Mazzuco Rosemarie, Evangelista Cristiane, Gobbato Daniela Orso, de Almeida Luiz Mauricio
Private Clinic, Carazinho, Rio Grande do Sul and Mato Grosso, Brazil.
Private Clinic, Belo Horizonte, Minas Gerais, Brazil.
J Cosmet Dermatol. 2022 Dec;21(12):6727-6733. doi: 10.1111/jocd.15356. Epub 2022 Sep 20.
Although much has been published on the use of poly-L-lactic acid (PLLA) and calcium hydroxyapatite (CaHA) for off-face indications, questions remain regarding their exact mechanisms of action in subcutaneous tissue and their comparative efficacy.
To present the clinical and histological results of the PLLA and CaHA injections into the opposing arms of the same patients.
Five women received superficial subcutaneous injections of PLLA into the left arm and CaHA into the right arm. After three sessions, the clinical and histological outcomes were analyzed.
After the first session, three patients showed improvement in the right arm (CaHA), but at the end of study, two patients showed better results in the left arm (PLLA). Histologically, moderate to intense lymphocytic and giant cell infiltrate, as well as collagen and elastic fiber neoformation, were observed equally near the particles of both products. Dermis had no inflammatory or fiber alterations.
In this study, there were no clinical differences between these two fillers. Despite current thinking and previous histological studies, we found both products produced moderate to intense inflammatory reaction, as well as collagenic/elastogenic fiber neoformation, only in the subcutaneous tissue of the immediate vicinity and surrounding the individual filler particles.
尽管关于聚左旋乳酸（PLLA）和羟基磷灰石钙（CaHA）用于面部以外适应症的研究已有很多发表，但关于它们在皮下组织的确切作用机制及其比较疗效仍存在疑问。
展示在同一患者的双侧手臂分别注射PLLA和CaHA后的临床和组织学结果。
五名女性患者在左臂进行PLLA皮下浅层注射，右臂进行CaHA皮下浅层注射。经过三个疗程后，对临床和组织学结果进行分析。
在第一个疗程后，三名患者的右臂（CaHA）有改善，但在研究结束时，两名患者的左臂（PLLA）效果更好。组织学上，在两种产品颗粒附近均观察到中度至重度淋巴细胞和巨细胞浸润，以及胶原纤维和弹性纤维新生。真皮无炎症或纤维改变。
在本研究中，这两种填充剂在临床上没有差异。尽管有目前的观点和先前的组织学研究，但我们发现这两种产品仅在紧邻单个填充剂颗粒及其周围的皮下组织中产生中度至重度炎症反应，以及胶原/弹性纤维新生。
