Russian Journal of Skin and Venereal DiseasesRussian Journal of Skin and Venereal DiseasesРоссийский журнал кожных и венерических болезней1560-95882412-9097Eco-Vector62958210.17816/dv629582DERMATOLOGYДЕРМАТОЛОГИЯResearch ArticlePoly-L-lactic acid in the correction of age-related changes in facial skinПоли-L-молочная кислота в коррекции возрастных изменений кожи лицаhttps://orcid.org/0000-0002-7968-76633785-7859SnarskayaElena S.СнарскаяЕлена Сергеевна
Russian Federation

MD, Dr. Sci. (Medicine), Professor

доктор медицинских наук, профессор

snarskaya-dok@mail.ruhttps://orcid.org/0000-0001-8528-91972666-9461ChurbanovaAnastasia I.ЧурбановаАнастасия Игоревна
Russian Federation
spuzovskaya@mail.ruI.M. Sechenov First Moscow State Medical University (Sechenov University)Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)08092024230920242744734822903202431072024Copyright ©; 2024, Eco-VectorCopyright ©; 2024, Эко-Вектор2024Eco-VectorЭко-Векторhttps://rjsvd.com/1560-9588/article/view/629582

Age-related changes in the skin of the face and neck are the result of a number of interrelated biochemical processes occurring in various tissues (dermis and epidermis, subcutaneous fat, musculoskeletal apparatus and bone tissue). Currently, there are a number of minimally invasive techniques to correct age-related changes in the skin of the face, but the discussion regarding the clinical efficacy and duration of retention of the effect in correcting age-related facial changes continues.

Poly-L-lactic acid (PLLA) is popular with specialists and is used as an effective method of correcting involutive changes in the skin of the face, however, despite the extensive experience of its use, there is not enough research in foreign and domestic literature to study the duration of retention of the effect of drugs based on poly-L-lactic acid.

The article presents an analysis of the data of modern literature devoted to the study of the effectiveness of the use of poly-L-lactic acid as a method of correcting age-related changes in the skin of the face.

Возрастные изменения кожи лица и шеи являются следствием целого ряда взаимосвязанных биохимических процессов, протекающих в различных тканях (дерме и эпидермисе, подкожной жировой клетчатке, мышечно-связочном аппарате и костной ткани). В настоящее время существует целый ряд малоинвазивных методик, позволяющих скорректировать возрастные изменения кожи лица, однако дискуссия в отношении клинической эффективности и длительности удержания эффекта в коррекции возрастных изменений лица продолжается.

Поли-L-молочная кислота (PLLA) популярна у специалистов и используется в качестве эффективного метода коррекции инволютивных изменений кожи лица, однако, несмотря на большой опыт её применения, в зарубежной и отечественной литературе недостаточно исследований по изучению длительности удержания эффекта препаратов на основе поли-L-молочной кислоты.

В статье представлен анализ данных современной литературы, посвящённой изучению эффективности использования поли-L-молочной кислоты в качестве метода коррекции возрастных изменений кожи лица.

