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Composition and mechanism of action of poly-L-lactic acid in soft tissue augmentation.

Poly-L-lactic acid (PLLA) is a synthetic, biocompatible, biodegradable polymer. For its use in soft tissue augmentation, it is supplied as a lyophilized powder containing PLLA microparticles, the size and chemical attributes of which are tightly controlled. As a biocompatible material, PLLA generates a desired subclinical inflammatory tissue response that leads to encapsulation of the microparticles, stimulation of host collagen production, and fibroplasia. Over time, the PLLA degrades, the inflammatory response wanes, and host collagen production increases. This response leads to the generation of new volume and structural support that occurs in a gradual, progressive manner, and which can last for years. Coupled with consistent, optimized injection methodology, the use of PLLA in soft tissue augmentation can result in a predictable cosmetic effect that is completely controlled by the treating clinician.