Collagen Biostimulators at SŌMA Bali Compared: Sculptra, Juläine, Juvelook and Radiesse, and When Each Is the Right Choice
Published by SŌMA Aesthetics and Longevity Club · Medically reviewed by Dr Shirley Yuliana Kwee, MBChB (Glasgow), GDFM (NUS), Executive Medical Director · Updated 28 September 2026
"Biostimulator" has become one of the most loosely used words in aesthetic medicine. It is applied to products that share a single idea, prompting the skin to build its own collagen, but that differ in material, in what they do on the day of treatment, in where they can safely be placed and in how long they last. SŌMA Aesthetics and Longevity Club in Uluwatu offers four, all described on the collagen biostimulators page: Sculptra, Juläine, Juvelook and Radiesse. This article sets out how each works, what the evidence supports, what the clinic's doctors consider when choosing between them, and where the products that are often mistaken for biostimulators, Profhilo, hyaluronic acid boosters and polynucleotides, fit in.
What a biostimulator does that a filler does not
A hyaluronic acid filler works by occupying space: the gel is placed where volume has been lost and the effect is immediate, reversible with hyaluronidase and temporary. A collagen biostimulator works by provoking a response. The injected material, whether poly-L-lactic acid microspheres or calcium hydroxylapatite, is recognised by the tissue as foreign and biocompatible at the same time, and the controlled inflammatory reaction that follows recruits fibroblasts, the cells that manufacture collagen. Over the following weeks those fibroblasts lay down new type I and type III collagen around the particles. As the material is gradually metabolised, the collagen remains.
Three consequences follow. First, the result is not visible on the day, or not fully; it develops over two to six months. Second, the result is the patient's own tissue rather than a gel, which is why well-planned biostimulator treatment reads as a firmer, better-supported face rather than a filled one. Third, it cannot be undone with an enzyme. Product selection, depth of placement and injection technique therefore matter more with biostimulators than with any hyaluronic acid product, and at SŌMA they are injected only by doctors.
The four biostimulators at SŌMA, one by one
Sculptra (poly-L-lactic acid, Galderma)
Sculptra is the reference product in the category. Poly-L-lactic acid has been used in absorbable sutures for decades; as an injectable it was approved in Europe in 1999 and by the FDA in 2004, initially for facial fat loss in HIV, and for aesthetic use in 2009. The freeze-dried PLLA microparticles are reconstituted with sterile water and usually lidocaine before the session, in larger dilution volumes than the original protocols, and placed deep, in the subcutaneous or supraperiosteal plane. Nothing much is visible on the day beyond the water, which is absorbed within a day or two. Collagen builds from about six weeks, peaks between three and six months and, once a course of two to three sessions four to six weeks apart is complete, lasts up to two years.
Sculptra suits volume loss over a broad area rather than a single line: hollow temples, flattened cheeks, a jawline that has lost definition, the lower face and, off the face, the buttocks, the backs of the hands and crepey skin on the arms and knees. It is not used in the lips, the glabella or the thin skin around the eyes. Its main drawback is the risk of small palpable papules if the product is under-diluted, placed too superficially or not massaged in the days after treatment; with current dilution and technique the reported rate is well under one per cent.
Juläine (poly-L-lactic acid, Nordberg Medical)
Juläine is the newest product on SŌMA's menu and the same material as Sculptra: poly-L-lactic acid that stimulates fibroblasts in the same way. The difference is in manufacturing. Nordberg Medical, a Swedish company, produces the PLLA as uniform, smooth, spherical microspheres under its LASYNPRO process, rather than the irregular milled particles of first-generation products, with the aim of a more predictable tissue response and easier reconstitution. Juläine is CE-marked as a Class III medical device under the EU Medical Device Regulation, is registered in more than 35 countries and launched in Indonesia on 29 August 2026. SŌMA is the first clinic in Bali to offer it.
Indications overlap almost entirely with Sculptra: temples, cheeks, jawline, lower face, neck, décolletage, hands and body areas where skin has lost firmness. The Indonesian launch guidance describes three sessions four to six weeks apart, and the PLLA literature reports collagen deposition continuing for 8 to 24 months. Juläine is priced per vial at three times the level of Sculptra, which in practice makes it the choice for patients who want the newest-generation product and are treating a limited area, while Sculptra remains the more economical option for a full-face or body course.
