# Biostimulators Explained: What Everyone Is Talking About

An episode of [Vain-ish](https://invisiblenetwork.ai/podcast/1824105551), 16 Jun 2026, 35 min.

Audio: https://enrichment.soundstack.com/4vjqq8/episode.flightcast.com/cgh1cqorev4bmih1ri4m9h0h.mp3

Biostimulators are a growing topic of discussion in aesthetic medicine, but what are they and how are they used in clinical practice? Cosmetic and Emergency Medicine Physician Dr Sean Arendse answers common questions and explores consultation considerations, treatment planning, potential risks, and emerging research in this evolving area of aesthetic medicine. This episode is intended for educational purposes only and should not be considered personal medical advice. Find us on Instagram: @vainishpodcast, and thanks to our guest Dr Sean Arendse Hosts: @becjudd and @jessierobertsx Producer: Liza Altarejos Audio Imager: Chris Marsh Video Producer: Justin Hill Find more great podcasts at www.listnr.com See omnystudio.com/listener for privacy information.

## Transcript

[0:02] a listener production.
[0:05] I'm Bec Judd.
[0:06] And I'm Jess Roberts.
[0:07] And we're done with the smoke and mirrors.
[0:09] Faye Nish shares honest stories about what it takes to look amazing because we did not wake up like this.
[0:15] And you should know the stuff that we chat about on this podcast is based on our personal experiences.
[0:21] We're sharing it for your entertainment.
[0:23] It's definitely not medical advice.
[0:26] And we'll always be clear with you when something is a paid endorsement.
[0:29] Please always chat with your qualified healthcare team before making any decisions about your health.
[0:49] Hey guys, it's Bec Judd.
[0:51] And Jess Roberts.
[0:51] And welcome to Fainish.
[0:53] How you going, babe?
[0:54] I'm good.
[0:54] How are you?
[0:55] I'm alright.
[0:55] I'm just a bit annoyed.
[0:57] Are you?
[0:57] I'm annoyed.
[0:58] Oh.
[0:58] Are you, um, what's it called?
[1:00] Ovulating?
[1:00] Not ovulating.
[1:01] The fourth week.
[1:02] Luteal phase.
[1:03] Yeah.
[1:05] Uh, no.
[1:05] No.
[1:06] Oh, no.
[1:07] I should be peaking right now.
[1:09] I should be super happy.
[1:10] Yeah, okay.
[1:10] I'm like day six.
[1:12] Oh, oh.
[1:13] The next week's gonna be fun.
[1:15] It's gonna be so fun.
[1:18] Oh, no.
[1:18] Do you know what?
[1:20] You know, in this day and age, we have so much life admin that catches us, not just, you know, in a work setting where you could, you go to work, you go home and your day was done.
[1:32] But the constant life admin, the constant stuff from the school, appointments, et cetera, setting up new things at home and the apps and the whatever, the to-do list is mind-boggling.
[1:43] It is.
[1:43] And as I'm sitting here with you today and we're recording today,
[1:47] The emails, I can see my phone going ding, ding, ding, ding.
[1:50] And one of the things that pisses me off the most, and I'm just, I'm refusing to ever do it again, right, is when you book an appointment, so a medical appointment, a specialist appointment, dental appointment, physio appointment, whatever, and they send you all these forms that you have to fill out before you get there.
[2:09] I'm like, no, I can fill them out when I get there.
[2:13] That whole like, come in 10 minutes early to fill out a form.
[2:17] Yeah.
[2:17] That's what we want.
[2:18] Yeah.
[2:18] A paper form.
[2:19] Yes.
[2:19] I don't need all these emails and notifications.
[2:23] It's lost.
[2:23] And say, you haven't filled out your form.
[2:24] You haven't done this.
[2:25] Yeah.
[2:25] I fill out the fucking form when I get into the office.
[2:27] Yes.
[2:28] It pisses me off.
[2:29] Yeah.
[2:29] And going on medical appointments, we used to go to our doctor and go, you might need a referral.
[2:34] And they would refer it to the doctor.
[2:36] Yeah.
[2:36] And then the doctor will call you and go, hey, we've just got your referral.
[2:38] Let's book you an appointment.
[2:39] Now it's like here's your referral and then you've got to send it via an email to the specialist that you're seeing and then you've got to call up.
[2:49] Yeah.
[2:50] There's another step in there now.
[2:51] Yes.
[2:52] It's like, oh.
[2:53] It's just like the life.
[2:54] Like can we just go back and…
[2:56] To the good old days when there weren't apps and forms and all these BS for everything.
[3:02] And we just need to simplify our lives.
[3:05] When we were building our house, the electrician was like, oh, do you want to put in, I think it was called CBUS or something.
[3:11] Oh, yes, we had that.
[3:12] Some like home automation system and do you want to do this?
[3:15] And I'm like, why would I want that?
[3:16] Oh, because you can turn on your lights and your heating before you even arrive home and you can turn the pool on and get it warm and all these things to automate your life.
[3:25] And I thought, well, that's going to be a pain in the ass.
