PLLA is a unique and versatile product that can effectively address the signs of facial ageing. It provides a gradual, natural and subtle improvement. Loss of volume and underlying skeletal support occurs with ageing.
This product is not a filler but a stimulator of the host to produce its own collagen. The collagen that is produced then volumises the tissue where it is injected. This biostimulatory agent works to interact with the host’s response to produce new collagen.
Sculptra Dermal Filler is a Poly-L-Lactic Acid, a synthetic polymer of L-lactic acid linked by ester bonds. PLLA are biocompatible and biodegradable and lack toxicity in humans. They degrade to lactic acid which is then metabolised via the citrate cycle.
This is a stimulator not a filler. It stimulates the host own collagen. It then acts to volume eyes tissue in a gradual progressive manner.
The Sculptra dermal filler is a safe and versatile agent that can be used in a manner that is both predictable and reproducible.
The medication received FDA approval for HIV associated facial lipoatrophy in 2004. In 2009 it receive approval for aesthetic use.
Injection of this material leads to an inflammatory or immune response. The PLLA product undergoes encapsulation and stimulation of fibroblasts. Over time the product is degraded and eliminated via the lymphatics . In the early stages the PLLA, which is a high molecular weight polymer undergoes hydration which occurs over several months. The second and last stage is degradation of the polymer to lactic acid.
The product undergoes phagocytosis by macrophages and is eventually eliminated from the body.
The aim is for a gradual and progressive correction with multiple treatment sessions.
The optimal candidate for the product is a volume-depleted patient.
It can improve the infra-orbital hollowing (dark circles) by refilling the mid cheek and lateral cheek as as well as the pre-auricular area and lifting the redundant skin along the mandible.
PLLA leads to a gradual improvement and possibly a more durable and natural look than filler.
Complications are rare.
Possible complications include granulomas which are more common in patients with poor dental hygiene or dental decay. However the rate of granulomas formation is very low between 0.01% and 0.1%.
I would avoid this product in patients who have received a permanent filler.
Common side effects
Bruising and swelling are common but are transient and subside after a few days.
PLLA provides volume and soft tissue support when injected at varying depths either supraperiosteal or into the subcutis.
PLLA is a unique product that is very versatile. It can address changes in the dermis, mimic fat and act as a volumiser as it stimulates your own collagen production. It can address the key features of facial ageing by smoothing wrinkles, restoring volume, improving skin structure and improving the appearance of scars.