Juvelook (poly-D,L-lactic acid with hyaluronic acid, VAIM Global)
Juvelook, from South Korea, is a hybrid. It combines poly-D,L-lactic acid (PDLLA) microspheres with non-cross-linked hyaluronic acid in a single vial. The hyaluronic acid hydrates and smooths the skin from the first week, giving an immediate effect that pure PLLA products lack; the PDLLA then stimulates collagen over the following four to eight weeks. PDLLA is an amorphous form of polylactic acid that is broken down faster than PLLA, so the collagen response is shorter-lived, around twelve months, but the product can be placed more superficially and in thinner skin. A 2024 preliminary study in the Journal of Cosmetic Dermatology examined the skin-rejuvenation effect of this PDLLA and hyaluronic acid combination.
This makes Juvelook the biostimulator SŌMA's doctors reach for where Sculptra and Radiesse are not used: fine lines, the under-eye area, atrophic acne scars, enlarged pores, the neck and décolletage, and as a skin-quality treatment for patients in their late twenties and thirties who are not yet losing volume. One to three sessions four weeks apart are usual. Because it sits between a skin booster and a biostimulator, it also appears in the clinic's skin boosters guide.
Radiesse (calcium hydroxylapatite, Merz)
Radiesse is a different material and behaves differently. Calcium hydroxylapatite microspheres, the same mineral as bone, are suspended in a carboxymethylcellulose gel. The gel gives immediate volume, so a Radiesse treatment looks like a filler treatment on the day; as the gel is absorbed over the following months the microspheres stimulate collagen, so the correction is maintained by new tissue. Radiesse was approved by the FDA in 2006 and is one of the most studied biostimulators; a 2024 systematic review in the International Journal of Dermatology confirmed the dual mechanism. At full strength it lasts 12 to 18 months and is used for the jawline, chin, cheeks, nasolabial folds and the backs of the hands.
Diluted with saline or lidocaine at ratios from 1:2 to 1:6, Radiesse becomes a skin-tightening treatment rather than a volumiser. A global consensus panel published guidelines for diluted and hyperdiluted calcium hydroxylapatite in Dermatologic Surgery in 2018, covering the neck, décolletage, upper arms, abdomen, thighs, buttocks and knees as well as the lower face. In this form it is the biostimulator of choice for crepey or lax skin over large areas, given as one to three sessions and lasting 12 to 18 months. Like PLLA it is not placed in the lips or around the eyes, and it cannot be dissolved with hyaluronidase.
Side by side
Sculptra | Juläine | Juvelook | Radiesse | |
Material | Poly-L-lactic acid | Poly-L-lactic acid (spherical microspheres) | Poly-D,L-lactic acid + hyaluronic acid | Calcium hydroxylapatite in CMC gel |
Maker | Galderma, Switzerland | Nordberg Medical, Sweden | VAIM Global, Korea | Merz, Germany |
Effect on the day | Temporary fullness from the diluent only | Temporary fullness from the diluent only | Hydration and smoothing from HA | Immediate volume (full strength); mild lift (hyperdiluted) |
Collagen response | From ~6 weeks, peak 3–6 months | From ~6 weeks, peak 3–6 months | 4–8 weeks | 2–4 months |
Duration | Up to 24 months | 8–24 months | About 12 months | 12–18 months |
Best areas | Temples, cheeks, jawline, lower face, hands, body | Same as Sculptra; neck, décolletage | Under-eye, fine lines, acne scars, pores, neck | Jawline, chin, cheeks, hands; neck, arms, abdomen, knees when hyperdiluted |
Not used | Lips, glabella, around the eyes | Lips, glabella, around the eyes | Deep volume replacement | Lips, around the eyes |
Sessions | 2–3, 4–6 weeks apart | 2–3, 4–6 weeks apart | 1–3, 4 weeks apart | 1–2 full strength; 1–3 hyperdiluted |
Price at SŌMA | IDR 8,500,000 per vial; IDR 14,500,000 for 2 vials | IDR 25,000,000 per vial | IDR 6,500,000 per vial | IDR 7,000,000 per 1.5 ml; IDR 7,500,000 per hyperdilution session |
Prices are current at 28 September 2026 and exclude 11% government tax. Currency conversions use the European Central Bank reference rates of 25 September 2026 (USD 1 = IDR 17,914) and are indicative; the clinic bills in rupiah.
Products that are called biostimulators but work differently
Profhilo is often described as a biostimulator and is not one in the sense used above. It is 64 mg of hyaluronic acid in 2 ml, stabilised without chemical cross-linking, injected at five points on each side of the face and left to spread. Its effect on laxity and hydration comes from the hyaluronic acid itself and from the signalling it triggers in fibroblasts and keratinocytes, which IBSA, the manufacturer, calls bio-remodelling. It gives a visible improvement in skin quality within weeks, lasts about six months and adds no volume; two sessions four weeks apart cost IDR 9,000,000 each at SŌMA.
