Tune In: How Biostimulators Mess With Collagen Production, According To A Plastic Surgeon

On today's episode of Clean Beauty School, I'm having on one of the world's most sought-after aesthetic specialists, Beverly Hills plastic surgeon Ben Talei, M.D. Most famously, he's worked with Sia and other celebs—but he has scores of other clients thanks to his natural, neutral approach. To know his work is to barely notice anything at all.

He's also amassed quite the following on social media thanks to his refreshingly blunt takes on current approaches to skin care. In fact, I became such a fan of his work thanks to his TikTok, where he explains the inner workings of the skin, sheds light on how various treatments work, and shares insights on plastic surgery in general.

"You have to look at the reputation of plastic surgery—it's not stellar. And there's a reason for that," he tells me during the episode before explaining how and why the field of plastics got such a bad reputation. It's a fascinating conversation, one that's worth a listen even if you don't have any future aspirations of getting aesthetic treatments. But it's especially worth a listen if you've been thinking about getting anything, most notably filler.

One of the reasons I was so eager to have Talei on the podcast was so I could ask him about biostimulator use. He had posted a few videos explaining why they're not being injected appropriately, and I had to learn more. 

Biostimulators are a form of injectable (typically falling under the "filler" category) in which a substance is placed in the dermis to stimulate new tissue growth in the skin rather than simply adding superficial volume. 

"These solutions are injected into the face, and the body will start to eat it up. And as it eats it up, it starts an inflammatory reaction. This process is called fibroplasia, which just means that your fibroblasts come in to heal the area and they deposit collagen and other fascial constituents, such as hyaluronic acid," Talei says. In theory, it sounds great, no? 

But as Talei explains to me, it's not so straightforward in practice. "These are beautiful and fantastic to use if you know how to use them, but everybody keeps describing it and using it wrong," he says. 

See, in practice many practitioners inject them into inappropriate layers of the dermis in a misguided attempt to create dermal collagen. Collagen primarily resides in the dermis, and it's what makes our skin firm, lifted, and youthful. We lose it with age (starting at some point in our 20s—yikes), and so much of what is done in the world of beauty and aesthetics is to recreate what is lost. 

There are many, many kinds of collagen—upward of 28 research suggests1. As Talei explains, these biostimulators aren't always producing the type of collagen intended. In fact, what you're getting is scar tissue—not the smooth, organized collagen layers of the dermis. 

"What you get when you incite a fibroblastic response is the kind of collagen that resembles more granulation tissue than anything2, but it is not the type of collagen that you would typically see in different parts of your dermis or sub-dermis. It's a completely different type of collagen," he says.