Poly-L-Lactic Acid for Hands

  • Francisco Marcos Perez AtamorosEmail author
  • Alberto Avila Lozano


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.


  1. 1.
    Jagdeo J, Ho D, Lo A, Carruthers A. A systematic review of filler agents for aesthetic treatment of HIV facial lipoatrophy (FLA). J Am Acad Dermatol. 2015;73(6):1040–54.CrossRefGoogle Scholar
  2. 2.
    Reszko AE, Sadick NS, Magro CM, et al. Late-onset subcutaneous nodules after poly-L-lactic acid injection. Dermatol Surg. 2009;35(Suppl 1):380–4.CrossRefGoogle Scholar
  3. 3.
    Goldman MP. Cosmetic use of poly-L-lactic acid: my technique for success and minimizing complications. Dermatol Surg. 2011;37:688–93.CrossRefGoogle Scholar
  4. 4.
    Vanaman M, Fabi SG. Regional approaches with injectablellers: décolletage. Plast Reconstr Surg. 2015;136(5 Suppl):276S–81S.CrossRefGoogle Scholar
  5. 5.
    Butterwick K, Sadick N. Hand rejuvenation using a combination approach. Dermatol Surg. 2016;42:S108–18.CrossRefGoogle Scholar
  6. 6.
    Sadick NS, Anderson D, Werschler WP. Addressing volume loss in hand rejuvenation: a report of clinical experience. J Cosmet Laser Ther. 2008;10:237–41.CrossRefGoogle Scholar
  7. 7.
    Lorenc ZP. Techniques for the optimization of facial and nonfacial volumization with injectable poly-L-lactic acid. Aesthetic Plast Surg. 2012;36:1222–9.CrossRefGoogle Scholar
  8. 8.
    Narins RS. Minimizing adverse events associated with poly-L-lactic acid injection. Dermatol Surg. 2008;34(Suppl 1):S100–4.PubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Francisco Marcos Perez Atamoros
    • 1
    Email author
  • Alberto Avila Lozano
    • 1
  1. 1.Centro Dermatologico TennysonMexico CityMexico

Personalised recommendations