Hyaluronic acid skin boosters, including Belotero Revive and Revok50, hydrate the dermis and improve glow and texture over one to three sessions. They are the right choice for dull or dehydrated skin and for patients who want a result within days; they do not rebuild structure.
Polynucleotides (Rejuran, from salmon DNA) act on cell repair rather than on collagen scaffolding. They are the treatment for acne scarring, enlarged pores and damaged skin barrier, and combine well with a biostimulator when both texture and firmness need work.
Autologous regenerative treatments, platelet-rich fibrin and the clinic's own exosome preparations, deliver the patient's growth factors and signalling vesicles to the skin. They improve healing and skin quality and are used alongside biostimulators, particularly in the under-eye area and for hair, rather than instead of them. The full range is on the regenerative treatments page.
How SŌMA's doctors choose
The decision starts with the problem, not the product. Four questions settle most cases.
Is the concern volume and contour, or skin quality? Loss of volume in the temples, cheeks and jawline, and a lower face that has lost definition, call for a deep biostimulator: Sculptra or Juläine for a gradual, natural rebuild, or full-strength Radiesse where the patient wants structure on the day. Crepey, lax or thinning skin with no real volume loss calls for hyperdiluted Radiesse over large areas, Juvelook for the face and neck, or Profhilo where hydration and mild laxity are the issue.
Where on the face or body? The under-eye area, fine lines and acne scars belong to Juvelook, polynucleotides or a hyaluronic acid booster. The neck, décolletage, arms, abdomen and knees belong to hyperdiluted Radiesse or, for body volume such as the buttocks, PLLA. Hands take either PLLA or Radiesse.
How soon is the result needed? A biostimulator is a three-to-six-month project. A wedding or an event in the next few weeks is a case for hyaluronic acid filler, Profhilo or a booster, with the biostimulator started afterwards.
What is the budget over two years? Costed over the life of the result, a course of Sculptra is usually the most economical way to rebuild volume; Juläine is the premium option; Radiesse gives the most immediate return for a single-session budget; Juvelook and Profhilo are the entry points for younger skin. The consultation sets the number of vials and sessions, and the treatment prices page lists the current menu.
Age is a guide rather than a rule. Patients in their late twenties and thirties are typically treated for prevention and skin quality with Juvelook or Profhilo; from the forties, when volume loss becomes visible, PLLA or Radiesse; from the fifties, most patients benefit from a combination, a biostimulator for structure with a booster or polynucleotides for the surface.
Safety, and why technique matters more than the brand
All four products are well tolerated when they are used correctly, and their complications are almost all complications of technique. With PLLA the recognised risk is the papule or nodule: a small, usually invisible lump that forms when product is under-diluted, placed too superficially or left unmassaged. The expert recommendations published in 2025 set out the current standard, larger reconstitution volumes, deep placement, no treatment of the lips or periorbital area and post-treatment massage, and under that standard nodule rates are reported at around 0.4 per cent against 5 to 7 per cent with the older concentrated protocols. With calcium hydroxylapatite the risks are those of any injectable, bruising, swelling and the rare intravascular injection, together with nodules if the product is placed superficially at full strength; the hyperdilution guidelines exist precisely to make superficial placement safe.
None of the four can be dissolved. Hyaluronidase, which reverses a hyaluronic acid filler in hours, has no effect on PLLA or calcium hydroxylapatite; a problem is managed with time, massage and, where needed, injected steroid. That is the reason SŌMA's protocol for a first biostimulator course is conservative: a smaller first session, review at four to six weeks and additional product only where it is needed. Biostimulators are not used in pregnancy or breastfeeding, over active skin infection or acne, or in patients with a history of keloid scarring; patients with autoimmune conditions are assessed individually. Every vial's batch number is recorded in the patient's file, and all four products are bought through authorised Indonesian distributors.