polylactic acidPLLAagingполимолочная кислотаPLLAстарениеCrowley JS, Kream E, Fabi S, Cohen SR. Facial rejuvenation with fat grafting and fillers. Aesthet Surg J. 2021;41(Suppl 1):S31–S38. doi: 10.1093/asj/sjab014Crowley J.S., Kream E., Fabi S., Cohen S.R. Facial rejuvenation with fat grafting and fillers // Aesthet Surg J. 2021. Vol. 41, Suppl. 1. P. S31–S38. doi: 10.1093/asj/sjab014Omurzakov AT, Isanov VA. Age ― related changes in facial skin: Literature review and own research results. J New Med Technologies. 2020;27(1):105–109. EDN: HKBVYO doi: 10.24411/1609-2163-2020-16621Омурзакова А.Т., Изранов В.А. Возрастные изменения кожи лица (обзор литературы и результаты собственных исследований) // Вестник новых медицинских технологий. 2020. Т. 27, № 1. С. 105–109. EDN: HKBVYO doi: 10.24411/1609-2163-2020-16621De Moura JP, de Moura Fernandes ÉP, Lustoza Rodrigues TC, et al. Targets involved in skin aging and photoaging and their possible inhibitors: A mini-review. Curr Drug Targets. 2023;24(10):797–815. doi: 10.2174/1389450124666230719105849De Moura J.P., de Moura Fernandes É.P., Lustoza Rodrigues T.C., et al. Targets involved in skin aging and photoaging and their possible inhibitors: A mini-review // Curr Drug Targets. 2023. Vol. 24, N 10. P. 797–815. doi: 10.2174/1389450124666230719105849Jeremias Tda S, Machado RG, Visoni SB, et al. Dermal substitutes support the growth of human skin-derived mesenchymal stromal cells: Potential tool for skin regeneration. PLoS One. 2014;9(2):e89542. doi: 10.1371/journal.pone.0089542Jeremias Tda S., Machado R.G., Visoni S.B., et al. Dermal substitutes support the growth of human skin-derived mesenchymal stromal cells: Potential tool for skin regeneration // PLoS One. 2014. Vol. 9, N 2. P. e89542. doi: 10.1371/journal.pone.0089542Windhager S, Mitteroecker P, Rupić I. Facial aging trajectories: A common shape pattern in male and female faces is disrupted after menopause. Am J Phys Anthropol. 2019;169(4):678–688. EDN: BONHZF doi: 10.1002/ajpa.23878Windhager S., Mitteroecker P., Rupić I. Facial aging trajectories: A common shape pattern in male and female faces is disrupted after menopause // Am J Phys Anthropol. 2019. Vol. 169, N 4. P. 678–688. EDN: BONHZF doi: 10.1002/ajpa.23878Tobin DJ. Introduction to skin aging. J Tissue Viability. 2017;26(1):37–46. doi: 10.1016/j.jtv.2016.03.002Tobin D.J. Introduction to skin aging // J Tissue Viability. 2017. Vol. 26, N 1. P. 37–46. doi: 10.1016/j.jtv.2016.03.002Lephart ED. A review of the role of estrogen in dermal aging and facial attractiveness in women. J Cosmetic Dermatology. 2018;17(3):282–288. doi: 10.1111/jocd.12508Lephart E.D. A review of the role of estrogen in dermal aging and facial attractiveness in women // J Cosmetic Dermatology. 