Skin Biostimulation (Polynucleotides, PLA, CaHA, Unlinked HA)

Skin biostimulation at Berska Clinic involves minimally invasive micro-injections of biological agents — including polynucleotides, unlinked hyaluronic acid with amino acids, polylactic acid (PLA), polycaprolactone (PCL), and calcium hydroxyapatite — to stimulate the skin's own collagen and elastin production from within. Unlike traditional fillers which replace volume, biostimulants primarily trigger fibroblast activity, improving skin quality, elasticity, and hydration from the inside out. The agents are fully absorbed within approximately two years, leaving behind newly produced structural proteins rather than foreign material.

Skin biostimulation represents a fundamental shift in the philosophy of aesthetic injection therapy: rather than replacing what is lost (volume, contour) with a filler material, the goal is to reactivate the skin's own regenerative biology. MUDr. Šárka Běrská uses a range of injectable biostimulants, selecting the appropriate agent or combination based on the individual patient's skin condition, age, and treatment goals. Polynucleotides (PDRN/PN) are fragments of purified DNA extracted from fish sperm or plant sources. They work through receptor-mediated tissue repair: polynucleotides activate A2A adenosine receptors in fibroblasts, directly stimulating the production of collagen, elastin, and extracellular matrix components. They also have anti-inflammatory and antioxidant effects at the cellular level, making them useful for dull, sun-damaged, and post-acne skin. Products such as Nucleofill, Plenhyage, and Plinest are common formulations in this category. Unlinked (free) hyaluronic acid with amino acids acts as a deep hydration depot in the dermis. Unlike cross-linked HA fillers (which are designed for structural support), unlinked HA spreads within the interstitial space, attracting and retaining water molecules and replenishing the hydration gradient that diminishes with age. It is typically combined with amino acids and vitamins (a mesotherapy cocktail) for enhanced skin nourishment. Products such as Juvederm Hydrate, Restylane Skinboosters, and Hyalual fall into this category. Polylactic acid (PLA) and polycaprolactone (PCL) are synthetic polymers that provoke a controlled foreign-body response, stimulating fibroblasts to encapsulate the microspheres with newly synthesised collagen. Both are fully bioresorbable over 18–36 months, leaving the deposited collagen behind. Sculptra (PLA) and Ellanse (PCL) are the most established products; they are used primarily for skin quality improvement over the face, neck, and décolletage rather than for focal volume. Calcium hydroxyapatite in its diluted form (hyperdiluted CaHA, sometimes marketed as the "HArmonyCa" or "Radiesse biostimulator" application) is injected in a hydrated, low-concentration preparation into the deeper dermis or subdermis, acting primarily as a biostimulant rather than a structural filler. The biostimulation session at Berska Clinic begins with a skin assessment and choice of agent. Injections are administered using fine needles or mesotherapy techniques across the treatment area. There is minimal downtime: the skin may show small injection marks and mild redness for 24–48 hours. Results improve progressively over 4–8 weeks as the biostimulation response matures. Ideal candidates include patients with dry, dehydrated, or ageing skin seeking long-term quality improvement rather than immediate volumisation, as well as those in their thirties who want to begin preventive anti-aging treatment.