Review Article| Volume 6, ISSUE 1, P63-70, May 2023

Download started.


Expanded Use of Biostimulators

Published:February 26, 2023DOI:


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Advances in Cosmetic Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Baumann L.
        Skin ageing and its treatment.
        J Pathol. 2007; 211: 241-251
        • Berlin A.L.
        • Hussain M.
        • Goldberg D.J.
        Calcium hydroxylapatite filler for facial rejuvenation: a histologic and immunohistochemical analysis.
        Dermatol Surg. 2008; 34: S64-S67
        • Yutskovskaya Y.
        • Kogan E.
        • Leshunov E.
        A randomized, split-face, histomorphologic study comparing a volumetric calcium hydroxylapatite and a hyaluronic acid-based dermal filler.
        J Drugs Dermatol. 2014; 13: 1047-1052
        • Kadouch J.A.
        Calcium hydroxylapatite: a review on safety and complications.
        J Cosmet Dermatol. 2017; 16: 152-161
        • Goldie K.
        • Peeters W.
        • Alghoul M.
        • et al.
        Global consensus guidelines for the injection of diluted and hyperdiluted calcium hydroxylapatite for skin tightening.
        Dermatol Surg. 2018; 44: S32-S41
        • Coleman K.M.
        • Voigts R.
        • DeVore D.P.
        • et al.
        Neocollagenesis after injection of calcium hydroxylapatite composition in a canine model.
        Dermatol Surg. 2008; 34: S53-S55
        • Marmur E.S.
        • Phelps R.
        • Goldberg D.J.
        Clinical, histologic and electron microscopic findings after injection of a calcium hydroxylapatite filler.
        J Cosmet Laser Ther. 2004; 6: 223-226
        • de Almeida A.T.
        • Figueredo V.
        • da Cunha A.L.G.
        • et al.
        Consensus recommendations for the use of hyperdiluted calcium hydroxyapatite (radiesse) as a face and body biostimulatory agent.
        Plast Reconstr Surg Glob Open. 2019; 7: e2160
        • Wu D.C.
        • Goldman M.P.
        The efficacy of massage in reducing nodule formation after poly-l-lactic acid administration for facial volume loss: a randomized, evaluator-blinded clinical trial.
        Dermatol Surg. 2016; 42: 1266-1272
        • Goldberg D.
        • Guana A.
        • Volk A.
        • et al.
        Single-arm study for the characterization of human tissue response to injectable poly-L-lactic acid.
        Dermatol Surg. 2013; 39: 915-922
        • Bauer U.
        • Graivier M.H.
        Optimizing injectable poly-L-lactic acid administration for soft tissue augmentation: the rationale for three treatment sessions.
        Can J Plast Surg. 2011; 19: e22-e27
        • Christen M.O.
        Collagen stimulators in body applications: a review focused on poly-l-lactic acid (PLLA).
        Clin Cosmet Investig Dermatol. 2022; 15: 997-1019
        • Chao Y.Y.
        • Chiu H.H.
        • Howell D.J.
        A novel injection technique for horizontal neck lines correction using calcium hydroxylapatite.
        Dermatol Surg. 2011; 37: 1542-1545
        • Yutskovskaya Y.A.
        • Kogan E.A.
        Improved neocollagenesis and skin mechanical properties after injection of diluted calcium hydroxylapatite in the neck and décolletage: a pilot study.
        J Drugs Dermatol. 2017; 16: 68-74
        • Guida S.
        • Longhitano S.
        • Spadafora M.
        • et al.
        Hyperdiluted calcium hydroxylapatite for the treatment of skin laxity of the neck.
        Dermatol Ther. 2021; 34: e15090
        • Casabona G.
        • Nogueira Teixeira D.
        Microfocused ultrasound in combination with diluted calcium hydroxylapatite for improving skin laxity and the appearance of lines in the neck and décolletage.
