The poly-l-lactic acid (PLLA) has been used for almost 20 years; this bio-stimulant substance is used for improving the lost volume of the face and many other parts of the body, not just like a filler but like one of the most potent stimulants of neocollagenesis. The poly-l-lactic acid (PLLA) has been used for improving the lost volume of many parts of the body by stimulating neocollagenesis.
The application in the dorsum of the hands to replace the lost volume is very effective and very long lasting. The PLLA vial is reconstituted in 10 ml of sterile solution (7 ml) and lidocaine (3 ml).
The use of blunt cannula (25G) in the application is made and significant improvement due to long range, less trauma and better diffusion of the PLLA. Two or three applications will be necessary in most of the patients to stimulate strong enough the neocollagenesis. During and after the application of PLLA, it is highly recommended to massage the area. It is very important to avoid the proximity to the tendon sheath because the formation of nodules is the most frequent side effect.
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