Cosmetic injectables can be grouped into several categories: neuromodulators, dermal fillers, and fat-dissolving treatments. In recent years, these cosmetic injectables have been growing in popularity, as they provide many of the same effects as surgical procedures but are much less invasive, without any of the associated downtime and complications of traditional surgical procedures.

Sculptra and Radiesse are two leading dermal fillers that act as collagen biostimulators, which are injected to encourage the body to produce additional collagen at the treatment site. Sculptra and Radiesse are perhaps the best-known dermal fillers in this category, so it is worthwhile to take an in depth look at how they compare to one another.

How Do Collagen Biostimulators Work?

Generally speaking, there are two types of dermal fillers: fillers that are injected to provide volume replacement, such as hyaluronic acid-based fillers, and collagen biostimulators, such as Sculptra and Radiesse. These two types of dermal fillers have their own characteristics, drawbacks, benefits, and method of application.

Biostimulators promote collagen growth through fibroblast activation, which is either inflammatory (Sculptra) or non-inflammatory (Radiesse). Over time, the formation of collagen after treatment has corrective benefits that extend the results over a long period of time, which is usually between one and two years.

The effects of these fillers are not immediate, as it takes time to stimulate tissue growth in the treatment areas. Note that the effects of these dermal fillers are irreversible, unlike those of hyaluronic acid based fillers. For this reason, collagen biostimulators are usually not recommended for first-time patients.

Sculptra

The popular brand Sculptra contains poly-L-lactic acid, a synthetic and resorbable material that is also used in other medical devices such as fixation screws, and dissolvable sutures. Like other biostimulators, the effects are delayed by several weeks or months; the results, however, are long-lasting, often lasting up to two years.

When injected, the poly-L-lactic acid microparticles of Sculptra incite a foreign-body response, stimulating fibroblasts, mononuclear macrophages, and vascular fibrous tissue at the site of the injection. Fibroblasts then envelope the deposited microparticles and are triggered to produce collagen fibres, resulting in skin thickening.

Treatment with Sculptra dermal filler requires slightly more aftercare on the part of the patient than other treatments, with the treated areas requiring a massage for five minutes, five times per day for five days after treatment. Also, repeat treatments are typically necessary in order to gain the full effects of Sculptra treatment. Typically, a treatment regimen is divided into a series of three sessions, once per month.

Radiesse

Radiesse contains microparticles of calcium hydroxylapatite, which are suspended in a gel of water, glycerine, and a small amount of carboxymethylcellulose. The resulting gel has a high elastic modulus, allowing it to resist deformation. Due to its physical properties, Radiesse should be placed deeper in the skin compared to its counterparts.

Radiesse has a slightly different method of stimulating fibroblast activity than Sculptra. As it is composed of the same component found in the mineral portion of bone and teeth, Radiesse is non-inflammatory. As such, the filler acts as a scaffold for collagen production that promotes the ingrowth of new tissue similar to its surrounding. Treatment result is an overall improvement in skin texture and volume, and these benefits can last as long as two years or more.

In addition to being a collagen biostimulator, Radiesse has volumizing properties due to its high elasticity and viscosity, which is an added advantage to using this dermal filler. Numerous studies and years of clinical experience have repeatedly demonstrated the benefits and efficacy of Radiesse.

Comparison

Both Radiesse and Sculptra can be used to add volume to large areas suffering substantial volume loss, such as the cheeks or temples; to fill in skin depressions, such as pitted acne scars; to treat aged hands; and also to treat pronounced nasolabial folds. The opacity of Radiesse is considered especially suitable for the purposes of hand contouring, as it causes prominent features such as veins and tendons to be obscured. This result cannot be achieved with other dermal fillers, including Sculptra.

The main difference between the two products is that Sculptra’s effects are not immediate, whereas Radiesse imparts a combination of both immediate and long-term volumizing effects. However, because Sculptra increases volume gradually, the results do tend to appear very natural – a feature often desired by patients.

As Radiesse is highly viscous, it is not suitable for superficial placement. Therefore, it is not recommended for areas with thin skin, such as the lips or lower eyelids – it should not be used for the treatment of fine lines and wrinkles. On the other hand, Sculptra provides purely volumizing effects, and not lifting effects, and its results are very diffuse and consequently not targeted. Therefore, it is not generally suitable for reshaping or augmenting procedures in areas such as the lips or eyes.

Conclusion

Dermal fillers with collagen biostimulation properties, including Sculptra and Radiesse, are valued for their long-lasting, natural-looking results. While these two fillers are comparable in terms of efficacy, safety, and their duration of results, there are considerable differences in terms of their composition, mode of fibroblast stimulation, and pverall physical properties. Practitioners should be knowledgeable about these differences in order to help their patients attain the optimal clinical outcomes from their dermal filler treatment.