Cosmetic use of polylactic acid for hand rejuvenation: report on 27 patients

Polylactic acid (PLA) is effectively used on the face. In the Author's opinion it can also be applied successfully to other body areas. The aim of the present retrospective study is to estimate the safety and results of this new technique in order to improve the hand skeletal status in old patients.

Twenty-seven patients were treated in the period from January 2004 to April 2005 (a total of 109 sessions). Their age averaged 65.9 years. In all cases the hand treatment was associated with a face or neck treatment. 150 mg polylactic acid was diluted with 0.5 mL of 3% Carbocain and water for injectable preparations (from 5 to 8 mL). Intermetacarpal spaces were injected with this solution in dosages ranging from 2 to 4 mL with a particular and rigorous technique. The protocol, consisting of 3-6 consecutive sessions, is discussed below.

The results have been evaluated by a Definitive Graduated Score (DGS) based on the patient's and doctor's satisfaction scores (from 1 to 10) and by the photograph score. They have ranged from 4 to 9 (average of 6.55). No important side effects have been detected. There has been one case of fine unnoticeable nodulations. In six cases the result has not been satisfactory. In seven cases the DGS was higher than 8.

The fibro-connectival restoration of hands is an important step in the global aesthetic treatment of old patients. This technique can give good results, particularly if associated with peelings and sclerotherapy. Side effects have been acceptable.