2018. Vol. 17, N 3. P. 282–288. doi: 10.1111/jocd.12508Wang QS, Cui YL, Gao LN, et al. Reduction of the pro-inflammatory response by tetrandrine-loading poly(L)-lactic acid films in vitro and in vivo. J Biomed Mater Res A. 2014;102(11):4098–4107. doi: 10.1002/jbm.a.35083Wang Q.S., Cui Y.L., Gao L.N., et al. Reduction of the pro-inflammatory response by tetrandrine-loading poly(L)-lactic acid films in vitro and in vivo // J Biomed Mater Res A. 2014. Vol. 102, N 11. P. 4098–4107. doi: 10.1002/jbm.a.35083Breithaupt A, Fitzgerald R. Collagen stimulators: Poly-L-lactic acid and calcium hydroxyl apatite. Facial Plast Surg Clin North Am. 2015;23(4):459–469. doi: 10.1016/j.fsc.2015.07.007Breithaupt A., Fitzgerald R. Collagen stimulators: Poly-L-lactic acid and calcium hydroxyl apatite // Facial Plast Surg Clin North Am. 2015. Vol. 23, N 4. P. 459–469. doi: 10.1016/j.fsc.2015.07.007Zouboulis CC, Ganceviciene R, Liakou AI, et al. Aesthetic aspects of skin aging, prevention, and local treatment. Clin Dermatol. 2019;37(4):365–372. doi: 10.1016/j.clindermatol.2019.04.002Zouboulis C.C., Ganceviciene R., Liakou A.I., et al. Aesthetic aspects of skin aging, prevention, and local treatment // Clin Dermatol. 2019. Vol. 37, N 4. P. 365–372. doi: 10.1016/j.clindermatol.2019.04.002Boismal F, Serror K, Dobos G, et al. [Skin aging:Pathophysiology and innovative therapies. (In French)]. Med Sci (Paris). 2020;36(12):1163–1172. doi: 10.1051/medsci/2020232Boismal F., Serror K., Dobos G., et al. [Skin aging: Pathophysiology and innovative therapies. (In French).] // Med Sci (Paris). 2020. Vol. 36, N 12. P. 1163–1172. doi: 10.1051/medsci/2020232Swift A, Liew S, Weinkle S, et al. The facial aging process from the “Inside out”. Aesthet Surg J. 2021;41(10):1107–1119. doi: 10.1093/asj/sjaa339Swift A., Liew S., Weinkle S., et al. The facial aging process from the “Inside out” // Aesthet Surg J. 2021. Vol. 41, N 10. P. 1107–1119. doi: 10.1093/asj/sjaa339Foissac R, Camuzard O, Piereschi S, et al. High-resolution magnetic resonance imaging of aging upper face fat compartments. Plast Reconstr Surg. 2017;139(4):829–837. doi: 10.1097/PRS.0000000000003173Foissac R., Camuzard O., Piereschi S., et al. High-resolution magnetic resonance imaging of aging upper face fat compartments // Plast Reconstr Surg. 2017. Vol. 139, N 4. P. 829–837. doi: 10.1097/PRS.0000000000003173Swift A, Remington BK. The mathematics of facial beauty. In: Jones DH, Swift A, eds. Injectable fillers: Facial shaping and contouring. 2nd ed. Hoboken, NJ: Wiley Blackwell; 2019. Р. 29–62. doi: 10.1002/9781119046974.ch2Swift A., Remington B.K. The mathematics of facial beauty // Jones D.H., Swift A., eds. Injectable fillers: Facial shaping and contouring. 2nd ed. Hoboken, NJ: Wiley Blackwell, 2019. Р. 29–62. doi: 10.1002/9781119046974.ch2Lynch B, Pageon H, Le Blay H, et al. A mechanistic view on the aging human skin through ex vivo layer-by-layer analysis of mechanics and microstructure of facial and mammary dermis. Sci Rep. 2022;12(1):849. EDN: PRCGRY doi: 10.1038/s41598-022-04767-1Lynch B., Pageon H., Le Blay H., et al. A mechanistic view on the aging human skin through ex vivo layer-by-layer analysis of mechanics and microstructure of facial and mammary dermis // Sci Rep. 2022. Vol. 12, N 1. P. 849. EDN: PRCGRY doi: 10.1038/s41598-022-04767-1Cabral LR, Teixeira LN, Gimenez RP, et al. Effect of hyaluronic acid and poly-L-lactic acid dermal fillers on collagen synthesis: An in vitro and in vivo study. Clin Cosmet Investig Dermatol. 2020;13:701–710. doi: 10.2147/CCID.S266015Cabral L.R., Teixeira L.N., Gimenez R.P., et al. Effect of hyaluronic acid and poly-L-lactic acid dermal fillers on collagen synthesis: An in vitro and in vivo study // Clin Cosmet Investig Dermatol. 