Biostimulatory Fillers in Facial Rejuvenation

Dr Jason Bloom discusses the evolution of facial rejuvenation from line-filling to comprehensive facial balancing through volumization and biostimulation. Learn how clinicians can select among PLLA, calcium hydroxylapatite (CaHA), and PMMA based on patient anatomy, aging patterns, and weight-loss–related volume changes, while achieving natural, long-lasting results through collagen stimulation and personalized treatment planning.

Transcript

Hi, I'm Jason Bloom. I'm a facial plastic surgeon in the Bryn Mawr, Pennsylvania area, which is right outside of Philadelphia. I own and operate Bloom Facial Plastic and Aesthetic Surgery and I'm a clinical assistant professor of both otolaryngology head and neck surgery and plastic surgery at the University of Pennsylvania. 

How has the shift from traditional line-filling to volumization and biostimulation changed the way you approach facial rejuvenation?

Dr Bloom: I think the way we looked at using fillers or different products such as HA, calcium hydroxyapatite, and other fillers in the past was to simply address a line. And that's because the studies that were done in order to get these products approved focused on, for example, nasolabial folds. The real move outside of that has been to address and look at the patient totally and completely and to work with these different indications, whether it be the mid face, now temple, chin. And the whole idea now is to go from addressing lines and wrinkles to balancing the face. So now we have different products that are used for different indications and different areas, and that completeness allows us to effectively treat these patients. 

When selecting between biostimulatory agents like PLLA, CaHA, and PMMA, what patient-specific factors guide your choice and treatment plan?

Dr Bloom: So when I'm talking to patients and they're interested in using biostimulatory products, so this isn't about filling lines. This is about using their own body to rejuvenate the face. These products like PLLA or PMMA or calcium hydroxyapatite actually stimulate collagen and elastin in the skin to volumize the patient. I think understanding specific things about the patient, meaning where they're hollow, are they on a weight loss journey, we're seeing a lot of patients start to lose weight and volume in their face, and then we can address certain areas with different products like biostimulatory agents more effectively than we can even do with some of the HA filler products. 

What practical techniques or strategies can help clinicians achieve natural, long-lasting results while minimizing complications with these agents?

Dr Bloom: I think it's important when we're talking to patients to understand what their goals are. Patients don't want to look different. They just want to look rejuvenated and better. And rather than filling a line or giving them, you know, cheek volume, it's slow, gradual improvements that can kind of heighten their appearance, make them look more rejuvenated. That's the most important thing as aesthetic providers that we give to our patients. 

What are some key clinical takeaways from your Music City SCALE session?

Dr Bloom: In my session, I focus on different factors with each patient when I'm using biostimulatory agents. I treat patients anywhere from their 20s to their 80s with these patients, and there are certain aspects of each patient's volume loss, aging situations that biostimulatory agents are great with. So you have to actually evaluate each patient and see where those products would best fit in each of these different patients.