Long-term aesthetic outcomes with injectable poly-l-lactic acid: observations and practical recommendations based on clinical experience over 5 years.

BACKGROUND Facial rejuvenation techniques have evolved in recent decades driven by a paradigm shift to restoration of lost volume, and an increase in the number of available products. As clinical experience has increased, practitioners have further refined the use of these products. OBJECTIVES To share observations and practical recommendations based on clinical experience with the aesthetic use of injectable poly-l-lactic acid (PLLA) in patients followed for up to 5 years. METHODS Literature review and retrospective case history review of the first 100 patients treated with injectable PLLA, many of whom have been followed for over 5 years. RESULTS Use of injectable PLLA, alone or in combination with other products, has provided excellent and long-lasting (up to 5 years) aesthetic results for most of the reviewed patients. Typically, patients have received one or two touch-up sessions between years 2 and 4 after initial full correction. There were minimal adverse events of papule formation; these eventually resolved. CONCLUSIONS Injectable PLLA is a safe and effective option for achieving long-term patient satisfaction with soft-tissue augmentation.