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Optimizing Collagen Biostimulator Choice in LATAM: Expert Consensus on Patient Selection, Ethnic Skin Phenotypes, and
Eugenia Cure1, Luis Alberto Parra Hernández2, Andreina Martinez Amado3
1University J. N. Corpas, Barranquilla, Colombia.
Journal of Cosmetic Dermatology
|November 29, 2025
Summary
This study provides the first Latin America-specific guidelines for using collagen biostimulators calcium hydroxylapatite (CaHA) and poly-l-lactic acid (PLLA). Recommendations optimize safety and efficacy for diverse ethnic skin types in the region.
Area of Science:
- Dermatology
- Aesthetic Medicine
- Regenerative Aesthetics
Background:
- Latin America (LATAM) presents diverse ethnic skin phenotypes and socioeconomic factors requiring tailored collagen biostimulator approaches.
- A specific consensus on the optimal use of calcium hydroxylapatite (CaHA) and poly-l-lactic acid (PLLA) in LATAM is currently lacking.
Purpose of the Study:
- To establish expert consensus guidelines for patient selection, techniques, and practical application of CaHA and PLLA in LATAM populations.
- To address the need for region-specific recommendations for collagen biostimulation.
Main Methods:
- A modified Delphi process involving 14 LATAM experts.
- Systematic literature review followed by drafting 58 statements across clinical domains.
- Consensus defined as ≥75% agreement, stratified as strong (≥85%) or moderate (75%-84%).
Main Results:
- Strong consensus (≥85%) achieved on 51 statements (87.9%), with 4 reaching moderate consensus (75%-84%).
- CaHA recommended for thicker skin and immediate volumization; PLLA for thinner skin and long-term remodeling.
- Specific dilution protocols, cannula use for safety, and post-PLLA massage emphasized. Age-based restrictions resolved via literature review.
Conclusions:
- This consensus establishes the first LATAM-specific framework for CaHA and PLLA utilization.
- Integrates ethnic diversity, anatomical considerations, and accessibility for optimized safety and efficacy.
- Provides crucial guidance for regenerative aesthetics in the region.
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