The Battle of Biostimulators: Sculptra vs. Hyperdilute Radiesse

With what feels like endless aesthetic treatment options and new treatments all the time, how are you supposed to know which is the best option for you and your goals? Between botox, filler, microneedling, skincare, laser and now biostimulators…it get overwhelming quickly. If you’ve hearing more buzz about biostimulator treatments like Sculptra and Hyperdilute Radiesse and you’re interested in learning more about them, here is a deeper dive into both of these treatments. When in doubt, ask your aesthetic provider for their recommendation. We’re here to create customized treatment plans to help you meet your goals. 

How do biostimulator treatments work?

To understand why Sculptra and Hyperdilute Radiesse are a great treatment choice, it’s helpful to understand how the skin works and what happens to it throughout our lives. Our skin has a support system called the extracellular matrix (ECM) — think of it like a strong, stretchy net just under the surface of the skin made of proteins that keep skin looking firm, smooth, and youthful. The proteins that make up this ECM “net” are mostly made of collagen (which gives structure/support), elastin (which gives skin its elastic characteristics, allowing it to stretch and bounce back), and other proteins and cells that keep skin hydrated and healthy. 

As we mature, sun exposure, pollution, and bad habits (things like smoking, not getting enough sleep, poor nutrition, lack of exercise, etc.) break down this stretchy, strong net of collagen and elastin. Loss of collagen and elastin makes skin looser, thinner, and more wrinkled. This happens because special skin cells called fibroblasts (which are responsible for making and maintaining collagen & elastin fibers) need a strong, stretchy net (aka the ECM) to stay active. When the ECM weakens, fibroblasts stop working properly, leading to less collagen production and faster age-related changes (wrinkles, loose skin, texture changes, etc.). 

How can we slow this process down? 

Treatments like Sculptra and Hyperdilute Radiesse restore the ECM’s strength and tension, allowing fibroblasts to work again, producing more collagen fibers and keeping skin firmer. The particles in Sculptra and Hyperdilute Radiesse act like a temporary scaffold that helps fibroblasts regain their function. This prevents collagen breakdown, and because the fibroblasts are functioning better, the body rebuilds itself naturally with production of new collagen and elastin fibers. 

In short: The ECM is like a net that keeps skin firm, but over time, it weakens. When fibroblasts lose their "grip," they stop making collagen, leading to wrinkles. Regenerative (or biostimulating treatments like Sculptra and Hyperdilute Radiesse) treatments help rebuild the ECM, keeping skin looking youthful for longer!

Key Differences

	Sculptra	Hyperdilute Radiesse
Active Ingredient	Poly-L-Lactic Acid (PLLA)	Calcium Hydroxyapatite (CaHa)
Preparation	24-72hrs before treatment Sterile water & lidocaine is combined with PLLA powder Creates thin clear liquid with suspended Sculptra particles	Immediately before treatment Sterile saline & lidocaine is combined with Radiesse gel Creates thin milky white liquid with suspended CaHa particles
How It Works	PLLA particles stimulate your body’s immune system to start the healing process. During this healing process, your body creates new collagen and clears away old collagen that isn’t working well anymore	CaHa particles cause mild stretching of existing collagen & elastin fibers. This process stimulates new collagen & elastin production and encourages the body to clear away old collagen that isn’t working well anymore
How It’s Dosed	Vials (1-3 per treatment)	Syringes (1-3 per treatment)

Key Similarities 

	Sculptra & Hyperdilute Radiesse
Why we love them	Natural, gradual results Biostimulating & regenerative - these treatments renew your skin from the inside out by making changes and renewing the skin at the cellular level Great option for those who are new to injectable treatments and for patients who have already tried a bit of everything  Addresses existing concerns & great as a preventative treatment approach
Treatment Plan* *varies patient to patient	Initial treatment:  2 sessions, 4-8 weeks apart 1-3 vials/syringes depending on concerns Maintenance:  1-2 sessions every 1-2 years 1-3 vials/syringes per maintenance session
Expected Downtime	Swelling 12-24 hours  Bruising 1-2 weeks
Results	Gradual improvement seen 4-6 weeks after treatment Results last about 2 years

As with all medical procedures, there are risks involved. Both Sculptra and Hyperdilute Radiesse are considered to be very safe treatments and have been performed for decades with low rates of complications. Risks include the possibility of infection, nodule (bumps) formation, unfavorable outcomes, and a very low risk for vascular occlusion. 

General considerations:

• Autoimmune conditions: In general, we do not recommend ANY aesthetic procedure when someone is newly diagnosed with an autoimmune condition or if it is unstable or not well-controlled. If you have questions about this, please talk with your provider. 

• Those who are undergoing head or neck imaging (like x-rays) for dental work or other procedures within 3-6 months may want to consider Sculptra over Hyperdilute Radiesse. Because Radiesse contains microscopic calcium particles, it can show up on x-rays as tiny dots for a short period of time after injections. 

• Those with certain conditions that impact the body’s innate collagen like Ehlers-Danlos Syndrome (EDS) or those who are prone to Keloid scarring may respond differently to biostimulator treatments than those without such conditions. 

So how do I pick which one is right for me?

• This part is easy: Leave it up to your aesthetic provider! Your provider is the expert you trust to create the best treatment plan for you, your anatomy, and your goals. 

No matter what treatments you’re considering it’s important to find an aesthetic provider you trust to build a treatment plan for you! As always, our team at Revee is here to guide you along your treatment journey.