Biostimulators are biologically active substances that can improve the quality and functioning of the skin and substructures to firm, rejuvenate and improve the aesthetic appearance.

Biostimulators South Africa

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Skin rejuvenation through improved skin function and quality

Biostimulators are biologically active substances that can be injected under the skin to improve the quality and functioning of the skin and substructures to firm, rejuvenate and improve the aesthetic appearance.

Wrinkles and loss of volume in the face are a natural part of the ageing process. Therefore, we are fortunate that scientists have developed a range of biostimulators to help fight and effectively delay signs of ageing.


We use calcium hydroxyapatite (CaHA) and Poly-L-Lactic acid (PLLA) to stimulate collagen formation in the face, neck, décolleté, and hands. Both these molecules stimulate collagen formation; a process that takes 6 to 12 weeks to show results. At present we offer Hyaluronic Acid hybrid filler with CaHA, CaHA only, and PLLA biostimulators.

Find out more about our approach to Biostimulators and book a consultation with Dr Nerina Wilkinson + Associates today.

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Frequently asked questions about Biostimulators

Our approach to Biostimulators

At Dr Nerina Wilkinson + Associates we understand the importance of embracing the facial structures and skin as a whole. The goal is to achieve harmonious results using facial reshaping injectables and state-of-the-art skin rejuvenating treatments.

No area of the face exists in isolation, all are connected and often corrected indirectly through facial reshaping. Treating areas in isolation leads to exaggerated and aesthetically unattractive features.

By understanding how all areas of the face are interconnected and how treating one area communicates with another facial area, we are able to use much less product and produce constant and beautiful, natural results.

Start your biostimulator journey! Contact us to book a consultation.

Who is the ideal candidate for a biostimulator treatment?

Biostimulators may be suitable for anyone with signs of ageing, who could benefit from potential improvements in skin architecture. They are ideal for the treatment of sagging skin on the lower face, neck, and hands and for improving overall skin quality.

Which areas can be treated with biostimulators?

Biostimulators are not used around the eyes, the lips, or around the mouth. Although not used in the mid-face, their lifting effect can improve the mid-cheek area by providing a skin-tightening effect.

They are ideal for the treatment of lower face sagginess, accordion lines in the cheeks, jawline sculpting, skin tightening, and quality improvement in the lower face and neck, as well as in the hands.

Lateral face (Cheek and jawline), Neck, Décolleté, Hands

Areas where there is movement such as around the eyes and mouth, nasolabial folds, and the anterior part of the neck.

How do CaHa and PLLA work?

CaHA particles support the body’s own collagen production by providing a structure for fibroblasts (collagen-producing cells) to rest on and form new collagen fibers. CaHA is delivered in a carrier gel that slowly disappears over time. As this gel disappears, a firm, dense collagen network is built in its place for a gradual, long-lasting lift.

PLLA recruits new fibroblasts into the area, which form more collagen fibers, providing a more intense collage-stimulating effect.

In some areas and in some patients, a gentler effect is preferable, which is why we offer both CaHA and PLLA.

What is the duration of a biostimulator procedure?

Treatment time can vary between 30-45 minutes, depending on the area(s) treated. You will be able to go home right away, and no downtime is required.

A repeat treatment may be done after 6 to 12 weeks and a follow-up appointment is required 12 weeks after your treatment to assess results.

How do biostimulators differ from dermal fillers?

Biostimulators are not dermal fillers or volumisers and differ in their mode of action by stimulating lasting collagen production in the substructures of the skin. Repeated treatments initially, may be necessary, depending on your age and the extent of your skin laxity, and may provide sustained tightening for up to 3 years.

We recommend maintaining your results by seeing your aesthetic doctor regularly to assess when your next treatment will be necessary. Usually, a top-up treatment is required every 12 – 18 months.

What are the benefits of biostimulators and how long do results last?

Hyaluronic Acid (HA) and CaHA-based biostimulators are considered hybrid fillers which may give you an immediate lift due to the HA component, whilst the CaHA component is responsible for the collagen production that happens slowly over the next 6 weeks to 3 months. This means that you may experience an instant lifting result that will gradually improve over a 3-month period and can last for 1-3 years. Depending on your initial result, your doctor may advise on a second treatment, 3 months after the initial treatment, to boost results.