[3:28] There's going to be system updates.
[3:29] It's not going to work.
[3:30] And it was like $30,000, right?
[3:32] And then you know that with the advances in technology, that all that investment in five, ten years, there'll be something else that's updated.
[3:40] Like now you can just do like a, hey, Alexa or whatever, and they can do it for you.
[3:45] But all that these extra things, I'm like, no, hear me out, electrician.
[3:49] I want a plain old light switch, like the ones that we used to have in the 80s and 90s, that you just go over and with your finger, you turn it off and off.
[3:58] on.
[3:58] That's all I want.
[3:59] He's like, oh, really?
[4:01] But you can keep...
[4:01] I'm like, no, I don't want all the connections.
[4:03] I don't want the apps.
[4:04] I don't want the headaches.
[4:05] I don't want the service guy having to come over and update the freaking software because, of course, we can't turn the lights on.
[4:09] We can't turn the heater on because the system's gone.
[4:11] No, give me a freaking light switch.
[4:13] That's all I want.
[4:13] Yep.
[4:14] I agree.
[4:14] I still want that.
[4:15] I still want that.
[4:15] Right?
[4:16] So did you put the C-Bus or whatever?
[4:18] What's it called?
[4:18] C-Bus, yes.
[4:19] It is called C-Bus.
[4:20] It sounds like a bank.
[4:21] Yeah, I know.
[4:21] I know.
[4:22] We had it for...
[4:23] a commercial building and a residential at the top.
[4:25] We had it all put through the system.
[4:27] We've still got it all through the building.
[4:29] And, yeah, there's always issues.
[4:31] And it costs so much money, right?
[4:33] Yeah, and, like, we got it when it was, like, first started.
[4:36] So we paid top dollar for it.
[4:37] Yeah.
[4:38] I think it's all right now.
[4:39] I haven't heard Val complain about it.
[4:41] Maybe he's swapped it over already.
[4:42] I don't know.
[4:43] But, yeah.
[4:43] He's got Alexa now.
[4:44] Yeah, yeah, yeah.
[4:46] Yeah, I don't know.
[4:47] She's cheap.
[4:47] Yeah, she's cheap.
[4:48] Yes, no, I agree.
[4:49] I agree.
[4:49] Do you know what I miss?
[4:51] And I used to do it for my mum and mum said it and I wish this happened to me because I'm so bad because I forget my passwords for everything because I'm constantly changing passwords.
[4:59] So anyway, it comes with apps for school and emails, all of that stuff.
[5:04] And obviously having three kids, having a lot of kids, there's just so much life happening.
[5:06] Like you said, I just miss the days where the kid used to write in the diary...
[5:12] Tuesday is pupil free day or like Friday is free dress day.
[5:16] Bring a dollar coin in for red nose.
[5:19] That's it.
[5:20] Just the kids to write it.
[5:21] It teaches them how to like schedule into their diary.
[5:24] Yeah.
[5:24] The diary comes home because we've got to sign it anyway.
[5:26] Yeah.
[5:27] Comes home, we look at it and go, oh, okay, tomorrow is this.
[5:30] Yeah.
[5:31] That's all you want.
[5:31] You don't need the forms, the permission forms that come from the schools every day, the consent form to go to the incursion at school or the excursion or the whatever.
[5:40] It's like just tick the box, yes, my kids are allowed to go to everything for the whole year.
[5:44] Yeah, yeah.
[5:45] That's it.
[5:45] Yeah, and I'll tell you.
[5:46] If you're listing schools, don't bother sending any more forms.
[5:49] The Judds are in.
[5:50] So is the Roberts.
[5:52] We're in.
[5:53] In.
[5:54] Yeah.
[5:54] Unless it's 5.30 in the morning, I have to get up and take you to Run Club, Scarlet.
[5:58] It's not happening.
[6:00] And you know the funny thing is I didn't sign the fucking forms And I still take my kid So I don't know why I'm signing the forms Why do I need to sign the forms She's going to go and do it anyway How many times I've not signed the forms And then I've gone shit That excursion was on Thursday Scarlett did you go to the zoo on Thursday last week She goes yes mum That's why I had the spots Because she makes my lunchbox And I was like Oh I've just seen the reminder I never signed it They still took it So why do we have a fucking form Sorry They still take them
[6:35] So guys, today we are having one of our really good friends on.
[6:40] He's the owner of Flawless in Hampton and Toorak.
[6:44] He's also one of the head emergency department physicians across Alfred Health.
[6:51] So yes, when you're in big trouble and your life needs saving,
[6:55] This guy, he's the one.
[6:57] He is.
[6:58] We do call him at 2am in the morning sometimes.
[7:00] Like, are kids sick?
[7:02] What do we do?
[7:02] Yeah.
[7:04] So, you know, like Alfred Health in Melbourne, if you're not from Victoria listening, is the major trauma hospital here.
[7:11] It's big.
[7:12] big.
[7:13] In the past, it's had its own TV show.
[7:15] And Sean, he's often the guy meeting the helicopter as it choppers in these people who are really, really unwell.
