Poly-L-Lactic Acid Treatment

What is it?

Poly-L-lactic acid (PLLA) is an absorbable synthetic polymer. When injected under the skin it does not give volume directly; instead it provokes a controlled response in the tissue and stimulates collagen production. The result comes not from the product itself but from the tissue's response to this stimulus.

No product name appears on this page; what is described is the active substance.

PLLA is a synthetic polymer that has long been used in medicine and is gradually broken down and absorbed by the body. In aesthetic practice it is injected under the skin and stimulates collagen production in the tissue. The distinction matters here: hyaluronic acid fillers create volume the moment they are placed, whereas PLLA does not provide volume itself. The fullness seen in the first days after treatment belongs largely to the carrier fluid and disappears within a short time; this does not mean the procedure has failed, it is how the process normally goes. The real change emerges over weeks, as the collagen response develops. For this reason the treatment is usually planned not as a single session but as a series of spaced sessions. The second important property is irreversibility: the enzyme hyaluronidase has no effect on this substance. The result being spread over time and the absence of a way back together make this treatment unsuitable for someone looking for a quick, reversible change.

Why is the result not visible straight away?

The appearance immediately after treatment is the temporary effect of the fluid given into the tissue. As this fluid is absorbed, the appearance moves back towards how it was at the start, and for most people this period is unsettling. The change comes gradually as the tissue's collagen response develops; this is why the assessment is made weeks later, and usually after the sessions have been completed. The degree of the collagen response varies from person to person and cannot be predicted precisely in advance.

1. Treatment: the product is given in diluted form into the target layer.
2. Early period: the fullness you see belongs to the carrier fluid and is temporary.
3. Transition: the fluid is absorbed and the appearance moves back towards the starting point. This is normal.
4. Collagen response: the change develops gradually over weeks; treatment is planned as a series of sessions.

Animated Explainer

Treatment Areas

• Cheeks and midface — appearance related to general volume loss
• Temples — hollowed appearance
• Face as a whole — skin quality and tissue support
• Not possible: the lip — this substance is not considered suitable for the lip
• Not possible: an expectation of sharp contour and immediate volume
• Not possible: a result completed in a single session

Procedure Steps

1. Assessment

   The goal, the condition of the skin and, most importantly, the timing of your expectations are discussed. If you are expecting a quick result, you are told at this stage that this treatment is not suitable.

2. Information on the process

   The number of sessions, the intervals, the fact that the appearance may return to the starting point in between, and irreversibility are all explained clearly.

3. Preparation

   The product is prepared appropriately; the area is cleaned with antiseptic.

4. Treatment

   The product is distributed into the target layer evenly and in controlled amounts.

5. Follow-up

   The assessment is made weeks later and after the sessions have been completed. No decision is made on the basis of the appearance in between.

Duration and Longevity

How long the effect lasts varies with the degree of the collagen response that develops and with the person's tissue structure. Because the duration ranges reported in the literature vary with the person and the area treated, an individual assessment is made at the examination. Independently of duration, this is what you need to know: the effect fading does not mean the substance that was injected can be dissolved. Irreversibility is a separate property from longevity, and a more decisive one for the decision.

Who is it suitable for?

• Adults aged 18 and over
• People aiming to address general volume loss and to support the tissue
• People who accept that the result develops over weeks and across a series of sessions
• People who come knowing and accepting that the treatment cannot be reversed
• People who prefer a natural, gradual change

Who is it not suitable for?

• People expecting a quick result — the change develops over weeks
• People expecting reversibility — hyaluronidase has no effect on this substance
• People looking for a procedure completed in a single session
• People aiming for lip treatment or sharp contour — this substance is not suitable for these purposes
• Pregnant and breastfeeding people, people with an active skin infection, and people with a bleeding disorder or taking blood thinners (physician assessment required)
• People who do not want to carry the uncertainty of the interim period: while the fluid is being absorbed the appearance returns to the starting point, and this is unsettling; for someone who does not accept this, hyaluronic acid fillers may be a more suitable place to start.

Aftercare

• Follow the massage protocol your physician describes — with this product, massage after treatment can be part of the process.
• For the first 24 to 48 hours avoid alcohol and any blood-thinning medicines your physician has not approved.
• Stay away from hot environments and strenuous exercise in the first days.
• The appearance moving back towards the starting point in the interim period is expected; do not make a decision at this stage.
• Keep using sunscreen.
• If pain increases, the skin blanches or a colour change spreads, contact the clinic without waiting.

Possible Side Effects

• Temporary swelling, redness and bruising
• The appearance moving back towards the starting point in the interim period — this is the expected progression, not a side effect
• Palpable firmness or nodules — reported with this class of substance, and one of the reasons for the massage protocol
• Asymmetry or a smaller response than expected — the collagen response varies from person to person
• Rare but serious: a vascular complication. The absence of an enzyme to reverse the treatment makes this harder to manage.

Frequently Asked Questions