CaHA-based biostimulators may give you an instant filling effect, due to the carrier gel, which will break down over the next 3 months. The true results rely on the collagen production, which takes 6 weeks to 3 months to occur. Repeated treatments will further stimulate collagen, and will improve your results. Results last up to 1 – 2 years and should be topped up every 12 – 18 months.

PLLA-based biostimulators contain no carrier gel or HA component and hence will not provide you with any initial visible result which may take up to 6-12 weeks to show. Your second treatment will be done at 6 weeks and you will only be able to start assessing results at the time of your third treatment. Sculptra is a pure biostimulator treatment with beautiful long-term results for those who are willing to wait for their beautiful skin to develop as collagen formation is stimulated.

What are the results I should expect after a biostimulator treatment?

Biostimulator procedures are normally safe when performed by a qualified Aesthetic Doctor.

Biostimulators are substances that have been used for a long time to improve features and surrounding skin. In the past, harmful substances used in these procedures could cause adverse reactions and side effects.

As a result, doctors have continuously improved on and sought out better ingredients to help them perform this procedure safely, with minimal or no adverse reactions.

Biostimulators: Before and After

The initial consultation with an Aesthetic Doctor is very important. We will need your complete medical history so check your own records ahead of time and be ready to provide this information. After your initial consultation, your doctor will decide if the Biostimulators are suitable for you.

You will have a comprehensive examination that includes a VISIA Skin Analysis and Next Motion photographs which track your before and after progress. Based on the results your doctor will be able to determine the best course of treatment.

It’s important to discuss your expectations frankly with your Aesthetic Doctor and to listen to her opinion. They will discuss the variables that may affect the procedure: such as your age, medical illnesses, and social habits, as well as describe the procedure in detail, explaining its risks and limitations.

Don’t hesitate to ask any questions you may have, especially those regarding your expectations and concerns about the results.


2 Weeks prior to your treatment, we advise you strongly to avoid:

Fish oil supplements
Aspirin or any other anti-inflammatory drugs for pain, swelling and/or fever, such as medicine containing diclofenac, mefenamic acid, indomethacin, or ibuprofen

Ask your doctor or pharmacist whether your medication includes any of these ingredients. This will reduce the risk of bruising or bleeding at the point of injection.

Because bruising and swelling are the most common side effects, especially in the lower face, schedule appointments at least 48 hours before any major event. Please let us know if you have been to the dentist / oral hygienist or if you are planning to go to the dentist/ hygienist in the next 4 weeks.

Why? When your teeth are cleaned, bacteria are released into your mouth and travel into the bloodstream. CaHA injectables of any kind are considered an implant, a foreign substance in the body, and these excess bacteria increase the risk of infection and the formation of Biofilm (bacterial infection). If this is your first visit you will need to provide us with information regarding your medical history and any medical concerns, as well as details of any allergies you have or medications you are taking.

Please contact us to find out our specific requirements before undergoing a Biostimulator procedure at Dr Nerina Wilkinson + Associates. 


Please note that you will have to arrive without makeup to prevent any Biofilm (bacterial infections) when doing any dermal filler or biostimulator treatments.

Once the Doctor has determined and confirmed your areas of concern by means of a detailed consultation, they will proceed. It is important that you’re honest with the doctor about your medical history, medication, and expectations during this time. So that if they are not in line with the treatment, then another can be recommended instead.


For 2 hours: Avoid make-up at the injection site to avoid contamination in the area.

For 4 hours: Do not lie down or do strenuous exercise and similar activities, nor should you do anything that increases the blood flow to the injected area.

FOR PLLA ONLY: Massage the treated area for 5 minutes, 5 times a day, for 5 days after your treatment as shown by your doctor at the time of treatment

For 12 hours: Massage the treated areas if you feel any small bumps.

For 24 hours: Avoid any high-intensity exercise or activities, exposure to sunlight, tanning beds, or extreme weather conditions.

For 24 hours: Apply an ice pack or cold compressions to the treated areas as with most injectable treatments there may be some redness, swelling, and irritation.

For 1 month: Avoid dental procedures and any invasive skin treatments.

For 3 months: Avoid any other injectable treatments, such as Dermal Fillers.

