The biological basis for poly-l-lactic acid-induced augmentation

Stein, Philipp; Vitavska, Olga; Kind, P; Hoppe, W.; Wieczorek, Helmut; Schürer, Nanna

doi:10.1016/j.jdermsci.2015.01.012

Cited by 53 publications

(50 citation statements)

References 51 publications

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“…Poly‐L‐lactic acid has biostimulatory effects through macrophages, (myo‐)fibroblasts, and collagen that orchestrate capsule formation. The reaction starts with subclinical inflammation that continues to microparticle encapsulation and then to collagen production by the host . PLLA itself degrades into carbon dioxide and water, and the surrounding collagen production continues even after the degradation.…”

Section: Discussionmentioning

confidence: 99%

“…Lumperle et al reported that there were no visible PLLA particles on light microscopic view 9 months after insertion. However, Stein et al found collagen‐enriched tissues with PLLA‐free sections 30 months after injection, which suggests continuous collagen production after the disappearance of PLLA. Contrary to previous reports, tissues with both PLLA and PDO injection showed decreased collagen‐stimulating effects 3 months after injection in this experiment.…”

Section: Discussionmentioning

confidence: 99%

“…The reaction starts with subclinical inflammation that continues to microparticle encapsulation and then to collagen production by the host. 10 PLLA itself degrades into carbon dioxide and water, and the surrounding collagen production continues even after to 30 months after PLLA injection depending on the study, 11,12 but other biostimulatory fillers have similar effects to those of PLLA.…”

Section: Discussionmentioning

confidence: 99%

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The efficacy of powdered polydioxanone in terms of collagen production compared with poly‐L‐lactic acid in a murine model

Kim

Suh³

et al. 2019

J of Cosmetic Dermatology

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Summary Background There are many collagen‐stimulating fillers, including calcium hydroxyapatite, polycaprolactone (PCL), and poly‐L‐lactic acid (PLLA), and other materials have been tested. Polydioxanone (PDO) has recently been used as absorbable thread‐lifting material due to its collagen‐forming effects. PDO in powdered form is expected to be a good material for collagen‐producing fillers. Objectives To evaluate the collagen‐producing effects of powdered PDO injection compared with PLLA injection in a murine model. Materials and Methods Powdered PDO mixed with sodium carboxymethyl cellulose, PLLA, and phosphate‐buffered saline was injected on dorsal skin of 8‐week‐old rat. Tissue samples were obtained 1, 2, and 12 weeks after the procedures for histopathologic review and for real‐time PCR to quantify collagen and tissue growth factors. Results Both PLLA and powdered PDO injections induced granulomatous reactions. Collagen type 1, collagen type 3, TGF‐β1, TGF‐β2, and TGF‐β3 showed increases 2 weeks after injection but decreased 12 weeks after injection for both powdered PDO and PLLA. Conclusion Our results suggested that powdered PDO injection induces collagen formation more effectively than PLLA injection. Therefore, PDO can be a good option for forming collagen.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The efficacy of powdered polydioxanone in terms of collagen production compared with poly‐L‐lactic acid in a murine model

Kim

Suh³

et al. 2019

J of Cosmetic Dermatology

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“…While the structure of the suture itself is designed to serve the mechanical function of supporting tissue, the physiochemical properties of the resident PLLA/PLGA are thought to serve the complementary function of volume restoration through stimulation of collagen. The collagen‐stimulating ability of PLLA is well documented, and there are multiple clinical reports of absorbable suspension suture outcomes that include patient‐ and physician‐reported improvements in volume and contour, as well as improvements in skin quality . Further, a similar product with a PLLA monofilament and PLGA cones (marketed as Silhouette Soft in Europe [Sinclair Pharma]) has been shown to induce type I collagen, effectively doubling the diameter of the PLLA monofilament at 12 months via encapsulation .…”

Section: Introductionmentioning

confidence: 99%

Stimulation of collagenesis by poly‐L‐lactic acid (PLLA) and ‐glycolide polymer (PLGA)‐containing absorbable suspension suture and parallel sustained clinical benefit

Goldberg

2020

J of Cosmetic Dermatology

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Background Though the collagen‐stimulating capacity of poly‐L‐lactic acid (PLLA) is well established, no data are available on collagen stimulation by the PLLA/PLGA within absorbable suspension sutures used for tissue repositioning. Aims To characterize collagen stimulation by absorbable suspension sutures through examination of patient biopsies and assess severity of nasolabial folds (NLF) over time. Patients/Methods Single‐center, open‐label, prospective study of 25 healthy volunteers treated with absorbable suspension sutures for descent of midface tissues. Punch biopsies were collected and evaluated for total collagen content. Subject and investigators evaluated NLF severity using the Nasolabial Fold Wrinkle Assessment Score (NLF‐WAS). Seventeen of 25 patients completed the collagenesis portion of the study. Results Collagen deposition was apparent at day 90 and increased significantly compared with baseline at days 180 and 270 and between days 90 and 180. Subject‐ and investigator‐reported NLF‐WAS were significantly improved at all post‐treatment time points through day 270. Conclusions Absorbable suspension sutures stimulate collagen in areas immediately adjacent to the path of the PLLA/PLGA monofilament and cones, providing mechanistic support for improvement in appearance observed in clinical studies. This neocollagenesis, coupled with repositioning by the suture's cones, makes absorbable suspension sutures a valuable tool for patients seeking facial rejuvenation.

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“…Histological studies demonstrate that PLLA produces the most exuberant response,22 but CaHA and HA will also cause some proliferation in collagen production 6,23. All of these injectables are moldable immediately after injection, and firm massage will usually distribute the agent exactly into the desired area.…”

Section: Filler Choice For Hand Augmentationmentioning

confidence: 99%

Volume correction in the aging hand: role of dermal fillers

Rivkin¹

2016

CCID

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The hands, just like the face, are highly visible parts of the body. They age at a similar rate and demonstrate comparable changes with time, sun damage, and smoking. Loss of volume in the hands exposes underlying tendons, veins, and bony prominences. Rejuvenation of the hands with dermal fillers is a procedure with high patient satisfaction and relatively low risk for complications. This study will review relevant anatomy, injection technique, clinical safety, and efficacy of dermal filler volumization of the aging hand.

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The biological basis for poly-l-lactic acid-induced augmentation

Cited by 53 publications

References 51 publications

The efficacy of powdered polydioxanone in terms of collagen production compared with poly‐L‐lactic acid in a murine model

The efficacy of powdered polydioxanone in terms of collagen production compared with poly‐L‐lactic acid in a murine model

Stimulation of collagenesis by poly‐L‐lactic acid (PLLA) and ‐glycolide polymer (PLGA)‐containing absorbable suspension suture and parallel sustained clinical benefit

Volume correction in the aging hand: role of dermal fillers

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