When it comes to dermal fillers, those made with hyaluronic acid (HA) are often the popular choice. And while there is no doubt about what HA-based fillers can do, there is another notable ingredient in the form of calcium hydroxylapatite (CaHA). This is known to stimulate collagen and provide an instant plumping effect. 

Biostimulators Quickly Gaining in Popularity

CaHA is a mineral-like compound naturally found in bones. It can be synthetically produced to create a biostimulator injectable, which is now a key trend in aesthetics. Many providers have been using this type of filler, which stimulates the fibroblast to create essential skin proteins, such as collagen and elastin. 

Benefits of CaHA fillers:

  • Provide immediate volume and lift
  • Can be used to improve different signs of aging
  • Long-lasting (12 to 18 months)
  • Work as a collagen/elastin stimulator

More about this biostimulator-type fillers

This filler is composed of CaHA microspheres suspended in an aqueous gel carrier. Once injected, the CaHA particles act as a scaffold under the skin, providing structure and stimulating the production of collagen and elastin. Newly formed skin proteins provide lasting correction and a rejuvenated appearance.

CaHA fillers are ideal for correcting moderate to severe lines, folds, and wrinkles in the face. It can also be used to improve or fill in your nasolabial folds (smile or laugh lines) and marionette lines (lines that run vertically from the outer corners of the mouth). Other uses include: 

  • Add volume to the cheeks
  • Replenish volume lost over time
  • Smooth hand wrinkles 
  • Restore volume to the hands 
  • Fill in facial wrinkles and nasolabial folds
  • Contour the jawline or lower face
  • Fill or soften acne scars on the face

Here is a brief discussion between Dr. Sylvia and Dr. Jani about the versatility and the things that make calcium hydroxylapatite (CaHA) filler special. 

Biostimulators are quickly gaining popularity

While hyaluronic acid (HA)-based fillers rule the filler market sector, there is a growing acceptance of CaHA or biostimulator fillers among patients and doctors. As many patients are looking to improve both their skin quality and collagen production, biostimulatory agents are now becoming more popular.

Last year, according to Merz Aesthetics’ access to point-of-sale data, HA-based products have decreased by around 4%, while biostimulators have increased to 11%. This continued in early 2023. This is partly due to patients looking for safe, effective, and more importantly, longer-lasting treatments.

The appeal of biostimulation

As patients are becoming more aware of what collagen and elastin can do, many are now leaning toward treatments that can stimulate their formation. And while there are lots of products and devices that can help promote collagen production, there’s not a lot that can do the same for elastin.

CaHA’s biostimulatory aspect is what appeals to both patients and providers. Apart from providing an immediate result, it can stimulate the fibroblast to create collagen for up to a year, and elastin for up to nine months after the injection. Mostly, this is what patients like and the fact that it is longer lasting also makes it cost-effective. 

Important trends for aesthetics with Dr. Sylvia and Dr. Jani

The use of the right treatments such as micro-focused ultrasound with visualization can help create a natural, beautiful lift, while CaHA dermal fillers can stimulate the tissue to become healthier and look younger. Combining treatments also matters in elevating aesthetic results, as many patients have multiple skin concerns they want to address

Dr. Sylvia points out the problem with overfilling dermal fillers, as this can create a puffy appearance that can look fake or unnatural. Dr. Jani, on the other hand, reminds us not to polish every flaw or wrinkle we see. Less is more in aesthetics, especially if you want subtle and natural-looking results. 

Here is the full discussion between Dr. Sylvia and Dr. Jani: 


  1. Merz Aesthetics. Leading Biostimulator Catches on Worldwide, March 22, 2023, 2023 Medical Insight, Inc.
  2. How it works – Radiesse Injectables; https://radiesse.com/how-it-works/#content
  3. https://www.cutislaserclinics.com/blog/radiesse-what-makes-it-different-from-other-fillers/