Fillers, skinboosters and collagen biostimulators are all injectable aesthetic treatments. But what’s the difference between them? Are there any specific reasons why we should choose one over the other? Another question is if they can be combined for an improved result.
Fillers, skinboosters and collagen biostimulators are both similar and unique
Aesthetic treatments often have different modes of action. They may all be supposed to make us look younger or improve our skin quality, but they do it in different ways.
Fillers, skinboosters and collagen biostimulators are so-called injectables. They are injected into the skin in contrast to other aesthetic treatments such as chemical peels that are used on the skin surface. Apart from that, they all have their own unique properties. Let’s start looking at fillers.
Fillers are used to fill specific areas of the face
Fillers, as the name indicates, are used to fill. For example, a filler can be used to fill a wrinkle to make it less visible.1 It can also be used to fill the lips to give them a bit more definition and volume,2 or for shaping the contours of the face.3
Fillers are not injected all over our facial skin but in specific areas. They may have slightly different properties, depending on where they are supposed to be used. For example, the filler Restylane® Lyft™3 is a firm filler whereas Restylane® Kysse™2, which is intended for the lips, has a medium firmness and flexibility.4
Although this may seem a bit technical, the purpose is to give healthcare practitioners several tools to work with so that treatments can be individualized to each person – to make us look the way we want to, whether that is natural or more pronounced.
Most fillers are based on hyaluronic acid5
What is injected when you have a filler treatment? If you were to take a closer look at a filler syringe, you would see that it contains a kind of transparent gel. The gel is based on a substance called hyaluronic acid. Hyaluronic acid occurs naturally in our bodies where it binds water and lubricates our tissues.6
Hyaluronic acid breaks down and reforms quite fast in the body, so if you would inject it as it is, the body would clear it out in a couple of days. The hyaluronic acid used for fillers is therefore “stabilized” with a cross-linking technology to make it last longer than hyaluronic acid in its natural form.7
In general, a filler treatment lasts between 3 to 24 months, depending on where the filler is injected, the kind of filler used and how fast the body breaks it down (which may differ from person to person).8
Skinboosters are used on a larger area of the skin
Like fillers, skinboosters are also based on hyaluronic acid. However, skinboosters are not injected in specific areas. Instead, multiple small injections are spread over larger areas to restore the skin’s hydrobalance and to improve skin elasticity.9
As the gel is stabilized (just like fillers) it helps maintain the effect of the treatment for a long time. For example, in a study which tested Restylane® Skinboosters™9 on hands, improvements were sustained for up to 12 months.10
Restylane Skinboosters have been shown to improve the skin in many more ways, in addition to improving the skin’s hydrobalance and elasticity. The treatment provides deep hydration that can make the skin “glow from within” and can reduce acne scarring.11 It has also been shown to reduce skin roughness12 and big pores.13
Collagen biostimulators are also used on a larger skin area
Collagens biostimulators are similar to skinboosters in that they are used on a larger area of the skin. However, they do not contain hyaluronic acid but a substance that can stimulate collagen formation in the skin. One example are microparticles of poly-L-lactic acid.14 (Yes, it breaks down to a kind of lactic acid. Lactic acid is a natural substance that the body produces when breaking down carbohydrates. It’s also produced by certain bacteria when fermenting foods like sauerkraut or sourdough bread).
Collagen is a fibrous protein that forms a supportive three-dimensional network in the skin. As we grow older, this supportive network gradually breaks down and becomes fragmented. Collagen breakdown and fragmentation are major causes of skin aging, with typical sign including sagginess, skin roughness, and wrinkles.14
The purpose of collagen biostimulators is to activate the skin’s own production of new collagen, to make it look younger. One such collagen biostimulator is Scupltra®20 that has been shown to increase skin collagen with up to 66.5% in three months.15
The increase of collagen changes the skin’s appearance in many ways. For example, Sculptra improves skin quality by enhancing its radiance and elasticity.16 The treatment also improves the appearance of wrinkles and folds for up to 25 months.17,18
At what age can you use injectables?
