Facial aesthetic correction with injectable poly-L-lactic Acid following removal of malar cheek implants.

Cheek implants may need to be removed from some patients due to pathologic conditions, such as infection, or patient dissatisfaction with cosmetic results. In these cases, correction of implant-associated facial volume loss may be achieved by using injectable poly-L-lactic acid. Injectable poly-L-lactic acid has been used successfully and safely for restoration and/or correction of the signs of facial fat loss (lipoatrophy) in people with human immunodeficiency virus. Here, the author reports the off-label use of injectable poly-L-lactic acid for the correction of facial volume loss following removal of malar cheek implants to yield a cheek lift and correction of prominent nasolabial fold wrinkles in a man with no significant medical problems. A total of three treatments using two vials of injectable poly-L-lactic acid per treatment were administered over the course of 16 weeks. Photographs were taken at baseline, during the 16-week injection period, and at a post-treatment evaluation visit 35 days after the final treatment (21 weeks after the initial injection). Although the patient has since been lost to follow up, he was very satisfied with the aesthetic results at the evaluation visit five weeks after the last treatment and expressed a desire to be treated with poly-L-lactic acid in the future. Injectable poly-L-lactic acid may be a good option for the correction of facial volume loss due to reasons other than human immunodeficiency virus-related lipoatrophy.