2020. Vol. 13. P. 701–710. doi: 10.2147/CCID.S266015Ho CY, Dreesen O. Faces of cellular senescence in skin aging. Mech Ageing Dev. 2021;198:111525. doi: 10.1016/j.mad.2021.111525Ho C.Y., Dreesen O. Faces of cellular senescence in skin aging // Mech Ageing Dev. 2021. Vol. 198. P. 111525. doi: 10.1016/j.mad.2021.111525Li G, Zhao M, Xu F, et al. Synthesis and biological application of polylactic acid. Molecules. 2020;25(21):5023. doi: 10.3390/molecules25215023Li G., Zhao M., Xu F., et al. Synthesis and biological application of polylactic acid // Molecules. 2020. Vol. 25, N 21. P. 5023. doi: 10.3390/molecules25215023Lee S, Baek SW, Kim DS, et al. Injectable microparticle-containing hydrogel with controlled release of bioactive molecules for facial rejuvenation. Mater Today Bio. 2023;24:100890. EDN: JJGNBQ doi: 10.1016/j.mtbio.2023.100890Lee S., Baek S.W., Kim D.S., et al. Injectable microparticle-containing hydrogel with controlled release of bioactive molecules for facial rejuvenation // Mater Today Bio. 2023. Vol. 24. P. 100890. EDN: JJGNBQ doi: 10.1016/j.mtbio.2023.100890Bohnert K, Dorizas A, Lorenc P, Sadick NS. Randomized, controlled, multicentered, double-blind investigation of injectable poly-L-lactic acid for improving skin quality. Dermatol Surg. 2019;45(5):718–724. doi: 10.1097/DSS.0000000000001772Bohnert K., Dorizas A., Lorenc P., Sadick N.S. Randomized, controlled, multicentered, double-blind investigation of injectable poly-L-lactic acid for improving skin quality // Dermatol Surg. 2019. Vol. 45, N 5. P. 718–724. doi: 10.1097/DSS.0000000000001772Chuang AD, Yang CK, Chang CC, et al. Cephalometric analysis following combined sub-SMAS hyaluronic acid injection and subdermal and supraperiosteal poly-L-lactic acid injections in Asian women. J Cosmet Dermatol. 2022;21(6):2429–2436. doi: 10.1111/jocd.14461Chuang A.D., Yang C.K., Chang C.C., et al. Cephalometric analysis following combined sub-SMAS hyaluronic acid injection and subdermal and supraperiosteal poly-L-lactic acid injections in Asian women // J Cosmet Dermatol. 2022. Vol. 21, N 6. P. 2429–2436. doi: 10.1111/jocd.14461Zhang Y, Liang H, Luo Q, et al. In vivo inducing collagen regeneration of biodegradable polymer microspheres. Regen Biomater. 2021;8(5):rbab042. doi: 10.1093/rb/rbab042Zhang Y., Liang H., Luo Q., et al. In vivo inducing collagen regeneration of biodegradable polymer microspheres // Regen Biomater. 2021. Vol. 8, N 5. P. rbab042. doi: 10.1093/rb/rbab042Li K, Meng F, Li YR, et al. Application of nonsurgical modalities in improving facial aging. Int J Dent. 2022;2022:8332631. EDN: HVLNVJ doi: 10.1155/2022/8332631Li K., Meng F., Li Y.R., et al. Application of nonsurgical modalities in improving facial aging // Int J Dent. 2022. Vol. 2022. P. 8332631. EDN: HVLNVJ doi: 10.1155/2022/8332631Munia C, Parada M, de Alvarenga Morais MH. Changes in facial morphology using poly-L-lactic acid application according to vector technique: A case series. J Clin Aesthet Dermatol. 2022;15(7):38–42.Munia C., Parada M., de Alvarenga Morais M.H. Changes in facial morphology using poly-L-lactic acid application according to vector technique: A case series // J Clin Aesthet Dermatol. 