[7:24] And he's also on that show.
[7:25] Yeah.
[7:25] A lot of multi-traumas, big car accidents.
[7:28] Sean's out there at the helipad.
[7:30] He's the first guy they see and he literally is saving lives.
[7:34] And he's been doing this for so long.
[7:36] Plus, he's also, yeah, into aesthetics and has his flawless clinics.
[7:40] And we've been lucky enough.
[7:41] We actually met him through school.
[7:43] He's a school dad.
[7:44] Yeah.
[7:44] We go to his clinic.
[7:46] We are customers and clients there.
[7:48] And we have partaken in many a biostimulator in the last, what, 18 months?
[7:54] Oh, yeah.
[7:54] Two years?
[7:54] Two years.
[7:55] four different ones on Friday.
[7:58] So when we're talking about biostimulators, this is different to fillers where we had Dr. Cara McDonald come on, who was great.
[8:05] Today, it's all about biostimulators.
[8:07] This is the buzz product.
[8:09] Everyone wants to know about it.
[8:10] It is confusing because there's so many different types, salmon, jizz, hyaluronic injections, you name it.
[8:15] So Sean's going to break it all down.
[8:17] Yeah, dumbify it for us.
[8:19] Welcome to Veinish, Dr. Sean.
[8:21] Thank you, Jess.
[8:22] So good to have you in here.
[8:23] So let's talk about your qualifications.
[8:25] Talk yourself up, mate.
[8:26] Let the world know how fabulous you are.
[8:29] Not quite that fabulous, but I am a full-time emergency physician at the State Trauma Centre and I work across the emergency department and the trauma unit.
[8:37] And then in my spare time, I am medical director for Flawless Rejuvenation, which is a full service sort of skin clinic, one location in Hampton and one in Toorak.
[8:48] In your spare time, you just run these aesthetic medical clinics.
[8:52] In your spare time.
[8:54] You do heaps of training as well, right?
[8:56] Yeah, do a fair bit of training and run a couple of courses about safety in the cosmetic industry.
[9:03] And then, yeah, try and attend as many conferences as I can a year to keep abreast of what's happening in this rapidly changing environment of cosmetics.
[9:12] So, yeah, it's a fun industry to be in.
[9:14] It's really interesting because a few years ago, when you're talking about aesthetics and injectables, it was anti-wrinkle and filler.
[9:23] And that was pretty much it.
[9:25] And then in the last couple of years, all of a sudden, all the talk is biostimulators.
[9:30] Yeah.
[9:30] So we thought, Sean, that we wanted to get you on because you inject all of these, you're trained in it, you train people on how to do it.
[9:37] Yeah.
[9:38] So we had Dr. Cara McDonald in to talk about fillers and we thought let's get biostimulators covered and we thought you were just the perfect person to do so because you're across it all.
[9:49] Yeah, I try to be.
[9:52] So can you tell us, for anyone new to the term, what are biostimulators?
[9:56] Like in simple terms that make it, dumbify it for us.
[9:59] Okay, so biostimulators are not fillers and not anti-wrinkle because they're something that are completely different.
[10:06] So what a biostimulator is, is really usually a medicine which will encourage your cells to produce elastin and collagen.
[10:15] Now, when you talk about elastin and collagen, you think about the skin.
[10:20] So the collagen there is to give your skin strength and to be like the scaffolding of your skin.
[10:26] And elastin is there to give your skin its kind of stretchiness and recoil.
[10:30] Now, if you look at a child, so look at Jagger or your youngest, Darcy, Mm-hmm.
[10:34] Have a look at their skin, how plump and how elastic their skin is.
[10:38] And when you pinch it, it kind of recalls and snaps back and it's nice and thick and pudgy.
[10:43] I actually do this often.
[10:45] I look at my kids' faces, their skin, and I pull it and I'm just mesmerized.
[10:50] Yeah, I do the whole like push it.
[10:51] It's so amazing.
[10:52] And their tiny pores as well.
[10:54] 100%.
[10:55] So is this what biostimulators are trying to do?
[10:58] Take us back.
[10:58] So we have elastin and collagen and as we age, we start to lose the ability to make elastin and collagen.
[11:06] So around about puberty, we start to decrease the amount of elastin and collagen we make in our skin and it usually is about 1% to 1.5% per year.
[11:18] When it comes to menopause, we get this acceleration of decrease of elastin collagen production.
[11:24] And some say, say menopause lasts for three to four years, you'll get a 30% reduction in elastin collagen production.
[11:32] I'm never doing the menopause thing.
[11:33] No.
[11:34] No.
[11:35] I'll be a Marilyn Monroe 37.
[11:37] I'm out.
[11:40] That's full on.
[11:41] So you've already had the one to one and a half percent per year from puberty and then you just whack another 30 percent in there.
[11:47] In like three, four years.
[11:49] Yeah.
[11:49] You have a good inkling of when a woman has gone through menopause by the texture and the look of her skin.
[11:57] There's definitely a change that is significant.
[12:02] And you can see that.
