The Evolution of Injectable Poly-L-Lactic Acid From the Correction of HIV-Related Facial Lipoatrophy to Aging-Related Facial Contour Deficiencies

Loss of facial volume due to skeletal resorption and facial fat redistribution is considered a primary cause for increased skin folding and sagging associated with aging. The objective of this review is to examine how use of injectable poly-L-lactic acid (PLLA) for correction of human immunodeficiency virus (HIV)-associated facial lipoatrophy supports wider use in treating aging-related facial changes given its approval for aesthetic use. A literature review of studies evaluating injectable PLLA for the treatment of HIV-associated or aging-related contour deficiencies was conducted via MEDLINE, supplemented by the author's clinical experience. In clinical trials of HIV-related facial lipoatrophy, injectable PLLA increased dermal thickness for up to 96 weeks. Another study showed significant improvements in aging-related nasolabial fold wrinkles that lasted up to 25 months. Understanding differences in the use of injectable PLLA between patients with HIV and those with aging-related facial changes will help physicians optimize patient treatment.