        J Cosmet Dermatol. 2018; 17: 66-72
        • Fabi S.G.
        • Alhaddad M.
        • Boen M.
        • et al.
        Prospective clinical trial evaluating the long-term safety and efficacy of calcium hydroxylapatite for chest rejuvenation.
        J Drugs Dermatol. 2021; 20: 534-537
        • Yutskovskaya Y.A.
        • Sergeeva A.D.
        • Kogan E.A.
        Combination of calcium hydroxylapatite diluted with normal saline and microfocused ultrasound with visualization for skin tightening.
        J Drugs Dermatol. 2020; 19: 405-411
        • Mazzuco R.
        • Hexsel D.
        Poly-L-lactic acid for neck and chest rejuvenation.
        Dermatol Surg. 2009; 35: 1228-1237
        • Wilkerson E.C.
        • Goldberg D.J.
        Poly-L-lactic acid for the Improvement of photodamage and rhytids of the décolletage.
        J Cosmet Dermatol. 2018; 17: 606-610
        • Bolton J.
        • Fabi S.
        • Peterson J.D.
        • et al.
        Poly-L-lactic acid for chest rejuvenation: a retrospective study of 28 cases using a 5-point chest wrinkle scale.
        Cosmet Dermatol. 2011; 24: 278-284
        • Hart D.R.
        • Fabi S.G.
        • White W.M.
        • et al.
        Current concepts in the use of PLLA: clinical synergy noted with combined use of microfocused ultrasound and poly-l-lactic acid on the face, neck, and décolletage.
        Plast Reconstr Surg. 2015; 136: 180S-187S
        • Vanaman M.
        • Fabi S.G.
        Décolletage: regional approaches with injectable fillers.
        Plast Reconstr Surg. 2015; 136: 276S-281S
        • Peterson J.D.
        • Goldman M.P.
        Rejuvenation of the aging chest: a review and our experience.
        Dermatol Surg. 2011; 37: 555-571
        • Fabi S.G.
        Fillers for the décolletage area.
        Pract Dermatol. 2015; 42: 29-40. 67
        • Amselem M.
        Radiesse(®): a novel rejuvenation treatment for the upper arms.
        Clin Cosmet Investig Dermatol. 2015; 9: 9-14
        • Lapatina N.G.
        • Pavlenko T.
        Diluted calcium hydroxylapatite for skin tightening of the upper arms and abdomen.
        J Drugs Dermatol. 2017; 16: 900-906
        • Coimbra D.
        • Gutstein da Fonseca Amorim A.
        Poly-L-lactic acid in the rejuvenation of the medial and anterior arms.
        Surg Cosmet Dermatol. 2012; 4: 182-185
        • Haddad A.
        • Menezes A.
        • Guarnieri C.
        • et al.
        Recommendations on the use of injectable poly-l-lactic acid for skin laxity in off-face areas.
        J Drugs Dermatol. 2019; 18: 929-935
        • Jabbar A.
        • Arruda S.
        • Sadick N.
        Off face usage of poly-l-lactic acid for body rejuvenation.
        J Drugs Dermatol. 2017; 16: 489-494
        • Guida S.
        • Longhitano S.
        • Shaniko K.
        • et al.
        Hyperdiluted calcium hydroxylapatite for skin laxity and cellulite of the skin above the knee: A pilot study.
        Dermatol Ther. 2020; 33: e14076
        • Casabona G.
        • Pereira G.
        Microfocused ultrasound with visualization and calcium hydroxylapatite for improving skin laxity and cellulite appearance.
        Plast Reconstr Surg Glob Open. 2017; 5: e1388
        • Kollipara R.
        • Hoss E.
        • Boen M.
        • et al.
        A randomized, split-body, placebo-controlled trial to evaluate the efficacy and safety of poly-l-lactic acid for the treatment of upper knee skin laxity.
        Dermatol Surg. 2020; 46: 1623-1627
        • Shridharani S.M.
