Poly-Lactic Acid - Sculptra

L-polylactic acid (PLA) is a synthetic product that has been known in the medical field for over 25 years, with various therapeutic applications such as suturing materials, materials for osteosynthesis or ligament repair, as well as in craniofacial reconstruction and orbital surgery. It is known to be highly biocompatible and biodegradable.

Numerous in vitro and in vivo toxicology and biocompatibility studies on different animal species, as well as human in vivo studies, have demonstrated the safety of PLA, which is therefore defined as an immunologically inactive substance.

The Food and Drug Administration has also recognized PLA as "generally safe."

In specialized medical literature, there are no known cases of allergic reactions to PLA.

Applications in aesthetic medicine:

Recently, a new formulation of a poly-lactic acid hydrogel has been developed in aesthetic medicine for wrinkle filling and skin sagging, as it is a non-animal, biocompatible, non-toxic, and long-lasting biodegradable product.

The product is called SCULPTRA™.

SCULPTRA™ implantation does not require preliminary skin tests.

Indications:

Sculptra™ is injected into the subcutaneous tissue and is particularly suitable for eliminating or improving lines, deep wrinkles, scars, and degenerative skin changes associated with aging.

Mechanism of action:

The SCULPTRA™ implant immediately improves skin conditions, but this improvement is temporary because the water contained in the product is absorbed by the body within a few days. The actual and effective correction of imperfections occurs through the synthesis of new collagen stimulated by PLA. This process requires a few months, so multiple sessions (usually at least four) are necessary to achieve the desired correction of defects. The sessions need to be spaced at appropriate intervals, and it is likely that at least six months will be required before the end of the treatment. SCULPTRA™ is a long-lasting biodegradable product with a half-life of approximately 18 months, meaning that after 18 months, about half of the product used will still be present.

This allows for individual touch-up sessions once a year.

Implantation technique:

SCULPTRA™ is injected into the subcutaneous tissue or deep dermis using a thin needle, or a cannula.

A small amount of anesthetic is usually added to the product to reduce the discomfort of the injection. Several injection points are usually required, and since the face always has asymmetries, the amount of product injected on one side may differ from the amount injected on the other side. The session ends with an energetic massage performed by the doctor or qualified personnel. Massage is crucial for the proper distribution of the product and to minimize the formation of granulomas.

Post-implantation care:

The patient must repeat a 3-4 minute massage as instructed by the doctor at least twice a day for the first week, and then once a day afterwards. In case of bruising, apply ice and any products containing vitamin K. Avoid exposure to extreme temperatures for 48 hours.

Complications:

• Bruising (it is advisable not to schedule social events in the following two to three days)
• Granuloma formation
• Accidental injection into blood vessels, leading to possible embolism and distal occlusion
• Allergic reactions to the components or excipients of the product

Contraindications:

• Acute or chronic skin diseases (infections or inflammations) near the area to be treated
• Known allergies to any of the product components
• Combination with synthetic products (permanent or semi-permanent)
• Pregnancy
• Autoimmune diseases
• Impaired wound healing (keloids, etc.)
• Patients undergoing anticoagulant or antiplatelet therapy