Fillers can be used by grown-ups from 18 years and above. When we are in or 20s or 30s, fillers are primarily used for beautification or to correct minimal imperfections.19 Once we reach our 40s, fillers are also used to add a little volume where it has been lost due to aging, for example in the cheeks, and to reduce wrinkles and folds.19
Skinboosters can also be used by grown-ups of all ages. Both when we are in our 20s and 60s, for example, we may wish to improve skin hydration and reduce big pores.
Sculptra is generally recommended for people from their 40s and onwards, when we experience a loss of skin firmness and have visible signs of sagging skin.19
Can different injectables be combined?
In general, different injectable treatments can be combined, but they should perhaps not be performed at the same time. For example, you may wish to improve skin hydration (with a skinbooster treatment) and at a future point add a bit of volume to the lips.
A qualified healthcare practitioner can explain if it’s possible to combine treatments in your specific case and design a treatment plan that is suitable for you. They can also tell you about potential side effects and risks.
1. Restylane Instructions for Use EU; 2. Restylane Kysse Instructions for Use EU; 3. Restylane Lyft Instructions for Use EU; 4. Öhrlund Å, New method to study the balance of firmness and flexibility for HA fillers, Galderma Development, Uppsala, Sweden, Presented at AMWC Monte Carlo, Monaco; 5. Lundgren, B. et al.; Using a New Photo Scale to Compare Product Integration of Different Hyaluronan-Based Fillers After Injection in Human Ex Vivo Skin, J Drugs Dermatol. 2018 Sep 1;17(9):982-986; 6. Necas J. et al, Hyaluronic acid (hyaluronan): a review, Veterinarni Medicina, 53, 2008 (8): 397–411; 7. Coleman S.R., Cross-Linked Hyaluronic Acid Fillers, Plast Reconstr Surg. 2006 Feb;117(2): 661-5; 8. Fallacara A. et al, Hyaluronic Acid in the Third Millennium, Polymers 2018, 10(7), 701; 9. Restylane Skinboosters Instructions for Use EU; 10. Gubanova E et al. 12-month Effects of Stabilized Hyaluronic Acid Gel Compared With Saline for Rejuvenation of Aging Hands, J Drugs Dermatol 2015; 14(3): 288–299; 11. Dierickx C et al. Effectiveness and Safety of Acne Scar Treatment With Non animal Stabilized Hyaluronic Acid Gel Dermatol Surg 2018; 44 Suppl 1: S104–S18; 12. Lee B et al. Rejuvenating Effects of Facial Hydrofilling using Restylane VitalArch Plast Surg 2015; 42(3): 282–287; 13. Kim J., Effects of Injection Depth and Volume of Stabilized Hyaluronic Acid in Human Dermis on Skin Texture, Hydration, and Thickness, Arch Aesthetic Plast Surg 2014; 20(2): 97–103; 14. Fischer GJ. et al., Looking older: Fibroblast Collapse and Therapeutic Implications, Arch Dermatol. 2008 May;144(5):666-72; 15. Goldberg D, et al., Single-arm study for the characterization of human tissue response to injectable poly-L-lactic acid, Dermatol Surg. 2013;39(6):915-922; 16. Bohnert K et al. Randomized, Controlled, Multicentered, Double-Blind Investigation of Injectable Poly-L-Lactic Acid for Improving Skin Quality, Plast Reconstr Surg 2019;127(4):1684–92; 17. Narins RS et al. A randomized study of the efficacy and safety of injectable poly-L-lactic acid versus human-based collagen implant in the treatment of nasolabial fold wrinkles, J Am Acad Dermatol 2010;62(3):448–62; 18. Brandt FS et al. Investigator global evaluations of efficacy of injectable poly-L-lactic acid versus human collagen in the correction of nasolabial fold wrinkles Aesthet Surg J 2011;31(5):521–8; 19. Haddad A. et al.; Managing the Aesthetic Patient; J Drugs Dermatol. 2019 Jan 1;18(1):92; 20. Sculptra Instructions for Use EU