        • Tisch G.M.
        • Ebersole T.G.
        • et al.
        Clinical experience of poly-L-lactic acid injections for body contouring treatment.
        J Cosmet Dermatol. 2021; 20: 1655-1662
        • Swearingen A.
        • Medrano K.
        • Ferzli G.
        • et al.
        Randomized, double-blind, placebo-controlled study of poly-l-lactic acid for treatment of cellulite in the lower extremities.
        J Drugs Dermatol. 2021; 20: 529-533
        • Mazzuco R.
        Subcision™ plus poly-l-lactic acid for the treatment of cellulite associated to flaccidity in the buttocks and thighs.
        J Cosmet Dermatol. 2020; 19: 1165-1171
        • Mazzuco R.
        • Sadick N.S.
        The use of poly-l-lactic acid in the gluteal area.
        Dermatol Surg. 2016; 42: 441-443
        • Durairaj K.K.
        • Devgan L.
        • Lee Bs A.
        • et al.
        Poly-L-lactic acid for gluteal augmentation found to be safe and effective in retrospective clinical review of 60 patients.
        Dermatol Surg. 2020; 46: S46-S53
        • Nikolis A.
        • Enright K.
        • Avelar L.
        • et al.
        A prospective, multicenter trial on the efficacy and safety of poly-l-lactic acid for the treatment of contour deformities of the buttock regions.
        J Drugs Dermatol. 2022; 21: 304-308
        • Harper J.
        • Avelar L.
        • Haddad A.
        • et al.
        Expert recommendations on the use of injectable poly-l-lactic acid for contour deficiencies of the buttocks.
        J Drugs Dermatol. 2022; 21: 21-26
        • Fabi S.G.
        • Goldman M.P.
        Hand rejuvenation: a review and our experience.
        Dermatol Surg. 2012; 38: 1112-1127
        • Edelson K.L.
        Hand recontouring with calcium hydroxylapatite (Radiesse).
        J Cosmet Dermatol. 2009; 8: 44-51
        • Busso M.
        • Applebaum D.
        Hand augmentation with Radiesse (calcium hydroxylapatite).
        Dermatol Ther. 2007; 20: 385-387
        • Bank D.E.
        A novel approach to treatment of the aging hand with Radiesse.
        J Drugs Dermatol. 2009; 8: 1122-1126
        • Gargasz S.S.
        • Carbone M.C.
        Hand rejuvenation using Radiesse.
        Plast Reconstr Surg. 2010; 125: 259-260e
        • Sadick N.S.
        A 52-week study of safety and efficacy of calcium hydroxylapatite for rejuvenation of the aging hand.
        J Drugs Dermatol. 2011; 10: 47-51
        • Marmur E.S.
        • Al Quran H.
        • De Sa Earn A.P.
        • et al.
        A five-patient satisfaction pilot study of calcium hydroxylapatite injection for treatment of aging hands.
        Dermatol Surg. 2009; 35: 1978-1984
        • Kim J.S.
        • Lee W.
        • Oh W.
        • et al.
        Identification of a suitable layer for injecting calcium hydroxylapatite fillers in the hands.
        J Plast Reconstr Aesthet Surg. 2021; 74: 866-873
        • Goldman M.P.
        • Moradi A.
        • Gold M.H.
        • et al.
        Calcium hydroxylapatite dermal filler for treatment of dorsal hand volume loss: results from a 12-month, multicenter, randomized, blinded trial.
        Dermatol Surg. 2018; 44: 75-83
        • Redaelli A.
        Cosmetic use of polylactic acid for hand rejuvenation: report on 27 patients.
        J Cosmet Dermatol. 2006; 5: 233-238
        • Nipshagen M.D.
        • Velthuis P.J.
        • Cook E.
        • et al.
        Non-inflammatory nodule formation after hyperdiluted calcium hydroxyapatite treatment in the neck area.
        Dermatol Ther. 2020; 33: e14272