Skip to main content Accessibility help
×
Hostname: page-component-848d4c4894-m9kch Total loading time: 0 Render date: 2024-04-30T20:27:51.886Z Has data issue: false hasContentIssue false

Chap. 22 - POLY-L-LACTIC ACID (SCULPTRA) FOR HAND VOLUME RESTORATION

from PART THREE - FILLERS AND NEUROTOXINS

Published online by Cambridge University Press:  06 July 2010

Sorin Eremia
Affiliation:
University of California, Los Angeles, School of Medicine
Get access

Summary

INTRODUCTION

Hand rejuvenation with minimally invasive, nonsurgical procedures has become increasingly popular to minimize the discrepancy between a rejuvenated facial appearance and the aged appearance of the hands. The dorsum of the hand is the most important target for rejuvenation due to its visibility and how it reflects the process of aging, from volume loss due to skeletinization to muscular atrophy, tortuous veins, and solar damage.

Multiple dermatological procedures are available for hand rejuvenation, including chemical peels, microdermabrasion, laser therapy (ablative and nonablative), sclerotherapy, dermal fillers, and fat augmentation. Dermal fillers are widely used for volume restoration because they can be expected to produce a natural, smooth appearance.

POLY-L-LACTIC ACID

Poly-L-lactic acid (PLLA) is semipermanent filler that is biocompatible and biodegradable. It is a synthetic polymer with microparticles of poly-L-lactic acid supplied in a clear glass vial as a sterile, freeze-dried preparation for injection. A carton of PLLA contains two vials, each containing 367.5 mg of powder. PLLA can be stored at room temperature up to 30 degrees Celsius during and after hydration. The manufacturer recommends that any remaining material be discarded seventy-two hours after reconstitution; however, we have found that the product can be safely stored for up to three weeks when it is mixed with bacteriostatic water.

PLLA is reconstituted by hydrating the powder with 4 mL of bacteriostatic water plus 1–2 mL of local anesthetic (lidocaine 1%).

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bains, RD, Thorpe, H, Southern, S. Hand aging: patients' opinions. Plast. Reconstr. Surg. 2006;117:2212–18.CrossRefGoogle ScholarPubMed
Broder, K, Cohen, S. An overview of permanent and semipermanent fillers. J. Am. Soc. Plast. Surg. 2006;118(Suppl 3):7S–14S.Google ScholarPubMed
Buford, GA, Burgess, CM, Lacombe, VG, et al. The role of stimulatory fillers in aesthetic facial rejuvenation. J. Cosmet. Dermatol. 2007;20(Suppl 5):4–18.Google Scholar
Butterwick, KJ. Rejuvenation of the aging hand. Dermatol. Clin. 2005;23:515–27.CrossRefGoogle ScholarPubMed
Medical Insight Inc. Executive summary: global market for dermal fillers 2005–2011. Available at: http://www.miinews.com/exec_summaries/Global%20Market%20for%20Dermal%20Fillers%20Executive%20Summary%20022106.pdf. Accessed November 30, 2007.
Parker, P. Hand lift plastic surgery. Available at: www.parkercenter.net/plastic_surgery_procedures_hand_lift.html. Accessed November 30, 2007.
Redaelli, A. Cosmetic use of polylactic acid for hand rejuvenation: report on 27 patients. J. Cosmet. Dermatol. 2006;5:223–38.CrossRefGoogle ScholarPubMed
Vleggaar, D. Soft-tissue augmentation and the role of poly-L-lactic acid. Plast. Reconstr. Surg. 2006;118(Suppl 3):46S–54S.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×