Review and Evaluation of Treatment Procedures Using Injectable Poly-L-Lactic Acid in the Treatment of Human Immunodeficiency Virus-associated Facial Lipoatrophy.

Injectable poly-L-lactic acid is United States Food and Drug Administration-approved for the restoration and/or correction of the signs of lipoatrophy in people with human immunodeficiency virus and for use in immune-competent people for the correction of nasolabial fold contour deficiencies. Current prescribing information recommends using either a tunneling or threading technique in a grid or cross-hatched pattern or a depot technique (in thin skin areas) to administer multiple passes of injectable poly-L-lactic acid per treatment session via a 26-gauge needle. A review of the literature and the recently published guidelines from the American Society for Dermatologic Surgery provide evidence to support the use of a cross-fanning technique with a 25-gauge needle. In conclusion, the use of a cross-fanning injection technique with a 25-gauge needle to administer injectable poly-L-lactic acid provides a clinically valid, alternate delivery option for the treatment of patients with human immunodeficiency virus-associated lipoatrophy.