A protocol for facial volume restoration with poly-L-lactic acid

Poly-L-lactic acid is a biodegradable synthetic polymer used in an injectable form for subcutaneous volume restoration. Volumetric correction following subcutaneous and deep dermal injection of poly-L-lactic acid is thought to occur through a foreign body tissue response leading to increased production of fibroblasts and subsequent neocollagenesis. Despite the growing popularity and use of this material, there has been a scarcity of published information describing proper injection technique, and many practitioners remain unfamiliar with its use. Appropriate injection technique is critical since incorrect placement of the material can lead to long-lasting unintended results. We present a protocol for successful injection of poly-L-lactic acid into the submalar and buccal regions.