Table of Contents
Posted on September 12, 2025
What is PLLA?
PLLA Is poly L lactic acid. It is used in products like PLLA, Sculptra, and some threads. It is a biocompatible and biodegradable synthetic polymer derived from lactic acid. In the world of plastic surgery, they love to refer to these as biostimulators.
It is a foreign body to your system, and your body reacts with an inflammatory response. This response encapsulates the PLLA particles with fibroblasts and immune cells, which lead to wound healing.
After inflammation, the fibroblasts deposit collagen. This is primarily Type 1 collagen, which is the main collagen in the skin and gives structure and support to the tissue. As the PLLA particles degrade over time, it gradually increases collagen density, which is seen as improved skin firmness and elasticity. This process takes 6-12 months to see. Generally, the “biostimulators” are used in multiple sessions, spaces 4-6 weeks apart.
How is it used in plastic surgery?
- PLLA is used in a diluted form as an injection into the skin to improve the skin surface.
- It is used in Sculptra to add volume. Sculptra has been used throughout the body- in the face for overall facial volumization, the buttock and the breast to add volume.
- It is used in threads, which are a minimally invasive way to lift the face.
Pros and cons
Let’s be clear. This is increasing Type 1 collagen, which is 90% of your body’s collagen. But it is also the collagen found in scar tissue. The way it is stimulating this collagen is through a foreign body reaction. Your body does not see this as part of your body- it sees it as a foreign object, so it responds with an inflammatory response.
IF YOU WANT TO DO FAT GRAFTING OR A FACELIFT IN THE FUTURE, BE WARY. At our recent Austin Aesthetic meeting, I went to a lot of facelift lectures, and many of the speakers showed photos of scar tissue and threads in their surgical fields. This made their surgery more difficult, tissue planes were obscured, and fat grafting doesn’t live (there is clay in the soil, so the grafts don’t survive).
There are some patients who are so thin in my practice that fat grafting is not an option. Sculptra is a good product for them. For most patients though, I steer away from these products and favor those with long lasting results like fat grafting and facelifts.
Do I still use PLLA? Yes. But for very specific areas and people. It is a valid tool in the plastic surgical toolbox, but I do not want to shut off future options like fat grafting (the volume and stem cells it brings using your own tissue) and facelifts.
The information provided on this website is for general informational purposes only and does not constitute medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider for any questions regarding your health or medical condition.
