JULÄINE™: PLLA Collagen Biostimulation for Gradual, Natural-Looking Rejuvenation

As we age, the skin’s collagen framework gradually becomes less supportive. Nasolabial folds may deepen, skin firmness may decrease, and the middle and lower face may appear less supported.

JULÄINE™ is a poly-L-lactic acid, or PLLA, collagen biostimulator developed and manufactured in Sweden by Nordberg Medical.

Rather than simply filling the face with a gel for immediate volume, JULÄINE™ is designed to support gradual collagen remodelling for a natural-looking and progressive improvement.

What is JULÄINE™?

JULÄINE™ is a PLLA-based injectable implant and collagen biostimulator.

It is CE-marked for use in Europe, and its stated intended use is the correction of shallow to deep nasolabial folds in immunocompetent adults. Treatment should be carried out by an appropriately trained medical professional.

Hyaluronic acid fillers principally use a gel to provide immediate volume or contour. JULÄINE™ takes a different approach: its primary effect develops as the treated tissues gradually form new collagen support.

Neither option is automatically better than the other.

A doctor should assess your facial structure, skin condition, degree of volume loss and desired outcome before recommending PLLA, hyaluronic acid or a combination treatment plan.

How does JULÄINE™ stimulate collagen?

JULÄINE™ uses a proprietary PLLA microsphere platform called LASYNPRO™, an abbreviation of “Lactic Acid Induced Synthesis of Collagen Protein.”

The product contains smooth, relatively uniform PLLA microspheres designed to disperse within the tissue.

Through biomaterial signalling and a controlled tissue response, the microspheres are intended to support fibroblast activity and the formation of new collagen and extracellular matrix.

As the PLLA gradually biodegrades, collagen support develops progressively. JULÄINE™ is therefore not designed to produce its full result immediately after one injection.

Each unreconstituted vial contains:

• 150 mg of PLLA microspheres;
• 45 mg of sodium carboxymethylcellulose;
• 145 mg of non-pyrogenic mannitol.

What can JULÄINE™ treat?

JULÄINE™’s stated intended use is the correction of shallow to deep nasolabial folds.

As collagen support develops, the folds may appear softer and the skin around the treated area may look smoother and firmer.

The cheeks, temples, jawline, neck and other anatomical areas are not included in the product’s stated nasolabial-fold indication.

Treatment in another area must be independently assessed by the doctor with reference to facial anatomy, the patient’s needs and local regulatory requirements. Some applications may be off-label and should not be advertised as approved indications.

How many JULÄINE™ treatments are needed?

An average initial course may consist of approximately three sessions, normally spaced two to four weeks apart.

The actual number of sessions, amount used at each appointment and treatment interval will depend on factors such as:

• age;
• nasolabial-fold severity;
• skin condition;
• previous treatments;
• desired degree of improvement.

A personalised medical assessment is therefore necessary.

When will I see the results?

JULÄINE™ is not primarily an instant volumising treatment.

Some people may notice early tightening within several weeks, while more visible collagen remodelling generally develops over approximately two to three months.

Improvement may continue to develop for several months following treatment, while the collagen renewal process may continue for more than 12 months.

The speed and durability of an individual result can be affected by age, skin condition, lifestyle, treatment frequency and the injection plan. A fixed duration should not be guaranteed to every patient.

Any immediate fullness after injection may partly reflect fluid or short-term swelling and should not be regarded as the final collagen result.

The outcome should be assessed after swelling has settled and sufficient time has passed for collagen remodelling.

What does the clinical evidence show?

A prospective, multicentre, non-randomised study followed 36 women treated with JULÄINE™ for nasolabial folds.

At six months, approximately 71.9% of assessed right folds and 68.8% of assessed left folds had improved by at least one grade.

No serious adverse events were reported, and laboratory and imaging measurements supported ongoing collagen formation.

These findings are encouraging, but the study was small, included women only and did not have a randomised control group.

It should therefore be interpreted as promising early evidence rather than a guarantee of outcome for every patient.

What are the common side effects?

Common and usually temporary injection-site reactions include:

• redness, swelling or bruising;
• short-term pain, tenderness or minor bleeding;
• temporary tightness or discomfort around the injection site.

Most mild reactions settle progressively over several days. In early clinical research, most reported adverse events were mild to moderate and self-resolving.

For PLLA injectables as a broader product class, less common delayed risks include:

• palpable lumps;
• nodules;
• inflammatory reactions;
• infection.