[12:02] So if you look at your kid's skin, look at your skin and how it behaves and how you pull it up, look at your parent's skin and then look at your grandparent's skin.
[12:11] And you can see this deterioration gradually and the skin gets thinner, it gets more photo-aged, it gets more damaged, it gets less elastic.
[12:18] And that's all because we're losing elastin and collagen.
[12:22] Mm-hmm.
[12:22] Now, there are certain things in the lifestyle that can accelerate that.
[12:25] So things like smoking and things like carbohydrates will degrade collagen and elastin a lot faster.
[12:32] Is that because it's a sugar?
[12:33] Yeah, so it basically destroys it, links onto it, glycates it is the term and will destroy the elastin and the collagen.
[12:40] And then things like UV rays.
[12:42] So that's why we're very vigilant, especially in Australia, that we wear sunscreen and protect our skin from UV rays because that's going to age us.
[12:48] It's going to photo age our skin, reduce our elastin, reduce our collagen, as well as do lots of other things that are harmful to our skin.
[12:55] You're going to say tequila too, aren't you?
[12:57] Not tequila.
[12:58] You might be okay.
[12:59] Is there much sugar in tequila?
[13:01] Wine and champagne.
[13:02] I don't think there's any sugar in tequila.
[13:04] No.
[13:04] I don't think vodka.
[13:04] I'm looking at you.
[13:05] Just with soda and a squeeze of lime.
[13:08] Yeah.
[13:08] Yeah.
[13:09] What are they called?
[13:09] Skinny bitches?
[13:10] That's the drink?
[13:11] Oh, is that what they're called?
[13:12] Yeah, yeah, yeah.
[13:13] I learned that from Sex and the City.
[13:15] Yeah, yeah.
[13:16] Oh, I love that.
[13:18] So I guess is that what...
[13:20] biostimulators are trying to do.
[13:22] So what biostimulators are trying to do is switch on that production of elastin and collagen.
[13:26] So I had a really good analogy from a colleague of mine, Dr. Christy, up in northern New South Wales.
[13:32] She's been on this podcast.
[13:34] Has she?
[13:34] Yeah.
[13:35] She was talking all about vaginal steaming.
[13:40] She had a great analogy for where bar stimulators work.
[13:44] If you think of a bed, there are lots of things that we can do to improve the base of the bed.
[13:49] And there are lots of things that we can do to improve the covers or the pillows.
[13:54] But where the bar stimulator works is in the mattress.
[13:57] So that's where I kind of tell my clients where we're working with a bar stimulator.
[14:02] So, Sean, biostimulators, there's so many around right now.
[14:06] There's lots of different brand names we're hearing.
[14:08] People get confused.
[14:09] Yeah, absolutely.
[14:09] Is that a filler?
[14:10] Is that a biostimulator?
[14:12] Tell us some of the brand names that people can hear and that fit under the biostimulator umbrella.
[14:17] Right, sure.
[14:17] So...
[14:19] The original two were PLLA, which is known as Sculptra, which is made from dissolvable suture material, put it bluntly.
[14:28] There is one which is calcium hydroxyapatite, which is Radiesse.
[14:32] And then the newer ones that we've seen are Profilo, which is a covalently bonded halorodic acid,
[14:39] You've got sunicos, which is six amino acids and a halogen acid component too.
[14:45] You have bi-elegant harmonica, which is a HA plus calcium hydroxyapatite.
[14:51] So that's like a blend of a profiler and a RADS type product.
[14:56] Yeah, correct.
[14:56] Oh, gosh.
[14:58] And there's a couple other ones out there, but those are probably the main ones that we would hear on a day-to-day basis.
[15:03] And how did you decide which...
[15:06] type for the patient?
[15:07] Is it just what your clinic stops and what you're trained in?
[15:10] Or do they all have their separate place?
[15:13] Is it like each biostimulator is for a different area or they can be all across the same area?
[15:19] Oh, no.
[15:19] Some of them can be used in different areas.
[15:21] Some of them work well in certain areas and some of them will work well with certain...
[15:25] patient type.
[15:25] So it's important to take a history from a patient, work out exactly what they're trying to achieve, how fast they're trying to achieve it, whether they've had any surgery, whether they're going to have any surgery because some of the bar stimulators are not a contraindication to plastic surgery.
[15:40] We had Dr. Andrew Greensmith come on and talk about some of the biostimulators he's had to dig out of people's faces when he's trying to separate planes during a facelift and he was not a fan of that particular one.
[15:50] Because that particular one would cause scar tissue, which would...
[15:53] It just made his job hard.
[15:54] I think when you can't find a nerve when you're in someone... Or if you've had a biostimulator and it's all scar tissue from a biostimulator, like that's... Yeah.
[16:02] Yeah.
[16:02] It's not ideal.
[16:03] It certainly doesn't make it impossible, but it can make it harder.
[16:06] Cost a bit more.
[16:07] More time, more time, more stress for the surgeon as well.
[16:10] More stress for the surgeon.
[16:11] So some of the surgeons say, you know, they don't want you to have the inflammatory biostimulators two years before you're going to have surgery.
