PLLA

-5th Generation-

Poly-L-Lactic Acid

Thread Lifting

What is PLLA?

• 5th Generation of polymer suture extracted from plants

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• A type of AHA (Alpha-Hydroxy Acid)

• Originally developed and marketed in Europe since 1999 in over 150,000 clinical cases

and in over 30 countries to date

• Used for numerous years in soluble suture material and other devices, including absorbable sealants, flow restrictors, fixation systems, fixation screw, and in tissue generation

• Currently being used in 46 countries in the world

• The U.S FDA & Korea FDA has approved PLLA for use in wrinkle filler respectively

• Poly-L-lactic acid is a biocompatible and biodegradable polymer from the alpha-hydroxy-acid family

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Poly-L-lactic acid

• Poly-L-lactic acid is a biocompatible and biodegradable polymer from the alpha-hydroxy-acid family

• Poly-L-lactic acid can be thought of as an approximate nonsurgical equivalent to facial fat grafting

• Serving in a rejuvenative capacity, PLLA is inserted into the subcutaneous plane to gradually cause volumetric expansion over time

• Unlike other dermal “fillers” that are intended to correct discrete facial deficiencies (e.g. lines, folds, and attenuated lips), PLLA is designed to provide volumetric expansion of volume-deficient areas

• The stimulatory action of PLLA is one of the main characteristics that differentiate it from other fillers

• PLLA provides a semi permanent to correct facial volume loss

Mechanism of Action

Hydrolysis

Metabolism CO2

H2O

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Hydrolysis(Non-enzymatic)

Lactic Acid monomers

Glucose

PLLA Polymer

Metabolic products

PLLA degradation occurs through non-enzymatic hydrolysis into lactic acid monomers that are metabolized into CO2, H2O or incorporated into glucose. The mechanism of action occurs through the stimulation of fibroblasts in response to a subclinical tissular inflammation. It is this fibroplasiathat produces the desired cosmetic result. After the certain period, there is no evidence of fibrosis and the PLLA particles disappear.

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Collagen stimulator

< PLLA & Collagen production at a period of 12 months and 30 months >

12 months after PLLA insertion

Cohesion of PLLA with collagen tissueand histiocyte

30 months after PLLA insertion

Absorption of PLLA materials

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Wrinkle Improvement

0.5

1

0.74

0.66

0.72

0.85

0.730.70

0.77

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WEEK 3

MONTH3

MONTH6

MONTH9

MONTH13

MONTH19

MONTH25

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0.5

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U.S FDA has approved of 25 months of consistent effects with PLLAImprovement effects from 3 week till 25 month continuously

How PLLA works?

Wrinkles before treatment When PLLA is inserted, the PLLA is absorbed

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Wrinkles before treatment When PLLA is inserted, the inserted volume immediately fills out the wrinkles and volume defects

PLLA is absorbed with a slight increase in wrinkle depth

Stimulation of your own facial collagen production resulting in a natural, soft build-up of the connective tissue, smoothing out wrinkles and contour defects; 8 weeks after treatment

Clear improvement and disintegration of PLLA

Benefits

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• Biodegradable • Effective product for the • Biodegradable

• Biocompatible

• Nonimmunogenic

• Long lasting filler material over period of several months; its effects may last up to 2 years

• Treatment for the sagging

• Effective product for the voluminization of the face and correction of unaesthetic scars

• A refined, more youthful looking appearance

• PLLA is totally eliminated from the body in 18 months

•Safety

PDO PLLA

Generation of Polymer 3rd Generation 5th Generation

Durability 6 monthsMore than 18 months

(up to 24 months)

Polydioxanone vs Poly-L-Lactic acid

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Durability 6 monthsMore than 18 months

(up to 24 months)

Efficacy

• Dermal disintegration & great absorbability • Safety• No infection• Easy procedure

• Long-term safety(decomposed into CO2 & H2O& Glucose)

• Facial lifting &restoration fullness to lost facialvolume• Long lasting• Cost efficiency

Diameter change in Saline solution

after 50 days

0.172μm ➔ 0.172μm (No change)

0.170μm ➔ 0.191μm (12% increase)→ lifting & volume

Changes in PLLA thread thickness by moisture

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Up to year of 2011, only monofilament thread was available in the markets.

By improving the shape and function over time, PLLA has been used both in Europe

and the United States since 2004.

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The story of PLLA thread

PDO(Polydioxanone)

• Mono-filament• 6 months lasting

PLLA(Poly-L-lactic acid)

• Poly-filament- bio-absorbable polymer• The most recent development

in thread lifting• Positive impact of methodology• Optimize treatment outcome • More consistent cosmetic effects- last up to 24 months

PLLA Thread Applications & Specification (1)

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Mono (Basic)

Type Gauge Length

MONO (Basic)

31G 12mm

29G40mm

50mm

27G 50mm

26G60mm

90mm

PLLA Thread Applications & Specification (2)

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Screw (Strong Face Lifting)-Patent no : 10-1344643

Type Gauge Length

SCREW29G 40mm

27G 50mm

26G 60mm

PLLA Thread Applications & Specification (3)

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Double Screw (Lifting & Volume)-Patent no: 1020120139595

2X Twin (Face Contouring, Body line lifting,Hip up, Breast up, Arms, Abdomen)-Patent no: 1020120097078

Type Gauge Length

DOUBLESCREW

27G40mm

50mm

25G 70mm

Type Gauge Length

2X TWIN 27G40mm

50mm

26G 90mm

PLLA Thread Applications & Specification (4)

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Net (Volume) CHAIN (Wrinkle)

Type Gauge Length

NET29G 40mm

27G 50mm

26G 60mm

Type Gauge Length

CHAIN29G 40mm

27G 50mm

26G 60mm

PLLA Thread Applications & Specification (5)

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Broom (wrinkle & volume)

Type Gauge Length

BROOM 25G30mm

40mm

50mm

Plla ThreadBefore & After

CaseCase

CASE 1- (1)

Effects : to add volume to face overall (side view)

CASE 1- (2)

Effects : to add volume to face overall (front view)

CASE 2

Effects : to remove forehead wrinkles & wrinkles around eyes

CASE 3

Effects : to remove smile line & treatment of sagging under eyes

CASE 4

CASE 5

Thank Thank You