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Collagen Stimulating Injections

Collagen-stimulating fillers are also known as biostimulators. These products carry volume adding benefits in addition to helping create new collagen in the skin.

Collagen-stimulating fillers are also known as biostimulators. These products carry volume adding benefits in addition to helping create new collagen in the skin.

Biostimulatory Fillers – How to Fix Your Skin with Hyperdilute Radiesse & Sculptra

‘Biostimulatory fillers’ or ‘Collagen Stimulating Injections’ actually refers to using hyperdilute formats of Sculptra and Radiesse (two dermal fillers that are not made of hyaluronic acid) to improve the skin, rather than changing the shape or volume of a face or feature.
In this technique, these agents can:

  • improve fine lines and wrinkles – like lip lines or wrinkles above the knee or elbow
  • boost the results of lasers, microneedling, or other resurfacing treatments for the skin
  • improve stretch marks, acne scars, other scars, and general skin texture concerns

Collagen stimulating injections have been on the market since 2004, but they were originally introduced as longer-lasting fillers that offered sculpting and contour changes through stimulating collagen growth (vs. Hyaluronic Acid Fillers which are simply HA that breaks down over time). What cosmetic doctors found was that the skin in the areas being treated with these fillers looked better. And through much study and reformulation of the saline-to-product ratios and injection techniques, consensus (a medical term meaning collective group agreement through study and peer-reviewed articles) was reached that these products could offer significant improvement of the skin through collagen induction or collagen stimulation.

Collagen Stimulating Injections Quick Facts

  • Injections Performed by Doctors Only
  • No Downtime
  • Face & Body Treatment
  • Results Appear in 3-6 Months & Last Years
  • FDA-Approved Products: Sculptra & Radiesse
  • Improves skin texture, firmness, elasticity, & fine lines

Common Uses For Collagen Stimulating Injections

Collagen stimulating injections can be used throughout the face and body to create amazing results – and because there’s such a long list of applications you might want to stimulate collagen for, we’re limiting this list to our most popular:

Hyperdilute Radiesse for Fine Wrinkles on Knees, Elbows, & Body

Elbows and knees have this tendency, especially after menopause, to get a ton of really small fine lines where the skin bunches up near the joint. And it just really ages your appearance. These are such a common concern for women of a certain age – but they’re very hard to treat non-surgically (and most don’t want to do a big surgery for something like this).
With hyperdilute Radiesse and Sculptra, you’re using a fan-like injection technique to spread the product throughout the skin and rough up the underside of the skin. Together, these 2 things spur the skin to heal itself, and in healing itself, to build much more collagen. This firms the skin up and creates a mild tightening effect, which can also be paired with skin tightening treatments like Sofwave, Thermage, or Ulthera for a more dramatic tightening effect in the area. Some other doctors recommend threads for this and we really do not agree – they’re quite painful and the results last much shorter than a tightening treatment.

  • Recovery & Downtime: Essentially none: expect some redness for a few hours, bruising is rare but possible
  • Numbing: mixed into the injections
  • Cost: Starts at $850 – 1000 for Sculptra or Radiesse
  • Candidacy: anyone with crepey loose skin from aging (not an alternative to a body lift after weight-loss)
  • Duration: Long-lasting
  • Why We Love It: Results look natural and are very long-lasting, treats area we haven’t had a great option for

Sculptra Applied Over Top of Lasering or Microneedling for Skin Quality Enhancements

Sculptra works exceedingly well to holistically rejuvenate the face when injected in small amounts throughout the entire face, but did you know there have been studies showing how well it works when applied after CO2 laser, especially for the lip lines around the mouth (peri-oral lip lines)? These very deeply set-in lines are hard to treat, for two reasons: one is that they’re usually pretty deep by the time people decide to do anything about them, and the second is that they’re caused by a movement we can’t stop doing – closing our mouths – so we really can’t give the skin a full break to rebound (like we can with forehead wrinkles or frown lines).
What we’ve learned over the years, though, is that using either Sculptra or Radiesse over top of skin that’s been lasered or microneedled works well not just for these very deep lines, but all kinds of lines and skin quality issues, and that’s because it’s working more superficially within the skin to create more collagen and elastin, two important keys to youthful-looking skin.

  • Recovery & Downtime: Based on laser or microneedling, not biostimulatory fillers
  • Numbing: Mixed into Injections
  • Cost: Starts at $850 – 1000 for Sculptra or Radiesse
  • Candidacy: anyone who wants to see bigger results from their treatment
  • Duration: long-lasting
  • Why We Love It: Big boost without adding more downtime or pain

Why Choose Reflections for Biostimulatory Fillers?

First of all, you’re not going to see most practices or injectors offering these services – and that’s a really good thing. Unlike hyaluronic acid fillers, biostimulatory fillers are not dissolvable or reversible, so it’s good that we don’t see that many novice injectors trying to dabble in this. But if you do manage to find one, be wary – you want someone who has experience using them in hyperdilute formats because it’s very different from using them to add volume to the face, and there is always a risk that as you stimulate the body to grow new collagen, that you can overstimulate it and create lumps or nodules, which is why you really want someone who knows how to manage this and has the experience using it. Even at our practice, not every injector offers this type of treatment, even though they are all physicians with many years of injecting experience.

Next, you want someone who has other options. Biostimulatory fillers could be substituted with exosomes or concentrated microfat or concentrated platelets or a treatment like laser or microneedling – all of these treatments stimulate new collagen growth in different ways. Often you’ll see our doctors stacking these treatments together. You really need to deeply know these treatments to be able to put together the perfect mix for each individual – and you’re not going to find that many providers who offer the number of treatments we do – which means they’ll have fewer options and less ability to pinpoint the perfect mix for you.


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    1. Sculptra’s FDA Approval
    2. Radiesse’s FDA Approval
    3. de Almeida, Ada Trindade et al. “Consensus Recommendations for the Use of Hyperdiluted Calcium Hydroxyapatite (Radiesse) as a Face and Body Biostimulatory Agent.” Plastic and reconstructive surgery. Global open vol. 7,3 e2160. 14 Mar. 2019, doi:10.1097/GOX.0000000000002160
    4. Goldie K, Peeters W, Alghoul M, Butterwick K, Casabona G, Chao YYY, Costa J, Eviatar J, Fabi SG, Lupo M, Sattler G, Waldorf H, Yutskovskaya Y, Lorenc P. Global Consensus Guidelines for the Injection of Diluted and Hyperdiluted Calcium Hydroxylapatite for Skin Tightening. Dermatol Surg. 2018 Nov;44 Suppl 1:S32-S41. doi: 10.1097/DSS.0000000000001685. Erratum in: Dermatol Surg. 2019 Feb;45(2):327. PMID: 30358631.
    5. Rovatti PP, Pellacani G, Guida S. Hyperdiluted Calcium Hydroxylapatite 1: 2 for Mid and Lower Facial Skin Rejuvenation: Efficacy and Safety. Dermatol Surg. 2020 Dec;46(12):e112-e117. doi: 10.1097/DSS.0000000000002375. PMID: 32205749.

Lorenc ZP, Black JM, Cheung JS, Chiu A, Del Campo R, Durkin AJ, Graivier M, Green JB, Kwok GP, Marcus K, Rammos CB, Werschler WP. Skin Tightening With Hyperdilute CaHA: Dilution Practices and Practical Guidance for Clinical Practice. Aesthet Surg J. 2022 Jan 1;42(1):NP29-NP37. doi: 10.1093/asj/sjab269. PMID: 34192299; PMCID: PMC8849118.