Biostimulators
such as Poly-L-Lactic Acid (PLLA), Calcium Hydroxylapatite (CaHA), and
polynucleotides promote skin rejuvenation by stimulating neocollagenesis, the
production of new collagen fibers. Understanding the timeline of this process
is essential for clinicians to set realistic expectations and optimize
treatment protocols. This article outlines the key phases of neocollagenesis
and when visible effects typically emerge after biostimulator injections.
The
Biological Process of Neocollagenesis
Neocollagenesis
is the body’s natural mechanism of repairing and remodeling dermal tissue,
triggered here by the controlled stimulation from biostimulators. The
process involves several overlapping stages:
- Acute Inflammatory Phase (Days
0–7):
Injection causes mild tissue injury, triggering immune cell recruitment. Macrophages
and neutrophils clean debris and secrete growth factors.
- Fibroblast Activation and
Proliferation (Weeks 1–4): Fibroblasts migrate to the treated area, proliferate, and begin
synthesizing new extracellular matrix components, including collagen types
I and III.
- Matrix Remodeling and
Maturation (Months 1–6): Newly formed collagen fibers reorganize, mature, and increase
dermal thickness, improving skin texture and elasticity.
- Sustained Collagenesis (Months
6–18+):
Depending on the biostimulator used, collagen production may continue for
up to 18–24 months, with gradual volumizing effects.
Timelines
for Specific Biostimulators
Poly-L-Lactic
Acid (PLLA)
- Initial inflammatory response
peaks within the first week.
- Noticeable collagen production
typically begins around 4–6 weeks post-injection.
- Maximum clinical results are
often observed between 3 and 6 months.
- Effects can last up to 18–24
months due to slow PLLA biodegradation.
Calcium Hydroxylapatite (CaHA)
- Immediate volumizing effect due
to gel carrier.
- Collagen synthesis begins
earlier, around 2–4 weeks post-injection.
- Peak neocollagenesis usually
occurs by 3 months.
- Effects sustain for about 12–15
months.
Polynucleotides
- Primarily act as antioxidants
and hydrating agents with mild collagen stimulation.
- Visible improvements may appear
within 2–4 weeks, with gradual skin quality enhancement over 3–6
months.
Clinical Considerations
- Multiple sessions spaced 3–4
weeks apart optimize fibroblast stimulation and collagen deposition.
- Patient age, skin condition,
and treatment area influence neocollagenesis rates and visibility.
- Combination protocols (e.g.,
microneedling plus biostimulators) may accelerate results.
Conclusion
Neocollagenesis
induced by biostimulators follows a predictable timeline beginning with an
inflammatory phase and culminating in sustained collagen production months
later. Clinicians should advise patients to expect gradual improvement, with
maximum effects appearing after several months and lasting up to two years
depending on the product. This understanding enables realistic expectations and improved patient
satisfaction.
References