All about polylactic acid fillers
Injectable remodeling agent
Due to the growing interest in PLLA-based drugs, we will consider the main clinical aspects of the use of polylactic acid, which are important to consider when working.
Svetlana Tkachenko, Candidate of Medical Sciences, Associate Professor of the Department of Dermatology, Venereology and Medical Cosmetology, Kharkiv National Medical University (Kharkiv)
Injectable PLLA (Sculptra/Sculptra Aesthetic; Dermik Laboratories; Bridgewater, New Jersey) consists of poly-L-lactic acid particles in a carboxymethyl cellulose sodium salt gel. PLLA is a biocompatible, biodegradable, synthetic, immunologically inert polymer from the alpha hydroxy acid family. Since the drug is a stimulant and not a volumizer, the clinical outcome of its use is less predictable, which explains its lesser popularity among both doctors and patients.
Indications and contraindications
PLLA injections are indicated to restore or correct signs of lipoatrophy in HIV-infected patients [Sculptra [package insert]. Bridgewater, NJ: Dermik Laboratories; 2009] and for use in healthy patients to correct fine and deep nasolabial and other facial wrinkles using the cross-hatch/mesh technique. PLLA is not recommended for use in the periorbital or lip area. The drug was approved in Europe after 1999 for soft tissue augmentation [Cheryl M. Burgess. cosmetic dermatology. Springer. Verlag Berlin Heidelberg, 2005.-170r.].
The injectable PLLA is perhaps best described as a remodeling agent. PLLA treatment causes a significant improvement in facial volume and skin thickness, however, the optimal effect requires time and several treatments, as well as patience and perseverance on the part of both the doctor and the patient. Achieving results when using PLLA is due to the stimulation of the production of natural collagen, while the duration of the result reaches 2 years [Palm MD, Goldman MP. Patient satisfaction and duration of effect with PLLA: a review of the literature. J Drugs Dermatol. 2009;8(suppl10):S15-S20.]. The immediate filling effect resulting from the injection is temporary and disappears within a few days.
*The full version of the article is available in Ukrainian and Russian
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