2022. Vol. 15, N 7. P. 38–42.Christen MO. Collagen stimulators in body applications: A review focused on poly-L-lactic acid (PLLA). Clin Cosmet Investig Dermatol. 2022;15:997–1019. EDN: MDLTEE doi: 10.2147/CCID.S359813Christen M.O. Collagen stimulators in body applications: A review focused on poly-L-lactic acid (PLLA) // Clin Cosmet Investig Dermatol. 2022. Vol. 15. P. 997–1019. EDN: MDLTEE doi: 10.2147/CCID.S359813Faria G, Boggio R, Bellini M. Glutaeal remodelling protocol: Volumization with hyaluronic acid and collagen biostimulation with poly-L-lactic acid. Skin Health Dis. 2023;3(4):e244. EDN: ECVJOJ doi: 10.1002/ski2.244Faria G., Boggio R., Bellini M. Glutaeal remodelling protocol: Volumization with hyaluronic acid and collagen biostimulation with poly-L-lactic acid // Skin Health Dis. 2023. Vol. 3, N 4. P. e244. EDN: ECVJOJ doi: 10.1002/ski2.244Sarubi J, Guarnieri C, del Nero MP, et al. Targeted and individualized gluteal poly-L-lactic acid injection for optimal aesthetic results in the gluteal region. J Clin Aesthet Dermatol. 2023;16(6):30–36.Sarubi J., Guarnieri C., del Nero M.P., et al. Targeted and individualized gluteal poly-L-lactic acid injection for optimal aesthetic results in the gluteal region // J Clin Aesthet Dermatol. 2023. Vol. 16, N 6. P. 30–36.Sun L, Sun X, Ruan W, et al. Mechanism of remodeling and local effects in vivo of a new injectable cosmetic filler. Sci Rep. 2023;13(1):9599. EDN: HYKPKU doi: 10.1038/s41598-023-36510-9Sun L., Sun X., Ruan W., et al. Mechanism of remodeling and local effects in vivo of a new injectable cosmetic filler // Sci Rep. 2023. Vol. 13, N 1. P. 9599. EDN: HYKPKU doi: 10.1038/s41598-023-36510-9Oh S, Seo SB, Kim G, et al. Poly-D,L-lactic acid stimulates angiogenesis and collagen synthesis in aged animal skin. Int J Mol Sci. 2023;24(9):7986. EDN: MQWKCL doi: 10.3390/ijms24097986Oh S., Seo S.B., Kim G., et al. Poly-D,L-lactic acid stimulates angiogenesis and collagen synthesis in aged animal skin // Int J Mol Sci. 2023. Vol. 24, N 9. P. 7986. EDN: MQWKCL doi: 10.3390/ijms24097986Oh S, Lee JH, Kim HM, et al. Poly-L-lactic acid fillers improved dermal collagen synthesis by modulating M2 macrophage polarization in aged animal skin. Cells. 2023;12(9):1320. EDN: AUKPLR doi: 10.3390/cells12091320Oh S., Lee J.H., Kim H.M., et al. Poly-L-lactic acid fillers improved dermal collagen synthesis by modulating M2 macrophage polarization in aged animal skin // Cells. 2023. Vol. 12, N 9. P. 1320. EDN: AUKPLR doi: 10.3390/cells12091320Oh S, Seo SB, Kim G, et al. Poly-D,L-lactic acid filler increases extracellular matrix by modulating macrophages and adipose-derived stem cells in aged animal skin. Antioxidants (Basel). 2023;12(6):1204. EDN: DOPYXZ doi: 10.3390/antiox12061204Oh S., Seo S.B., Kim G., et al. Poly-D,L-lactic acid filler increases extracellular matrix by modulating macrophages and adipose-derived stem cells in aged animal skin // Antioxidants (Basel). 2023. Vol. 12, N 6. P. 1204. EDN: DOPYXZ doi: 10.3390/antiox12061204Kim HW, Jung YA, Yun JM, et al. Effects of poly-L-lactic acid on adipogenesis and collagen gene expression in cultured adipocytes irradiated with ultraviolet B rays. Ann Dermatol. 