[16:19] So if someone's coming in and said, I'm going to have a facelift in a month or in a year, then probably going to reduce the usage of this particular biostimulator.
[16:28] And I'll pick something that's less inflammatory or is less inclined to stick planes of the tissue together.
[16:32] I think that's important to know if you're listening.
[16:34] There's so many different types, different indications.
[16:37] And you've got to think about your lifestyle and also what your future plans are.
[16:40] Yeah.
[16:41] If you are going to get a facelift, you need to tell your doctor or your injector what you're doing so that they can kind of guide you and give you the right treatment.
[16:49] So how long does it take for it to kind of kick in?
[16:51] Yeah.
[16:52] Well, that's the thing.
[16:53] It's not like you fillers a couple of days or even immediately, whereas anti-wrinkle injections take two to seven days.
[17:01] Your biostimulase are going to be in the range of weeks to months.
[17:05] So you have to plan for this.
[17:07] And you really have to educate your clients that this is not going to be a quick fix.
[17:11] This is a journey that we're going to go on together.
[17:13] So this is the thing with Jess and I, right?
[17:14] We get all the biostimulators, but then we also do the lasers and the skincare and the peels.
[17:18] So we stick to the schedule, but we can't pinpoint and say, I had that biostimulator and I did this because there's so many other variables that are in the mix.
[17:28] Overall, it's an upward trend.
[17:31] And I know there's lots of different things that you can use to support the biostimulators, like good skincare, good lifestyle and so forth.
[17:38] But it would be hard to measure these things, right, for that reason.
[17:41] It is extremely hard to measure these and it's very hard to photograph these things as well.
[17:46] So, Dr. Sean, what potential risks and side effects should patients be aware of before considering this type of treatment?
[17:52] Absolutely.
[17:52] So we should never forget that what we're doing is a medical treatment.
[17:57] So it does carry risks.
[17:59] Worst case scenario...
[18:01] is blindness, and we can certainly get blindness with most of the biostimulators that are out there, so it's not a free shot.
[18:09] Pain, bruising, some of them form nodules or historically form nodules, but there's lots of ways that we can do to make sure that we administer these biostimulators in the safest possible way.
[18:20] And that's why, again, I would pick a medical practitioner that is experienced, that knows how to deal with emergencies in not just the cosmetic field, but also in the medical field to make sure that when we see you, you don't walk out or not walk out of the clinic being harmed or blind or having skin necrosis.
[18:41] What's the worst you've ever seen?
[18:42] And I know that you're an emergency boss and you work in cosmetics.
[18:46] So I imagine in your trainings and the conferences around the world that you would have seen some of the worst side effects and studied.
[18:56] Can you give us an idea of some of the worst?
[18:58] So I am a field officer for a group called AMET and they manage cosmetic emergencies around Australia.
[19:05] So if there's an adverse event, then...
[19:09] the call goes out to the field officers and we pick up the case and we manage the case.
[19:14] Based on what state you're in and where the patient is.
[19:16] Based on what state.
[19:17] So this weekend, there were two in Victoria.
[19:20] One was a vascular occlusion of the facial artery that was managed by a number of very experienced cosmetic physicians with ultrasound.
[19:30] with intravascular halase and very specific halase to unblock that vessel so that we don't get skin necrosis or your nose fall off basically.
[19:41] Yeah, that's scary.
[19:42] And was the result positive?
[19:44] The result was very positive but it took a number of attempts and a whole host of people to manage this process.
[19:53] this weekend.
[19:53] So luckily the patient survived and hopefully she'll have no scarring and no tissue damage.
[19:59] But certainly I haven't seen it, but I've certainly read about cases of blindness.
[20:03] So if you go into a cosmetic clinic for a treatment that's supposed to make you more attractive and you walk out with one eye blind, I think it's career ending for whoever it was that administered that.
[20:16] And it's also devastating for the patient.
[20:18] That's everyone's worry in this industry that we'd cause something that serious to a patient.
[20:23] So it's all about where it's injected, how it's injected.
[20:26] Yeah, exactly.
[20:27] And making sure that your injector or your cosmetic physician or cosmetic nurse knows their anatomy.
[20:34] And the difference between normal anatomy and sort of injecting anatomy is it's not 2D anatomy, it's 3D anatomy.
[20:40] So you've got to know A, where the vessel is,
[20:42] but you also need to know, or the nerve, you also need to know what depth it's at.
[20:47] do you know, and I say this to my husband all the time, how do you know where the nerves are and all that sort of stuff?
[20:53] Because everyone's face is like structurally different.
[20:56] Like, you know, vessels are all different.
[20:58] Bone structure is different.
[20:59] Like I know the main nerves you have an understanding, but like, you know.
[21:02] How do you pinpoint them when you're injecting?
[21:04] Because that would frighten the bejesus out of me.
[21:06] Yeah, I've got scoliosis.
[21:06] And for them to do even a spinal block, it's like this full assessment.
[21:11] It's a maze.
[21:12] Yeah, it's a maze.
[21:13] So it's like the same thing with the face.
