Optimizing Collagen Biostimulator Choice in LATAM: Expert Consensus on Patient Selection, Ethnic Skin Phenotypes, and Accessibility

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Background The diverse ethnic skin phenotypes and socioeconomic landscape of Latin America (LATAM) necessitate tailored approaches to collagen biostimulators, calcium hydroxylapatite (CaHA) and poly-l-lactic acid (PLLA). A region-specific consensus on their optimal use is lacking. Objectives To establish expert consensus guidelines on patient selection, techniques, and practical application of CaHA and PLLA for collagen biostimulation in LATAM populations. Methods A modified Delphi process was conducted with 14 LATAM experts. Following a systematic literature review, 58 statements were drafted across key clinical domains. Consensus was defined as ≥ 75% agreement, stratified as strong (≥ 85%) or moderate (75%-84%). Results Strong consensus was achieved on 51 statements (87.9%), with 4 reaching moderate consensus. Key recommendations include: selecting CaHA for thicker skin and immediate volumization, and PLLA for thinner skin and long-term collagen remodeling; using specific dilution protocols (e.g., CaHA 1:1 for face, 1:4 for body); employing cannulas for safety; and implementing vigorous post-PLLA massage. Initial disagreements on age-based restrictions were resolved through literature review, achieving final consensus. Conclusion This consensus provides the first LATAM-specific framework for CaHA and PLLA use, integrating ethnic diversity, anatomical considerations, and acces

Evidence level

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

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