Soft-tissue augmentation and the role of poly-L-lactic acid

Plast Reconstr Surg. 2006 Sep;118(3 Suppl):46S-54S. doi: 10.1097/01.prs.0000234846.00139.74.


Background: Facial rejuvenation has traditionally centered on the correction of ptosis, lines, and wrinkles, typically achieved by surgical tightening of the skin or by injecting soft-tissue fillers. In recent years, volumetric augmentation and recontouring have been recognized as fundamentally important aspects of facial rejuvenation.

Methods: An overview of volume restoration and recontouring is presented. A literature search was also conducted to identify the injectable products representing potential treatment options for facial recontouring. The author also presents the results of his extensive experience with poly-L-lactic acid in the treatment of thousands of cosmetic patients in Europe, with special emphasis on the efficacy and tolerability of this product.

Results: Several injectable treatment options can be used to recontour and restore volume, to the face and beyond. All of these products, except calcium hydroxylapatite and poly-L-lactic acid, are nonresorbable, offering permanent volume augmentation, but with the increased risk of severe foreign-body reactions. Poly-L-lactic acid provides semipermanent results and has been documented to offer volume augmentation with a favorable safety profile. Achieving good efficacy and safety is dependent on the appropriate reconstitution of the product and adhering to the correct injection technique.

Conclusions: Injectable products offer a flexible means of recontouring the face and localized regions beyond the face. The potential of some of these products is supported by a wealth of published results and clinical experience, helping the physician to identify the most appropriate treatment for their patient.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biocompatible Materials / administration & dosage
  • Biocompatible Materials / adverse effects
  • Biocompatible Materials / therapeutic use*
  • Cicatrix / therapy
  • Cosmetic Techniques / adverse effects
  • Face
  • Female
  • Funnel Chest / therapy
  • HIV-Associated Lipodystrophy Syndrome / therapy
  • Hand
  • Hematoma / etiology
  • Humans
  • Injections, Subcutaneous
  • Lactic Acid / administration & dosage
  • Lactic Acid / adverse effects
  • Lactic Acid / therapeutic use*
  • Male
  • Middle Aged
  • Neck
  • Patient Satisfaction
  • Polyesters
  • Polymers / administration & dosage
  • Polymers / adverse effects
  • Polymers / therapeutic use*
  • Prospective Studies
  • Rejuvenation*
  • Skin Aging*
  • Thorax
  • Treatment Outcome


  • Biocompatible Materials
  • Polyesters
  • Polymers
  • Lactic Acid
  • poly(lactide)