[21:15] Like, how do you...
[21:16] No, you just kind of just do, I guess.
[21:18] Well, you don't.
[21:19] Basically, you're playing, every time you stick a needle into someone's face, you're playing Russian roulette.
[21:24] Yeah.
[21:25] But your knowledge of anatomy and your examination of them, palpation...
[21:31] you lower your chances.
[21:32] But everyone, including myself, has had times when we've injected substances into vessels.
[21:39] Yeah.
[21:39] But, you know, the important thing is that we know how to deal with it.
[21:42] Yeah.
[21:43] And we deal with it immediately.
[21:44] We don't let the patient go home and touch wood.
[21:48] I haven't had one for a few years now.
[21:49] But again, you know, like this weekend, it does happen.
[21:52] And one of my mentors, Professor Greg Goodman, who you know very well, says, if you haven't had a vascular event, then you're just not injecting enough.
[22:00] Yeah.
[22:01] Okay.
[22:02] So it's not a case that you, you know, if it's when it's going to happen if you're a high volume injector.
[22:08] Yeah.
[22:09] Gosh, that's scary.
[22:10] But yeah, if you're trained in emergency situations and you know what you're doing.
[22:14] The one on the weekend, was that a biostimulator or was that a filler?
[22:18] That was an AHA filler.
[22:21] But it happens with biostimulators as well.
[22:24] Now, there are some biostimulators that they have done studies where they've injected them into rabbit ears to try and occlude them and they've been unsuccessful.
[22:34] Okay.
[22:35] So there are some biostimulators that I would say were safer than others and there are some biostimulators that we could potentially reverse with an antidote that we have and there are some biostimulators that we couldn't.
[22:48] And I've certainly seen cases through the Alfred Hospital where one biostimulator was injected, which was quite thick, and we couldn't dissolve it.
[22:56] And the patient ended up having some hair loss, quite a large patch of hair loss due to that artery being blocked.
[23:05] Okay, so how do you manage patients who are seeking very noticeable or immediate changes?
[23:10] They come in looking one way, they want to leave looking like Kim Kardashian.
[23:17] I think the best way I can answer this is a colleague of mine.
[23:22] a woman came into her and said, I want to have Angelina Jolie's lips.
[23:25] And she did nothing like Angelina Jolie.
[23:29] There's no structure there to give her those lips.
[23:31] And she said, the day you walk in here with Brad Pitt is the day you can have Angelina Jolie's lips.
[23:35] I love that.
[23:37] This is when Angelina was married to Brad.
[23:39] But yeah, I mean, sometimes you can't do that.
[23:41] And you have to be realistic with your patients about what you can achieve.
[23:44] And sometimes they have unrealistic expectations about what you can achieve.
[23:48] And that is all driven by Instagram and filters.
[23:52] And I get it all the time.
[23:53] I see, you know, we're obsessed or we were obsessed a couple of years ago with tear troughs.
[23:59] and they were looking at Vogue covers and covers of other magazines, what they don't understand is those covers are airbrushed within an inch of their life.
[24:08] So if you actually look at the person in real life, they don't look like that.
[24:11] And that is an unrealistic expectation for us to try and achieve with cosmetic treatments.
[24:17] 100% and not just airbrushing the skin.
[24:19] They change the hair colour.
[24:21] They also change the size and shape of structures.
[24:25] So they make the nose smaller, the forehead, they shrink that.
[24:29] The face that you often see is, yeah, not just an airbrush.
[24:33] It's complete remodelling.
[24:34] I'm always in so much shock when I meet like a massive celebrity.
[24:38] I'm always like, I literally walk past them and not realise and then I'm like, oh, that was – and I'm like, sit there going –
[24:44] Oh, my God, they look so different.
[24:45] Yeah.
[24:46] They look like humans.
[24:47] A hundred percent.
[24:48] How many really, really super famous people have we met in real life?
[24:54] But online, they are like, not real.
[24:58] It's almost like AI.
[24:59] And then you meet them in real life.
[25:00] They look nothing like they're... No.
[25:02] Even in our industry, just going to like events and like, yeah, influences and stuff.
[25:06] Influences.
[25:06] I'm like, whoa, you do not look like your photos.
[25:09] Yeah.
[25:09] Yeah.
[25:10] You look like you've got normal skin in real life.
[25:12] Yeah.
[25:12] Yeah.
[25:12] It's amazing.
[25:13] I think it's really important to know that, yeah, those photos you see online.
[25:17] It's all fake.
[25:17] It's all fake, baby.
[25:19] Only time you know it's real, it's when they're doing...
[25:22] stories and piece to cameras and talking, then you're like, oh, yeah.
[25:26] Yeah, videos.
[25:26] I'm sure there'll be filters and stuff on videos.
[25:28] Or Paris filter, of course.
[25:29] Yeah.
[25:39] Sean, there has been a shift toward more subtle regenerative approaches in aesthetics, and I guess because we've got the tools to be able to do that now.
[25:46] How did biostimulators fit into that broader evolution?
[25:50] Oh, yeah.
