Skin Ageing
The demand for injectable dermal fillers has undergone significant growth within the aesthetic industry and with demand, comes innovation! Currently a diverse range of injectable agents, such as Poly-L-Lactic Acid (PLLA) and Hyaluronic Acid (HA), are used to combat the unfavourable effects of skin ageing and for non-invasive facial enhancement. Skin Ageing is marked by structural and functional changes to the epidermis and dermis- resulting in wrinkles, loss of elasticity and a rough-textured appearance. If your patient is looking for a non-invasive, natural, and gradual treatment to reverse the signs of ageing, volume and collagen loss then PLLA dermal fillers are the latest alternative with results lasting up to 2 years!What are Poly-L-Lactic Dermal Fillers?
Injectable Poly-L-Lactic acid is a synthetic biocompatible substance that is used in a variety of medical devices in Europe and the US for over 30 years. As we age, our bodies produce less collagen, leading to volume loss and a loss of elasticity of the skin. Volume loss can lead to deep creases, hollowed temples, and sagging jowls. When strategically injected into specific areas of the deep dermis, PLLA fillers can restore volume to the face creating a youthful fullness and desired contours.How do PLLA fillers work?
Collagen is a fibrous protein located in the deep dermis of the skin that gives it structure. Elastin is a protein that helps the skin maintain it's shape, while HA nourishes the skin and keep it hydrated.The image below illustrates the process of Ageing:
Younger Skin Ageing Skin
During the process of ageing, collagen fibres damage over time and decrease their ability to function correctly. As a result, aged skin has a reduced density of collagen fibres, elastin and hyaluronic acid. As collagen levels start to decline, the collagen structure becomes fragile and brittle, weakening the skin's structural support. The skin will begin to loose volume and firmness and starts to become thin and wrinkled.
As illustrated above, the reduction in collagen production coincides with a loss of hyaluronic acid. This impacts the hydration and suppleness of the skin. As a result, collagen is required to help both Elastin and Hyaluronic Acid performs their tasks. Therefore the more collagen your patient has, the more effective the Elastin and HA are.
PLLA fillers, unlike HA fillers, are revolutionary collagen-replenishing treatment that helps your patient's body regenerate collagen. This restores the skin's inner structure and volume by working deep beneath the dermis rather than on the surface. When PLLA micro-particles are absorbed into the skin, they rebuild collagen strands. As a result, promoting facial volume- adding fullness to deep wrinkles and visible skin folds over time.
Best Uses
Technical advances, coupled with an improved understanding of the contribution of volume loss to facial ageing, has led to the emergence of PLLA. The injectable is a soft tissue filler that is commonly used to:- Restore volume of depressed areas of the midface
- Stimulate neocollagensis (stimulation of new collagen)
- Increase dermal thickness
- Treatment of facial wrinkles and folds
Advantages
Poly-L-Lactic Acid Dermal Fillers are a safe, minimally invasive, and effective treatment that restores facial volume and smooths our wrinkles. As a result, patients can expect a more youthful appearance without the need for surgery. The effects are progressive and can last up to 2 years- significantly longer than conventional dermal fillers.- Improves skin tone and texture
- Restores lost volume and collagen
- Reduces deep lines and wrinkles around the eyes, cheeks, mouth, lips, and neck.
- Promotes natural looking results
- Effects lasting up to 2 years
Adverse Effects
Acute injection site reaction- This is the most common side effect of this dermal filler.
- This can manifest into swelling or bruising that can take up to one week to heal. This risk increases if the patient takes a blood-thinning agent.
- This carries the risk of a hypersensitivity reaction upon injection in the skin.
- Patients need to remove all makeup and the skin will be be prepped before injection to minimize the introduction of additional foreign particles
- Skin testing be performed before treatment.
- Can lead to lumpiness or visibility of the filler through the skin.
- Post-treatment massage to the area can help decrease this risk.
- This is rate but can occur.
- Some injectors inquire about a history of HSV (Herpes) and provide appropriate prophylaxis of anti-vials up to 2 days before and 2 days after if the treatment is performed on or around the lip.
The difference between Poly-L-Lactic and Hyaluronic Acid Dermal Fillers
The main difference between HA and PLLA fillers are simple however critically important for the correct application of treatment.- HA fillers stimulate a small amount of collagen deposition however, they are most efficient in filling soft tissue rather than stimulating collagen levels.
- HA fillers increase volume by using more product in a single session. PLLA however, gradually restore volume and stimulate collagen formation over a series of treatments.
- HA fillers are made from hyaluronic acid which is a natural-occurring substance in our bodies. In comparison, the main ingredient in PLLA fillers is poly-L-lactic acid, a compound that stimulates the growth of new collagen. This type of filler depends on the host response to the product rather than a direct fill.
- HA fillers provide patients with instant results in their first treatment, however, will not last as long compared to PLLA fillers.
- In the case of extensive volume loss, treatment with PLLA achieves a natural looking result as opposed to filling an area with several vials of HA tissue filler. This happens as PLLA works by inducing and promoting the body’s own natural collagen production as opposed to using a filling material.
Treatment Sessions
The amount of product used within your patient's first session is determined by the surface area treated in that session. The number of sessions will impact the desired outcome.- Treatment sessions are spaced 4 to 6 weeks apart to allow time for the host response to develop between session.
- Patients require around 3 sessions to achieve maximum results.
- Less PLLA is needed in younger and fuller faced patients.
- Treating your patient over several sessions with PLLA will promote a slower, more subtle approach to rejuvenation. As a result, your patient's results will be longer-lasting.
