Progressive treatment of lower third of the face laxity using different forms of poly-1-lactic acid (PLLA), from a solution to threads

Main Article Content

Enrico Massidda
Annalisa Calisti

Keywords

skin quality,, skin laxity, polylactic acid, suspension threads, lower third, PLLA threads

Abstract

Background: Treating ageing in the lower third of the face focuses on restoring volume and correcting the position of the subcutaneous tissue (SC). Among the various injectable substances used for volume restoration, PLLA (poly-1-lactic acid) has proven to be effective as a collagen biostimulator and can be used to correct both shallow and deep nasolabial fold contour deficiencies as well as other wrinkles. Once the SC volume has been restored, suspension threads can be used for an even more effective repositioning of the SC. Aim: In this study we present the findings of using an injective PLLA solution and PLLA suspension threads for an optimal treatment, aiming to combat sagging in the lower third of the face, combining neocollagenesis and mechanical tissue repositioning. Methods: Between February 2020 and January 2022, 23 patients with sagging in the lower third of the face were selected to undergo combined therapy using an injected solution of PLLA and a thread-lift using PLLA suspension threads. The injection of PLLA was carried out three times, once a month. One month after the last PLLA injection, PLLA threads were inserted. Results: At a 12-month follow-up, all 23 patients presented a more defined jawline, an improvement in the distribution of volume in the lower third, and an increased skin toning, as well as a long-lasting lifting effect. There were no short or long-term complications. Conclusions: The reshaping of the lower third using a combination of a biostimulatory solution of PLLA and a PLLA suspension thread-lift is a safe, effective and long lasting therapy. It is worth noting that the final outcome of the acid treatment depends on a careful facial analysis that is necessary to determine the appropriate treatment.

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