biostimulator, and how long do they actually last?

With biostimulators, the results take time, and that’s something I always explain to my patients before treatment. During the first couple of weeks, you’re unlikely to see much of a change once any initial swelling has settled. The collagen-building process usually becomes more noticeable from around four to six weeks, and the results continue to develop over the following three to six months.

This is also why treatment is often planned over more than one session. Depending on the product and the individual patient, we may recommend two or three treatments, usually spaced around four to six weeks apart. This gives the skin time to respond between sessions.

As for how long the results last, there isn’t one answer because it depends on the product, the treatment plan and the individual patient. PLLA-based biostimulators, such as Sculptra and JULÄINE, can provide results that last beyond 12 months, while some PCL-based products have shown improvements in skin quality lasting up to around two and a half years in clinical studies.

That doesn’t mean that a product that lasts longer is necessarily the better choice. The important thing is choosing the right product and treatment plan for your skin and the result you want to achieve.

This is why I prefer to assess each patient properly and discuss what we can realistically expect from the treatment before deciding on a protocol.

Q3. What makes JULÄINE different from other biostimulators like Sculptra or Radiesse?

The main difference comes down to the material used and how the product is designed to stimulate collagen.

JULÄINE, like Sculptra, is based on poly-L-lactic acid, or PLLA. What makes JULÄINE different is its PLLA-LASYNPRO formulation, which uses highly uniform, spherical microspheres with a consistent size and smooth surface. The aim is to provide a more controlled interaction with the surrounding tissue and stimulate collagen production over time. Early clinical studies are showing promising results, although it is still a relatively new product compared with Sculptra.

Radiesse is different because its active ingredient is calcium hydroxylapatite, or CaHA, rather than PLLA. It can provide some immediate structural support because of its gel carrier, while the CaHA microspheres stimulate collagen and elastin production over time. When Radiesse is diluted or hyperdiluted, the focus shifts more towards improving skin firmness and quality rather than adding volume.

So, although JULÄINE and Radiesse can both be used for collagen stimulation, they work with different materials and can be used in different ways depending on what we are trying to achieve.

The choice between them really comes down to the patient’s skin, the amount of structural support needed, the area being treated and whether we are looking for more volumisation, skin tightening or overall improvement in skin quality.

Q4. Who is JULÄINE suitable for, and what should I expect during and after treatment?

I usually recommend JULÄINE for patients who are starting to notice a loss of skin firmness, density or support, often from the mid-to-late thirties onwards. It can be a good option for someone who wants to improve the quality and firmness of their skin without adding significant volume.

The treatment itself is a relatively straightforward injectable procedure carried out in clinic. JULÄINE is prepared before treatment and then injected into the deeper layers of the skin, usually across the mid and lower face, depending on what we are treating.

Afterwards, it’s normal to have some mild swelling, redness or tenderness around the injection points. This usually settles within a few days, and there is generally very little downtime. I do recommend avoiding intense exercise, saunas and facial massage for a short period after treatment while the area settles.

JULÄINE isn’t suitable for everyone. For example, I would not recommend treatment over an active skin infection, and there are other medical factors, such as a history of keloid scarring or pregnancy and breastfeeding, that need to be considered.

That’s why I always start with a consultation. I want to assess the skin properly, understand what you want to improve and make sure JULÄINE is actually the right treatment for you, whether that means using it on its own, combining it with another treatment, or choosing a different approach altogether.