
In the ever-evolving world of aesthetic treatments, the battle for the "Biostimulator Iron Throne" is heating up. Contenders like Radiesse, Sculptra, Ellanse, and Juvelook are all vying for the top spot. But who truly deserves the crown? Let's dive into the realm of biostimulators to find out which one reigns supreme.
Introduction to Injectable Biostimulators
Injectable biostimulators are innovative treatments designed to rejuvenate the skin from within. Unlike traditional fillers that simply add volume, biostimulators work by stimulating the body's natural collagen production. This leads to long-lasting improvements in skin texture, elasticity, and overall appearance. By promoting collagen synthesis, these treatments offer a more natural and gradual enhancement, making them a popular choice for those seeking subtle yet significant results.
Why Do We Need Biostimulators?
As we age, our body's natural collagen production decreases, leading to wrinkles, sagging skin, and loss of volume. Biostimulators help combat these signs of aging by stimulating the production of collagen, restoring the skin's youthful fullness and elasticity. Unlike hyaluronic acid-based fillers, which provide immediate but temporary volume by physically filling in spaces under the skin, biostimulators offer a longer-term solution by encouraging the body to regenerate its own collagen. This results in a more natural and enduring rejuvenation.
The Contenders: Radiesse, Sculptra, Ellanse, Juvelook

Designed by Dr. Vera

Table by Dr. Vera
To add a note, Radiesse also contains carboxymethylcellulose (CMC) gel with high viscosity and cohesiveness which gives tissue elevation and immediate improvement in facial contour. Overtime, the implantation of CaHA microspheres stabilises the extracellular matrix (ECM) facilitates adhesion of fibroblast to dermal fibres, which supports the growth of fibroblasts and the formation of new collagen without calcifications, physiologically inducing neocollagenesis by a process in which type I would gradually replace the type III collagen. Due to its composition which is biocompatible to the human body, the risk of granuloma formation is also significantly lower compared to biostimulator with synthetic polymers.
Why is Radiesse Favoured by Many?
Radiesse stands out for several reasons. As we learn from the table above, Its unique composition of Calcium Hydroxylapatite (CaHA) provides not only immediate volume but also stimulates collagen production over time.
This dual action makes it a versatile choice for various aesthetic needs. Here’s how you can use Radiesse:
As a Filler: Instantly restores volume to sagging or hollow areas of the face.
As a Biostimulator: Encourages collagen production, improving skin texture and elasticity.
As a Vertical Lifting Tool: Provides a subtle lift to facial contours.
As a Volumizer: Enhances facial features by adding volume to areas like cheeks and jawline.

Retrieved from: https://www.merzaesthetics.nl/radiesse-campaign/en
How Radiesse Works
Radiesse's magic lies in its unique formulation. Composed of tiny calcium hydroxylapatite (CaHA) microspheres suspended in a CMC gel carrier, Radiesse provides both immediate and long-term benefits:
1. Immediate Volumizing Effect: Upon injection, Radiesse adds instant volume to the treated area, smoothing out wrinkles and folds. This immediate effect came from the CMC gel carrier, with a high integration into the tissues, it gives a filling effect for soft tissue volumizing.
2. Long-Term Collagen Stimulation: Over time, the CaHA microspheres stimulate the body’s natural collagen production. As the gel carrier gradually gets absorbed, the newly formed collagen maintains the skin's improved structure and volume, ensuring long-lasting results.
Ideal Candidates for Radiesse
Radiesse is suitable for a wide range of individuals, including those who:
- Want to address moderate to severe facial wrinkles and folds, such as nasolabial folds.
- Seek to enhance facial contours or restore lost volume due to aging.
- Desire a non-surgical option for hand rejuvenation.
- Are looking for a long-lasting solution with both immediate and progressive results.

Combining Radiesse with Other Treatments
Absolutely! Radiesse can be combined with other treatments from hydrators to Botox to energy based devices to achieve comprehensive facial rejuvenation. Combining treatments can enhance overall results and address multiple concerns in one go. “I’m concerned with the lines and wrinkles on my face.” Why not pair Botox with Radiesse treatment to reverse time and age by 10 years. “I’m in my early 20s to 30s and just wanting some treatment for aging prevention.” Well, combining Radiesse and hydrators such as Profhilo, Revok50, Volite sounds like a solid plan. “I would rather have a very taut and snuggling skin, what should I do?” A-H-A, a combination of energy based devices such as HIFU, Oligio, Fotona 4D and Radiesse will do the trick.
Let's discuss your aesthetic goals and create a personalized treatment plan. Contact Dream Clinic today and schedule a consultation with me, Dr. Vera. Let's make your skin's fairytale ending a reality!

References
Amiri, M. et al. (2024) ‘Calcium hydroxylapatite (CAHA) and aesthetic outcomes: A systematic review of controlled clinical trials’, Journal of Clinical Medicine, 13(6), p. 1686. doi:10.3390/jcm13061686.
Biostimulators and their mechanisms of action. Available at: https://docs.bvsalud.org/biblioref/2022/04/1363771/12_n2_771_en.pdf
Koren, A. et al. (2019) ‘Efficacy of a combination of diluted calcium hydroxylapatite‐based filler and an energy‐based device for the treatment of facial atrophic acne scars’, Clinical and Experimental Dermatology, 44(5). doi:10.1111/ced.13952.
Pavicic, T. (2013). Calcium hydroxylapatite filler: an overview of safety and tolerability. Journal of drugs in dermatology : JDD, 12 9, 996-1002 .
Płatkowska, A. et al. (2023) ‘Combined bipolar radiofrequency and non-crosslinked hyaluronic acid mesotherapy protocol to improve skin appearance and epidermal barrier function: A pilot study’, Pharmaceuticals, 16(8), p. 1145. doi:10.3390/ph16081145.
Why should you take the collagen skin test? Discover here. Radiesse Campaign. Available at: https://www.merzaesthetics.nl/radiesse-campaign/en