The use of poly-L-lactic acid in the management of soft-tissue augmentation: a five-year experience

Poly-L-lactic acid (PLA) New-Fill* is one of the latest implants commercialized among bioresorbable fillers. This synthetic polymer is biocompatible, biodegradable, immunologically inert, and free from toxicity. All these necessary properties provide theoretical safety. New-Fill* has to be injected deeply into the dermis or into the subcutaneous tissue, so the main indications of New-Fill* are the correction of important wrinkles and furrows from face (Nasolabial folds, "Marionette" lines), and especially spread tissue augmentation for "face modeling" as for cheeks lipoatrophies in HIV patients receiving an antiprotease treatment. After two or three sessions, results are appreciable and equivalent to other resorbable fillers, but seem to last longer. On the other hand, the cost of this material is widely cheaper than others. However, we do not lose sight that the practitioner fee related to a series of two to three sessions of injections compensates for this material economy. Superficial injections should be avoided. They may increase the risk of persistent granulomas, which will be difficult to manage. Even if severe complications are rare, they must be revealed to the patient to obtain his informed consent before injecting.