Magacho-Vieira Fabiano Nadson, Vieira Abrahao Osta, Soares Amarilho, Alvarenga Hellise Christine Lana, de Oliveira Junior Iran Roger Alkimin, Daher João Antonio Correa, Napoli João Vitor Moraes Pithon, Serra Júlia Portocarrero de Almeida, Provázio Suellen Costa
Magacho Institute for Health Education, Fortaleza, CE, Brazil.
Department of Clinical, Aesthetic and Surgical Dermatology, Batista Memorial Hospital, Fortaleza, CE, Brazil.
Clin Cosmet Investig Dermatol. 2024 Dec 4;17:2755-2765. doi: 10.2147/CCID.S497691. eCollection 2024.
Poly-D,L-lactic acid (PDLLA) microspheres, marketed globally as Aesthefill (Regen Biotech, Seoul, South Korea), are recognized for their biocompatible and biostimulatory properties, positioning them as a preferred option in aesthetic medicine. This article presents consensus recommendations from Brazilian experts on the reconstitution and clinical application of PDLLA for facial and non-facial treatments. Developed using a modified Delphi method with contributions from leading dermatologists and plastic surgeons, the consensus outlines protocols for reconstitution, injection techniques, and patient management. Key recommendations include reconstitution with 7-8 mL of sterile water for injection, the addition of lidocaine to improve patient comfort, and a preference for targeting the superficial subcutaneous layer. Dosing guidelines are specifically tailored to each treatment area and the desired degree of correction, underscoring the importance of personalized treatment plans. Maintenance treatments are advised at biennial intervals or at shorter intervals for patients exhibiting accelerated collagen degradation. The consensus also highlights the need for proper training and patient screening to minimize adverse effects, such as nodules and granulomas. This comprehensive guide aims to standardize the use of PDLLA, prioritizing patient safety and optimizing outcomes. While clinical trials evaluating PDLLA's aesthetic indications remain limited, these evidence-based guidelines bridge the gap by offering practical protocols grounded in clinical expertise. Further research is encouraged to validate these recommendations and explore new applications for PDLLA in aesthetic medicine.
聚-D,L-乳酸（PDLLA）微球以Aesthefill（韩国首尔Regen Biotech公司）的名称在全球销售，因其生物相容性和生物刺激特性而受到认可，使其成为美容医学中的首选选项。本文介绍了巴西专家关于PDLLA用于面部和非面部治疗的复溶及临床应用的共识性建议。该共识采用改良的德尔菲法制定，有顶尖皮肤科医生和整形外科医生参与，概述了复溶方案、注射技术和患者管理。关键建议包括用7-8毫升无菌注射用水复溶，添加利多卡因以提高患者舒适度，以及倾向于靶向浅表皮下层。给药指南针对每个治疗区域和所需的矫正程度进行了专门定制，强调了个性化治疗计划的重要性。建议每两年进行一次维持治疗，对于胶原蛋白降解加速的患者可缩短间隔时间。该共识还强调需要进行适当培训和患者筛查，以尽量减少结节和肉芽肿等不良反应。这份全面指南旨在规范PDLLA的使用，将患者安全放在首位并优化治疗效果。虽然评估PDLLA美容适应症的临床试验仍然有限，但这些基于证据的指南通过提供基于临床专业知识的实用方案填补了空白。鼓励进一步研究以验证这些建议，并探索PDLLA在美容医学中的新应用。
