Biostimulators and hybrid fillers · Professional comparison
Three products that are often compared, but which address volume loss and signs of ageing in entirely different ways. Here we go through mechanism, timeline, longevity and which product suits which patient.
Poly-L-lactic acid (PLLA) without hyaluronic acid. Stimulates the body's own collagen production gradually over several weeks and treatments, for a natural, gradual rejuvenation of large areas.
Calcium hydroxylapatite microspheres in a carboxymethylcellulose gel. Gives structural volume immediately and stimulates collagen over time, mouldable for precise contour.
From Allergan Aesthetics. Combines hyaluronic acid for immediate volume and calcium hydroxylapatite for long-lasting collagen stimulation — the newest addition to the category.
| Property | Sculptra | Radiesse | HArmonyCa |
| Active ingredient | Poly-L-lactic acid (PLLA) | Calcium hydroxylapatite (CaHA) | Hyaluronic acid + CaHA |
| Immediate volume effect | No | Yes | Yes |
| Collagen stimulation | Strong, gradual | Moderate | Moderate |
| Number of treatments | 2–3, with 4–6 weeks between | Usually 1 | Usually 1 |
| Longevity | Up to 25 months | 12–18 months | 12–18 months (collagen effect up to 3 years) |
| Reversible with hyaluronidase | No | No | Partly (the HA component) |
| Best suited for | Large, diffuse volume loss in the face and body | Precise contour and structure | Immediate result + long-term effect in one treatment |
Longevity figures are the manufacturers' general product documentation (Galderma for Sculptra, Merz Aesthetics for Radiesse, Allergan Aesthetics for HArmonyCa), not results from a specific independent study. Individual duration varies with the treatment area, the injected volume and the patient's metabolism.
All three are calcium-based or lactic acid-based alternatives to pure hyaluronic acid fillers, and are often addressed to clinicians considering volume and structural treatments beyond standard HA. Sculptra and Radiesse have been established for many years as two separate approaches — pure biostimulation versus immediate structural volume. HArmonyCa is newer and attempts to combine the strengths of both approaches in one product, by placing hyaluronic acid and calcium hydroxylapatite in the same syringe.
Sculptra is a pure biostimulator of poly-L-lactic acid (PLLA) without hyaluronic acid, which gives zero immediate volume and builds up collagen gradually over several treatments. Radiesse is calcium hydroxylapatite (CaHA) in a carrier gel, which gives some immediate volume plus biostimulation, usually in one treatment. HArmonyCa is a hybrid that combines hyaluronic acid and calcium hydroxylapatite in the same syringe, and gives both immediate volume from the HA component and long-lasting collagen stimulation from the CaHA.
HArmonyCa and Radiesse both give visible volume immediately after injection, since they contain a carrier gel or hyaluronic acid that fills the tissue straight away. Sculptra does not give immediate volume — the effect builds up gradually over 4 to 12 weeks as the body produces new collagen.
The hyaluronic acid component of HArmonyCa can be partly broken down with hyaluronidase, in contrast to Sculptra and Radiesse, which do not contain hyaluronic acid and therefore cannot be reversed in this way. The calcium hydroxylapatite component in both Radiesse and HArmonyCa is not reversible.
Sculptra normally requires 2 to 3 treatments 4 to 6 weeks apart in order to build up the full effect. Radiesse and HArmonyCa usually give a satisfactory result after one single treatment, although follow-up treatments can give further improvement.
Sculptra can last up to 25 months thanks to the gradual collagen build-up. Radiesse typically lasts 12 to 18 months. HArmonyCa usually lasts 12 to 18 months for the visible volume effect, while the collagen stimulation can give a lasting improvement in skin quality for up to 3 years.
BC Nordic distributes all three biostimulators to clinics in the Nordics, with fast delivery and professional support.
See the HArmonyCa range →