By Taylor Siemens, NP, Vitalyc MedSpa

In the ever-evolving world of aesthetic medicine, new trends and technologies are as common as a packed Botox schedule. As a nurse practitioner with almost a decade of experience in this industry, I’ve seen treatments rise to fame (and fade into oblivion) faster than you can say “collagen production.” Yet, one question continues to bubble to the surface of our consult room discussions and industry panels: Should we embrace the use of non-hyaluronic acid (non-HA) fillers and biostimulators in our practices? Like debating between a retinol or a retinoid, the answer isn’t one-size-fits-all.

First, what are non-HA fillers and biostimulators?

Hyaluronic acid (HA) fillers have been the darling of the dermal filler world for years. They’re predictable, reversible, and as approachable as a latte on a Monday morning. Non-HA fillers and biostimulators, however, bring a different kind of magic to the table.

Non-HA fillers, otherwise known as biostimulators, focus not only on volumizing but also on stimulating the body’s own collagen production. They’re the “teach a man to fish” philosophy in injectable form. These products provide structural support while encouraging longer-term improvements in skin quality and elasticity.

Popular examples include:

• Radiesse (CaHA): Known for its immediate volumizing effects and ability to stimulate collagen and elastin over time.
• Sculptra (PLLA): Encourages gradual collagen remodeling, with effects peaking months after the injection.
• Bellafill (PMMA): A longer-lasting filler that’s FDA-approved for acne scars and nasolabial folds.

These treatments are often marketed as long-lasting or even semi-permanent solutions, which can be both a blessing and a burden—but more on that later.

The pros of non-HA fillers and biostimulators

1. Collagen Stimulation: Unlike HA fillers, which act primarily as space-occupying agents, biostimulators improve skin quality by encouraging natural collagen production. This can lead to longer-lasting and more natural results.
2. Durability: Many non-HA fillers boast extended longevity compared to their HA counterparts. Patients love the idea of not having to visit the clinic every six months for a touch-up (though you’ll still have your Instagram-worthy “before and after” shots).
3. Treatment Diversity: These injectables can address areas where HA fillers struggle, such as larger-volume restorations, lower face rejuvenation, skin laxity to the face and/or body, and even acne scarring.
4. Innovation Appeal: Let’s be real—our patients love being ahead of the curve. Offering non-HA fillers and biostimulators can position your practice as a trendsetter.

The cons of non-HA fillers and biostimulators

1. Irreversibility: Unlike HA fillers, which can be dissolved with hyaluronidase, non-HA fillers are not easily reversible. This requires a higher level of precision and patient education.
2. Delayed Gratification: With biostimulators, results take weeks or months to appear. For the instant-gratification crowd (we’re looking at you, social media influencers), this may feel like an eternity.
3. Technique Sensitivity: Injecting non-HA fillers requires advanced training and a solid understanding of facial anatomy. One misstep could lead to complications that aren’t easily remedied.
4. Cost Considerations: While the results last longer, the upfront cost for patients can be higher as multiple sessions are typically indicated. This requires clear communication to ensure patients understand the value proposition.

Is it worth the hype?

The decision to incorporate non-HA fillers and biostimulators into your practice depends on your patient demographic, your skillset, and, frankly, your appetite for advanced procedures. These products are not a replacement for HA fillers but rather an extension of our toolbox. Used appropriately, they can elevate your patient outcomes and diversify your offerings.

But let’s not sugarcoat it: these treatments come with a steeper learning curve and more potential for complications. This isn’t your “fresh out of injectables training” kind of product. It’s more of a “I’ve mastered the basics and want to level up” move.

Clinical pearls for non-HA filler success

1. Invest in Training: Non-HA fillers require precise techniques and a thorough understanding of patient selection. Attend advanced courses, shadow experienced injectors, and practice, practice, practice.
2. Set Realistic Expectations: Biostimulators, in particular, require patient buy-in. Educate them on the delayed timeline and the necessity of multiple sessions for optimal results.
3. Start Small: Begin with low-risk areas and patients who have realistic goals. Build your confidence before tackling more challenging cases.
4. Stay Current: Keep up with industry advancements and peer-reviewed studies. Your expertise is your best marketing tool.

The final word

So, should you be injecting non-HA fillers and biostimulators? The answer is as personal as your go-to skincare routine. For clinicians ready to expand their offerings and elevate their artistry, these products can be game-changers. But, as with any trend or new offering, proceed with caution, clinical knowledge, and a clear plan for managing risks.

As I like to tell my patients, "Your aesthetic journey is a marathon, not a sprint." The same applies to us as injectors. Whether you're Team HA or Team Biostimulator, what matters most is that we continue to prioritize safety, education, and exceptional results.

Taylor Siemens, NP-C, a board-certified nurse practitioner recognized by the American Association of Nurse Practitioners, is a dynamic force in the world of aesthetic medicine. With an unyielding passion for empowering and educating aesthetic clinicians, Siemens stands at the forefront of innovation. As the VP of operations at Vitalyc Medspa and the visionary founder of My Aesthetic Training, she seamlessly marries the expertise of a practitioner of medicine and multi-site business. Siemens's journey into aesthetic medicine commenced as an operating room nurse specializing in facial plastic surgery. This foundation equipped her with invaluable insights and skills, encompassing laser resurfacing procedures and the artistry of cosmetic injectables. Through her diverse patient interactions, Siemens has honed a profound understanding of the aging process, fueling her skillset in crafting comprehensive, multi-modality treatment solutions that align seamlessly with patients' aesthetic objectives. While patient care remains a priority, Siemens's focus has transitioned towards nurturing industry professionals in the field of medical aesthetics. Her dedication lies in arming them with the tools necessary to elevate patient outcomes, ensure safety, and foster income growth.