Appropriate product preparation, injection depth, dosage and knowledge of facial anatomy are important parts of safe treatment.

As with facial injectable implants generally, rare but serious vascular complications may occur.

Seek urgent medical attention for unusual or increasing pain, blanching or mottled discolouration of the skin, changes in vision, stroke-like neurological symptoms or other severe symptoms during or after treatment.

Who may not be suitable for JULÄINE™?

JULÄINE™ may be unsuitable, or treatment may need to be postponed, in people who:

• are under 18;
• are pregnant or breastfeeding;
• have an active infection, inflammation or skin disease at the proposed injection site;
• have a known allergy to any product ingredient;
• have a bleeding disorder;
• are receiving anticoagulant therapy;
• have a history of, or susceptibility to, keloid or hypertrophic scarring;
• have an immune deficiency;
• are undergoing treatment that may affect healing or immune response.

Tell your doctor about all medical conditions, allergies, medicines, supplements and previous aesthetic procedures.

Do not stop an anticoagulant or any other prescribed medicine without instructions from the prescribing doctor.

What should I do after treatment?

After treatment, patients are generally advised to:

• avoid excessive touching, pressure or rubbing of the treated area;
• avoid alcohol for 24 hours;
• avoid excessive sun exposure for one week;
• avoid energy-based aesthetic procedures for one week;
• follow the treating doctor’s instructions for swelling, bruising and skincare.

Massage instructions can differ between PLLA products, preparation methods and injection techniques.

Do not automatically follow the massage protocol of another PLLA product. Massage JULÄINE™ only when, and in the manner, specifically instructed by your treating doctor.

How much does JULÄINE™ cost?

The cost of JULÄINE™ depends on:

• the number of vials required;
• the depth of the nasolabial folds;
• the number of treatment sessions;
• the individual treatment plan.

A doctor must first assess your facial structure and skin condition before recommending the appropriate amount and providing an accurate quotation.

Contact LM SKINCENTRE to arrange a medical consultation and ask about JULÄINE™ availability, suitability, anticipated outcomes, potential risks and current treatment fees.

Frequently Asked Questions About JULÄINE™

1. What are the main ingredients in JULÄINE™?

The primary active biomaterial is poly-L-lactic acid.

Each vial also contains sodium carboxymethylcellulose and non-pyrogenic mannitol to support reconstitution and the formation of a uniform suspension.

2. How is JULÄINE™ different from hyaluronic acid filler?

Hyaluronic acid principally provides relatively immediate volume or contour.

JULÄINE™ principally works through progressive collagen remodelling. They address different treatment needs, and the choice should be based on medical assessment.

3. Which areas can be treated with JULÄINE™?

Its stated intended use is the correction of shallow to deep nasolabial folds in adults.

Other facial or body areas are not part of the stated indication and require individual medical and regulatory assessment.

4. How many sessions will I need?

An average initial course may consist of around three sessions, normally two to four weeks apart.

Your doctor may recommend a different plan based on your starting condition and treatment objective.

5. Will I see a result after one treatment?

Short-term swelling may be visible after treatment, but genuine collagen remodelling takes time.

Early changes may appear within several weeks, with more visible improvement commonly developing over two to three months.

6. How long do the results last?

Results vary between individuals.

Collagen remodelling may continue for several months after treatment, while the collagen renewal process may continue for more than 12 months.

The actual duration depends on factors such as age, skin condition, lifestyle and the treatment plan.

7. Is there any downtime?

Many patients can return to normal daily activities relatively quickly.

However, redness, tenderness, bruising or swelling may be visible for several days. Patients with an important social event or photography should allow extra recovery time.

8. Is JULÄINE™ suitable for every skin type?

Suitability is not determined by skin tone alone.

The doctor must also consider nasolabial-fold severity, skin condition, medical history, medicines, immune status, scarring tendency and treatment expectations.

9. Can I have JULÄINE™ while pregnant or breastfeeding?

Treatment is generally not recommended during pregnancy or breastfeeding. It is also not normally suitable for patients under 18 years old.

10. Do I need to massage after treatment?

Do not apply another PLLA product’s massage routine to JULÄINE™.

Whether massage is needed, and its frequency and pressure, should be determined by your treating doctor.

11. Is JULÄINE™ painful?

Patients may experience a needle-prick sensation, pressure or temporary discomfort.

Depending on the treatment area and individual needs, the doctor may consider topical or local anaesthesia.