Poly-L-Lactic Acid (Sculptra®Aesthetic)

Advanced Injection TechniquesCME VIDEO

After completing this CME activity, participants should be better able to:

• Describe the uniqueness of PLLA compared with other dermal fillers

• Recite adverse events for filler injections and establish a clinic-wide plan to handle adverse events

• Decide on the best PLLA reconstitution methods for your clinic

• Identify the best PLLA candidates for the injection sites demonstrated

• Integrate into practice injecting PLLA in the arm, chest, and buttocks

Learning Objectives

2015 Nonsurgical Procedures in U.S.

http://www.surgery.org/sites/default/files/ASAPS-Stats2015.pdf

Nonsurgical procedures in 2015 accounted for 42% of the total expenditures in 2015

Percent Change in Nonsurgical Procedures 2015

http://www.surgery.org/sites/default/files/ASAPS-Stats2015.pdf

Common Dermal Filler Areas

www.clearskinmd.net/dermal-filler/

Aesthetic Facial Rejuvenation

Common Dermal Injectable Fillers in U.S.

Trade Name Generic

Radiesse® Hydroxylapatite

Restylane Lyft with Lidocaine® Hylauronic acid with lidocaine

Restylane Silk® Hylauronic acid with lidocaine

Juvederm Volumna Xc® Hylauronic acid with lidocaine

Restylane® Injectable Gel Hyaluronic Acid

Belotaro Balance® Hyaluronic Acid

Bellafill® Polymethylmethacrylate(PMMA) Beads, Collagen and Lidocaine.

Evolence®Collagen Filler Porcine Collagen

fda.gov/MedicalDevices/ProductsandMedicalProcedures/CosmeticDevices/WrinkleFillers

Poly-L-Lactic Acid (PLLA)*

• Only product in class• Not hyaluronic acid or

collagen• Takes multiple treatments• Collagen stimulator• Gives subtle, longer lasting

results• “Natural”• Not an immediate, dramatic

change

Int. J. Mol. Sci. 2011, 12(6), 3857-3870

J Cosmet Laser Ther 2005 Dec;7(3-4):201-5.

Biomaterials. 1991 Jan; 12(1):32-6.

*Sculptra®Aesthetic)

-0.3

-0.1

0.1

0.3

0.5

0.7

0.9

0 3 6 9 12 15 18 21 24 27Me

an Im

pro

vem

en

t in

WA

S

PLLA (116)

Collagen (117)

Months

Week 3

Month 13

Month 25

Effect of PLLA Lasts Significantly Longer vs. Collagen

Biostimulatory PLLA Overcomes Collagen Deficits

Young Collagen Aging Collagen

TIME

Collagen decreases with age

PLLA Stimulates Collagen Production Over Time

PLLA Treatments

Common• Bruising• Redness• Swelling• Pain• Tenderness• Itching, rash

Less Common• Raised bumps in or under

the skin (nodules or granulomas)

• Infection• Open or draining wounds• A sore at injection site• Allergic reaction• Tissue necrosis

KNOW the Possible Adverse Events with Fillers

Avoid Unintentional Vessel Injections

Periorbital

Glabella

Expert Faculty

Sabrina Fabi, MD, FAAD, FAACSSan Diego, California

Expert Faculty

Neil Sadick, MD FAAD, FAACS, FACP, FACPhGreat Neck, New York

PLLA and Décolletage (Chest)SABRINA FABI, MD, FAAD, FAACS

Subcutaneous Plane for PLLA – Chest, Arm

PLLA and the Medial Upper ArmSABRINA FABI, MD, FAAD, FAACS

PLLA and ButtocksNEIL SADICK, MD FAAD, FAACS, FACP, FACPH

GREAT NECK, NEW YORK