title: Injectable poly-l-lactic acid: 3 years of aesthetic experience.
abstract: BACKGROUND
  Injectable poly-l-lactic acid (PLLA) has been used to correct age- or disease-related facial volume deficits.
  
  
  OBJECTIVE
  This single-center, retrospective survey evaluated PLLA for cosmetic use.
  
  
  METHODS
  A questionnaire was mailed to 281 patients treated with PLLA 6 months or more previously. PLLA was reconstituted 4 hours or more before injection with 5 mL of sterile water plus 1 mL of 1% xylocaine added before injection.
  
  
  RESULTS
  Two hundred twenty-one patients responded (210 female; average age 54.3; average treatments 3.3 per patient); the majority had received facial injections. Transient side effects included bruising, swelling, and discomfort. After treatment (1-6 months), 14/41 patients developed Grade 1 papules or nodules (slightly palpable, nonvisible; clinically nonrelevant; all resolved spontaneously), 15/41 developed Grade 2 papules or nodules (palpable, slightly visible; clinically nonrelevant; all resolved spontaneously), and 12/41 developed Grade 3 nodules (easily palpable, obviously visible [9 perioral; 3 periorbital or temple]; 5 resolved spontaneously; 7 were treated [5 intralesional corticosteroids; 2 surgery]).
  
  
  CONCLUSIONS
  Patients treated with PLLA experienced duration of improvement of up to 24 months. Maximum improvement took several treatment sessions. Nodules occurred in perioral and periorbital regions, so incidence is reduced by avoiding these areas.
authors.affiliation: Cranley Clinic, London, United Kingdom. cranley@cranleyclinic.com
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Lowe
authors.forename: C Anne
authors.initials: CA
authors.lastname: Maxwell
authors.forename: Philippa
authors.initials: P
authors.lastname: Lowe
authors.forename: Ardash
authors.initials: A
authors.lastname: Shah
authors.forename: Rickie
authors.initials: R
authors.lastname: Patnaik
mesh_terms: D000328:Adult; D000368:Aged; D002482:Cellulose / Q000008:administration & dosage*; D003357:Cosmetic Techniques; D005145:Face; D005260:Female; D006801:Humans; D007271:Injections, Intradermal; D019344:Lactic Acid / Q000008:administration & dosage*; D008297:Male; D008353:Mannitol / Q000008:administration & dosage*; D008875:Middle Aged; D019736:Prostheses and Implants; D019651:Plastic Surgery Procedures; D019233:Retreatment; D012189:Retrospective Studies; D015595:Skin Aging / Q000187:drug effects; D016896:Treatment Outcome
chemical_list: C482305:New-Fill; D019344:Lactic Acid; D008353:Mannitol; D002482:Cellulose