[25:51] I think that in the old days, all we had was botulinum toxin and filler.
[25:56] And so everything we saw was a nail and that's what we hit with our hammer.
[26:00] But now we have this broad toolbox of products and medicines that we can use.
[26:06] And I think people's aesthetic have shifted.
[26:09] So filler has been overused and overused.
[26:13] Yeah.
[26:13] And we had this sort of distorted aesthetic of this really doughy looking face, this overfilled face that was just everywhere.
[26:20] Puffy.
[26:21] Yeah, puffy.
[26:22] I think there are a number of celebrities that have gone back and just dissolved everything out of their face and started again.
[26:29] And then what they've come back in is said, I don't want to look like that.
[26:32] I don't want to look overfilled.
[26:33] I don't want to look fake.
[26:35] I don't want to look augmented.
[26:36] I want to look a better natural version of myself.
[26:39] So I want to age, but I want to age gracefully.
[26:42] I don't want to age.
[26:45] But okay.
[26:47] If we must.
[26:47] If we must.
[26:49] Not everyone gets to age though.
[26:50] So aging is a privilege.
[26:52] It is a privilege.
[26:52] I do say that to myself.
[26:53] So you have to embrace it.
[26:55] You do.
[26:55] You do.
[26:56] So I see the biostimulators fitting really well into that and allowing us to give a very natural aesthetic, which is what aesthetic I've always had since I started in the industry.
[27:05] I really try to push that natural aesthetic.
[27:07] And finally it's swung back to where we are today, which I think is awesome.
[27:11] Yeah, it's in a better place now, for sure.
[27:12] Is it true, Dr. Sean, that if you have had filler and then you get a biostimulator put on top, will that make you puffy?
[27:19] It depends on the biostimulator.
[27:21] Some biostimulators don't have HA in them, so they're not going to give you that hydration.
[27:26] But yes, we've certainly seen it with Profilo.
[27:29] If we put a couple of dots in the wrong spot or we go according to the exact protocol, we can get some puffiness around the eyes for
[27:38] A week, a couple of weeks.
[27:39] And like if you've got filler in your cheek and then you get prophyllo put into your cheek with that cause.
[27:44] It can draw more water in.
[27:45] And as we age, our lymphatic drainage, especially around the eye, gets very sluggish and you do get sort of little sort of maloedema and some fat pads around the eyes, which are due to fluid retention.
[27:56] And it's a very difficult thing to treat.
[27:58] So the way to do it with that particular biostimulator is just to move that point lower away from that troublesome area and try and use it that way.
[28:06] So will you say to your patients, have you had filler in your teardrop and your cheeks?
[28:11] And if you have, you'll kind of just place the injection somewhere else.
[28:15] Yeah, 100%.
[28:15] And I think it's important to know exactly when someone walks into your practice, what they've had done before and where they've had it put and what product it is.
[28:23] Yeah.
[28:23] So be honest, guys, you're not going to be judged.
[28:25] Just it's so important for the injector to know, yeah, what you've got in your face.
[28:31] 100% and that's one of the first things that we'll do is go through your cosmetic history and work out exactly what we're dealing with.
[28:38] And I think that's the other thing.
[28:39] A lot of people that have had filler can go, oh, yeah, but I had it done like five or six years ago, so I won't even have any left.
[28:45] But you do.
[28:46] Yeah.
[28:47] So make sure you always be honest.
[28:49] Like what David Beckett said, be honest.
[28:51] Your list would be like five pages long.
[28:52] Yeah.
[28:53] I love it.
[28:56] Talk to us about combining these treatments with, you know, lasers or skin needling.
[29:00] Can you do that or does it need to be standalone or does it depend on the product?
[29:04] No, you can definitely combine them with lasers and high-focused ultrasound and microneedling and needling and skincare.
[29:11] That will all boost the effects of the collagen stimulation, but you just need to be doing it at the right time.
[29:17] So not have the biostimulator and then the next day have skin needling.
[29:23] Give it a little bit of time.
[29:24] Let the skin heal.
[29:25] Again, it depends on the biostimulator.
[29:28] There's a couple of people around the world doing really good work off face with radio frequency needling, high-fuel ultrasound, and one of the bar stimulators for backsides, for arms, for legs, tummies.
[29:42] I'm still reading their research at the moment, but there's some really good stuff coming out of the Netherlands and the US.
[29:47] Interesting.
[29:48] And just talking about the body then, a lot of these biostimulators can be used off face.
[29:53] Yes.
[29:53] Correct?
[29:54] Yeah.
[29:54] Your knees, Jess.
[29:55] Knees and elbows, guys.
[29:57] What do you call the elbows?
[30:00] It's a weenus.
[30:01] It's a weenus.
[30:01] Do you know what's so funny?
[30:03] I've like, when I lie on my bed on my stomach and I'm on my phone and I've got my elbows down like this, you know, resting on my bed, I literally about three seconds and go, oh, I've got to get up because I don't want to stretch my weenus.
[30:16] It's in my head.
[30:17] But now, if I can get a biostimular, I'm going to lay down on my knees.
