A new option for volumetric restoration: poly-L-lactic acid.
OBJECTIVE
The market for products and techniques that correct the visible signs of facial ageing is now huge. There is a diversity of devices and treatments now vying for a share of this growing marketplace, including polymer implants and injectable preparations that are based on an array of substances. The vast majority of these devices can only provide temporary correction of superficial lines and wrinkles, with volumetric augmentation being beyond their capabilities. The products and procedures suitable for the restoration of facial volume are discussed here.


RESULTS
The restoration of facial volume has long been neglected in cosmetic rejuvenation as surgical procedures increase skin tension but do nothing to restore the underlying facial volume, which is a subtle yet important characteristic of the youthful face. Fortunately, devices are now available which can augment facial volume for long periods of time or even permanently. These include implants based on expanded polytetrafluoroethylene and silicone rubber, which provide permanent restoration of volume, but require invasive surgery and do not age with the surrounding tissues eventually resulting in an unnatural appearance. The cosmetic rejuvenation market now abounds with various injectable devices, including: poly-L-lactic acid (PLLA), polymethylmethacrylate, collagens, hyaluronic acids, silicone and calcium hydroxylapatite. The choice of which one to use in practice is physician led, based on facial assessments, product characteristics and the desires of the patient.


CONCLUSIONS
Although there is a wealth of products available, injectable PLLA (Sculptra) can restore volume to the face providing a natural look. Not only are the results of volume augmentation using this device long lasting, but they are also safe.
Thioly-Bensoussan
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St Louis Hospital, Paris, France. drdaphnetb@free.fr
D000818:Animals; D003357:Cosmetic Techniques; D005145:Face; D019344:Lactic Acid / Q000627:therapeutic use*; D011091:Polyesters; D011108:Polymers / Q000627:therapeutic use*; D015595:Skin Aging
D011091:Polyesters; D011108:Polymers; D019344:Lactic Acid; C033616:poly(lactide)