What a course costs at SŌMA
Product | Unit | Price (IDR) | USD | AUD | SGD |
Sculptra, single vial | per vial | IDR 8,500,000 | $474 | A$675 | S$606 |
Sculptra, full protocol | 2 vials | IDR 14,500,000 | $809 | A$1,151 | S$1,034 |
Juläine | per vial | IDR 25,000,000 | $1,396 | A$1,985 | S$1,782 |
Juvelook | per vial | IDR 6,500,000 | $363 | A$516 | S$463 |
Radiesse, full strength | per 1.5 ml syringe | IDR 7,000,000 | $391 | A$556 | S$499 |
Radiesse, hyperdilution protocol | per session | IDR 7,500,000 | $419 | A$596 | S$535 |
Profhilo (for comparison) | per 2 ml session | IDR 9,000,000 | $502 | A$715 | S$642 |
Prices are current at 28 September 2026 and exclude 11% government tax. Currency conversions use the European Central Bank reference rates of 25 September 2026 (USD 1 = IDR 17,914) and are indicative; the clinic bills in rupiah. A typical first course is two vials of Sculptra over one or two sessions, two to three vials of Juläine over as many sessions, one to two vials of Juvelook, or one syringe of Radiesse; the doctor confirms the quantity at consultation after examining the face.
Patients who are unsure which product suits them can send a photograph and a short description of their concern by WhatsApp, or book an assessment at the clinic in Uluwatu; a video consultation is available for patients travelling to Bali.
Frequently asked questions
What is the difference between a biostimulator and a filler?
A hyaluronic acid filler adds volume the moment it is injected and can be dissolved with hyaluronidase. A collagen biostimulator adds little or no volume on the day; it places a biocompatible material in the skin that the body responds to by building its own collagen over three to six months. The result is firmer, thicker skin and gradual restoration of contour, and it cannot be dissolved.
Sculptra or Juläine: which PLLA product is better?
Both are poly-L-lactic acid and work the same way. Sculptra, from Galderma, has the longer track record: approved in Europe in 1999 and by the FDA in 2004, with more than two decades of published data. Juläine, from Nordberg Medical in Sweden, uses a newer manufacturing process that produces uniform spherical microspheres and is CE-marked as a Class III device; it arrived in Indonesia in August 2026. At SŌMA the choice turns on the area, the amount of product needed and the patient's budget, since Juläine costs roughly three times as much per vial.
Which biostimulator lasts longest?
Sculptra and Juläine (PLLA) typically last up to two years once a course is complete. Radiesse lasts 12 to 18 months at full strength and when hyperdiluted; Juvelook around 12 months. Profhilo, which is hyaluronic acid rather than a biostimulator, lasts about six months.
Can Radiesse or Sculptra be used under the eyes or in the lips?
No. PLLA and calcium hydroxylapatite are not placed in the lips or the thin skin around the eyes, where the risk of visible nodules is highest. For the under-eye area and fine lines SŌMA's doctors use Juvelook, polynucleotides or a hyaluronic acid booster instead.
How long before an event should a biostimulator be started?
Three to six months. A course of two or three sessions takes six to twelve weeks to deliver, and the collagen response continues for months after the last session. A patient with an event in a few weeks is better served by a hyaluronic acid filler, Profhilo or a skin booster.
Can biostimulators be combined with fillers, Botox or XERF?
Yes, with sequencing. Botulinum toxin can be given on the same day. Hyaluronic acid filler for a specific contour is usually added once the biostimulator result has developed, or placed first where immediate structure is needed. Energy-based treatments such as XERF are generally scheduled a few weeks apart from a biostimulator session so that fresh product is not heated. The doctor sets the order at consultation.
What do biostimulators cost at SŌMA in Bali?
Sculptra IDR 8,500,000 per vial or IDR 14,500,000 for the two-vial protocol; Juläine IDR 25,000,000 per vial; Juvelook IDR 6,500,000 per vial; Radiesse IDR 7,000,000 per 1.5 ml syringe, or IDR 7,500,000 per session for the hyperdilution skin-quality protocol. All prices exclude 11% government tax and are confirmed at consultation, where the number of vials and sessions is set.
Sources
Goldie K, Peeters W, Alghoul M, et al. Global consensus guidelines for the injection of diluted and hyperdiluted calcium hydroxylapatite for skin tightening. Dermatologic Surgery, 2018.
Injectable poly-L-lactic acid as a versatile treatment in current aesthetic medicine: expert recommendations. Cosmetics, 2025.
Calcium hydroxylapatite dual mechanism: systematic review. International Journal of Dermatology, 2024.
Seo et al. Skin rejuvenation effect of the combined PDLLA and non cross-linked hyaluronic acid: a preliminary study. Journal of Cosmetic Dermatology, 2024.
Profhilo effectiveness for skin quality and acne scars: randomised trial. Journal of Cosmetic Dermatology, 2024.
Nordberg Medical. Juläine product information.
SŌMA Aesthetics and Longevity Club. Collagen biostimulators in Bali and Pricing.