Please follow these instructions carefully to aid in achieving optimal results: Please note that no treatment can halt the ageing process completely, you will require top-up treatments if you want to maintain the effect, so please ask your doctor when she would recommend rescheduling another appointment.


What are the possible risks and complications associated with biostimulators?

As with other injectable treatments, the most common side effects after injection with biostimulators include:

  • Redness
  • Swelling
  • Pain
  • Tenderness and itching

These are often mild and typically improve within 24-48 hours, while swelling and bruising may take up to a week to completely resolve. Applying ice packs or cold compresses to the treated areas for 24 hours after treatment can help to reduce redness, swelling, and irritation. It is also possible that you may feel small bumps under the skin in the injected areas. If this happens, make sure to massage the skin in these areas. Any lumps that remain after 5 days should be reported to your treating doctor.

In rare cases, you may experience numbness and or weakness on both or one side of the face where it was treated, and may which may last up to 1 to 2 days before it resolves completely. This may be due to the prolonged effect of the local anesthetic agent and in some cases when the product is injected around the temples, may even cause blurry vision. Please contact your doctor if you experience any of these symptoms.

What do biostimulators cost?

The cost of treatment depends on your face shape, concerns, personal goals, how much product is required, and the treatment(s) required. You will be provided with an estimate after your initial consultation with one of our Aesthetic Doctors.

We are unable to provide you with an exact cost/quotation for pre-treatment as an in-depth consultation is part of our individualised and holistic Aesthetic Couture journey to help you achieve the results you desire; we quote on the steps required to achieve this outcome, not simply on the amount of product required.

Please contact us for any more information.

Are there alternative procedures to biostimulators?

Yes, there are alternative treatments for reducing issues associated with facial skin ageing and improving skin architecture.

Natural Lift procedures restore youth and refine the facial profile allowing light to naturally reflect from the skin, and involve the precise placement of very small volumes of hyaluronic acid filler in multiple areas of the face to build deep structural support and the shift the balance between the elevator and depressor muscles of the face.

Bio skin remodelling involves the use of stabilised Hyaluronic Acid boosters to provide noticeable improvements in the hydration, tightness, and firmness of your skin.

Botulinum toxin treatments are popular non-surgical procedures that appeal to adults looking to attain a more youthful and relaxed appearance, and also to younger clients who want to prevent the formation of fine lines and wrinkles.

Are biostimulator treatments painful?

All our biostimulator products of choice contain lidocaine, a local anaesthetic that reduces pain during treatment. Biostimulators treatments are comparable to other fillers when it comes to discomfort during and after treatment.

Where are biostimulator treatments performed in Cape Town?

Dr Nerina Wilkinson + Associates is a private, high-end, luxurious clinic located in the prestigious V&A Waterfront in Cape Town. Dr Wilkinson founded the House of Aesthetic Couture and Skin Science. Your treatment will be performed at this clinic.


Similar to Biostimulators


Natural-Lift combines sophisticated techniques to microscuplt the proportions of the face to restore youth and refine the facial profile, allowing light to naturally reflect from the skin.
View Treatment

Bio skin remodelling

Bio skin remodelling involves the use of stabilised hyaluronic acid boosters to provide noticeable improvements in the hydration, tightness and firmness of your skin.
View Treatment

Botulinum Toxin Treatments

Popular non-surgical procedures that appeal to adults looking to attain a more youthful and relaxed appearance, and also to younger clients who want to prevent the formation of fine lines and wrinkles.
View Treatment


The Aesthetic Couture Team

About Dr Nerina Wilkinson + Associates

We pride ourselves on affording our patients the best service through their journey with us. Whether you are having a skin treatment with one of our skincare experts, aesthetic medical treatments or cosmetic surgery, the team at Dr Nerina Wilkinson + Associates will be there for you, every step of the way.

Skin Science & Aesthetic Couture

As an all-female team, we understand the importance of naturally beautiful-looking skin. Known as leaders in the skincare industry we have pioneered industry-changing rejuvenation techniques and signature procedures such as 3D Microneedling™, FORMA™ Hydralyft, and the GlowGetter™.

Our Patients'


“Thank you to the wonderful ladies at your skin clinic. I have always suffered from problem skin. They have over the last few months advised me on the correct skincare and through their dedicated treatments I am now proud to show my skin without wearing too much makeup.”

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