Poly-L-lactic acid in contemporary facial rejuvenation: a regenerative approach

Contemporary facial aesthetic practice is increasingly aligned with regenerative principles that prioritise tissue quality, structural integrity, and natural expression over immediate volumetric correction. Poly-L-lactic acid (PLLA) functions as a collagen biostimulator, inducing fibroblast activation, neocollagenesis, and progressive extracellular matrix remodelling. Emerging evidence suggests regenerative effects extending beyond collagen deposition, including modulation of dermal white adipose tissue and improvements in skin biomechanics. This article reviews the mechanistic basis of PLLA and presents a case study of a 57-year-old female treated with a staged, anatomy-led protocol using four vials of PLLA-SCA. Progressive improvements in facial support, symmetry, dermal firmness, and skin quality were achieved while preserving dynamic movement. PLLA represents a regenerative modality aligned with contemporary preferences for subtle, authentic rejuvenation.