[30:21] On my weenus.
[30:22] On my weenus.
[30:23] But I'm like, yeah.
[30:24] Put those weenuses to work, babe.
[30:27] Yeah, literally.
[30:28] Yeah.
[30:28] I think that's like, you see people and they...
[30:32] invest in a lot of treatments for their face and they look insanely good and fresh and rejuvenated.
[30:38] And then from the neck down, they kind of neglect.
[30:40] And you can actually, it's the giveaway of the sun damage and the lack of elastin and collagen and all of that.
[30:47] I think given that there's more products, we've got a bigger toolbox for the body.
[30:53] For me personally, it's exciting.
[30:55] Being a vain person, I'm like, great, I'll get my weaners done, get my kneecaps done.
[30:58] Also, you could probably even like when people have lost heaps of weight, you could probably get your fanny done.
[31:04] Well, we'll take it back a step.
[31:06] Sorry, Sean, we are friends.
[31:08] It's just like these two unhinged girls again.
[31:12] With the GLP-1s, there is one company that are marketing biostimulators to try and keep up with their rapid fat loss and the rapid weight loss that you get from your face by instituting one of the biostimulators when you start your GLP-1.
[31:27] Right.
[31:28] To try and make sure you don't face it.
[31:30] Oh, okay, sorry, yeah.
[31:31] Yeah.
[31:32] Yeah.
[31:32] Oh, there you go.
[31:33] Because remember, your face is made up of fat pads.
[31:35] So if you're losing fat from everywhere else, you're going to lose it from your face.
[31:37] And you've got this, I think it's called the Exempic Face.
[31:40] Yes.
[31:41] And there's a whole marketing campaign directed towards that.
[31:45] And they're trying to get on the front foot when they're on their GLP ones.
[31:48] We need to buy shares in that company.
[31:50] I know, we do.
[31:50] We do.
[31:51] Also, what about, I've heard that you guys can do biostimulators for stretch marks.
[31:57] Yeah.
[31:58] Is that a thing yet here?
[31:59] You can.
[32:00] It's difficult and I don't think it would be on its own.
[32:03] It's certainly off-label for most of the bar stimulators, but there is some research looking at using bar stimulators and radiofrequency needling and high-focused ultrasound to treat stretch marks.
[32:14] It's about trying to get, you know, a stretch mark has lost most of its elastin and collagen.
[32:19] You're trying to get that back in place.
[32:22] into that area.
[32:23] But I don't know how successful they are.
[32:25] I don't think it's a brilliant treatment, but there certainly is some research and some treatments behind that.
[32:30] So what advice would you give someone who is considering aesthetic treatments for the first time?
[32:35] There's a lot of our audience out there wanting to dip their kind of
[32:39] their toes in but not knowing where and how.
[32:43] I would do your research on who's injecting you and make sure that they have the skill set not only to assess you properly, recommend the treatment that you need, not what your friend had, but what you need.
[32:55] be able to manage any sort of adverse event that is going to hopefully not occur, but they know how to deal with that.
[33:03] And they're treating you holistically and it's not focused on price.
[33:08] So they give you what you need, not what you want.
[33:10] Yeah.
[33:10] Yes.
[33:11] That's what Dr. Cara McDonald said as well.
[33:13] Yeah.
[33:13] Give them what they need, not what they want.
[33:14] And also don't copy your friend.
[33:16] I do that all the time.
[33:18] I'm like, she has and she has and she has.
[33:21] No, Jess, you cannot.
[33:22] I'm like, oh, okay.
[33:24] So what is an age that you could possibly get by a stimulator's?
[33:29] again, it would vary between person to person.
[33:31] So some people who've had lots of sun damage and are smoking and are doing all sorts of bad things in their skin and they don't wear sunscreen and they've really hammered their skin will probably start earlier than somebody who has been looking after their skin and...
[33:45] has had other treatments and has a good diet, reducing carbohydrate, reducing UV exposure, not smoking.
[33:52] So it does vary from person to person.
[33:54] Also skin type will vary as well.
[33:56] Genetics.
[33:58] If you're a very fair person compared to someone who has a bit of color in their skin, your skin is going to react differently as you age.
[34:04] So it really is individualized to see different people will need it at different times of their life.
[34:11] Okay, that was so informative.
[34:14] I get overwhelmed with all the different types of biostimulators.
[34:17] And what they do.
[34:18] Yeah, but I think that was, Sean, you really made that really easy to understand.
[34:22] Thank you.
[34:23] Thanks, Jess and Bec, for having me on.
[34:25] It's been a pleasure and we'll get back to work.
[34:27] Yeah, so much fun.
[34:28] Got to save some lives now.
[34:29] Yeah, and make them pretty at the same time.
[34:33] We'll see you next week for another episode of Veinish.
[34:35] Bye.
[34:36] Bye for now.
[34:36] Bye.
[34:42] Same.

Shows are listed from Apple Podcasts' charts and directory, and Podcast Index where it is used. Every show and episode belongs to its publisher and plays from the publisher's own feed; this site hosts none of them.