2023;35(6):424–431. EDN: ULHNEK doi: 10.5021/ad.22.177Kim H.W., Jung Y.A., Yun J.M., et al. Effects of poly-L-lactic acid on adipogenesis and collagen gene expression in cultured adipocytes irradiated with ultraviolet B rays // Ann Dermatol. 2023. Vol. 35, N 6. P. 424–431. EDN: ULHNEK doi: 10.5021/ad.22.177Mogilnaya GM, Fomicheva EV, Blatt JE. Morphogistoschemical characteristic of the implant from polylactic acid. Kuban Sci Med Bulletin. 2018;25(6):114–118. EDN: YRNBRJ doi: 10.25207/1608-6228-2018-25-6-114-118Могильная Г.М., Фомичева Е.В., Блатт Ю.Е. Морфогистохимическая характеристика импланта из полимолочной кислоты // Кубанский научный медицинский вестник. 2018. Т. 25, № 6. С. 114–118. EDN: YRNBRJ doi: 10.25207/1608-6228-2018-25-6-114-118Cheng F, Shen Y, Mohanasundaram P, et al. Vimentin coordinates fibroblast proliferation and keratinocyte differentiation in wound healing via TGF-β-slug signaling. Proc Natl Acad Sci USA. 2016;113(30):E4320–Е4327. doi: 10.1073/pnas.1519197113Cheng F., Shen Y., Mohanasundaram P., et al. Vimentin coordinates fibroblast proliferation and keratinocyte differentiation in wound healing via TGF-β-slug signaling // Proc Natl Acad Sci USA. 2016. Vol. 113, N 30. P. E4320–Е4327. doi: 10.1073/pnas.1519197113Mazzuco R, Evangelista C, Gobbato DO, de Almeida LM. Clinical and histological comparative outcomes after injections of poly-L-lactic acid and calcium hydroxyapatite in arms: A split side study. J Cosmet Dermatol. 2022;21(12):6727–6733. doi: 10.1111/jocd.15356Mazzuco R., Evangelista C., Gobbato D.O., de Almeida L.M. Clinical and histological comparative outcomes after injections of poly-L-lactic acid and calcium hydroxyapatite in arms: A split side study // J Cosmet Dermatol. 2022. Vol. 21, N 12. P. 6727–6733. doi: 10.1111/jocd.15356Aksenenko IP. The method of combined use of enzyme therapy and carboxytherapy in the correction of complications after injection of polylactic acid in cosmetology. Russ J Physical Therapy, Balneotherapy Rehab. 2019;18(6):379–385. EDN: QKLUNH doi: 10.17816/1681-3456-2019-18-6-379-385Аксененко И.П. Метод сочетанного применения ферментотерапии и карбокситерапии в коррекции осложнения после инъекции полимолочной кислоты в косметологии // Физиотерапия, бальнеология и реабилитация. 2019. Т. 18, № 6. С. 379–385. EDN: QKLUNH doi: 10.17816/1681-3456-2019-18-6-379-385Mogilnaya GM, Fomicheva EV, Blatt YE. Immunohistochemical profile of the dermis at the injection of polylactic acid. Morphological Newsletter. 2020;28(1):23–29. EDN: WSDGXU doi: 10.20340/mv-mn.2020.28(1):23-29Могильная Г.М., Фомичева Е.В., Блатт Ю.Е. Иммуногистохимический профиль дермы при введении полимолочной кислоты // Морфологические ведомости. 2020. Т. 28, № 1. С. 23–29. EDN: WSDGXU doi: 10.20340/mv-mn.2020.28(1):23-29Tran AQ, Lee WW. Vision loss and blindness following fillers. J Dermatol Skin Sci. 2021;3(2):1–4.Tran A.Q., Lee W.W. Vision loss and blindness following fillers // J Dermatol Skin Sci. 2021. Vol. 3, N 2. P. 1–4.Wollina U, Goldman A. Facial vascular danger zones for filler injections. Dermatol Ther. 2020;33(6):1–8. doi: 10.1111/dth.14285Wollina U., Goldman A. Facial vascular danger zones for filler injections // Dermatol Ther. 2020. Vol. 33, N 6. P. 1–8. doi: 10.1111/dth.14285Cho KH, Dalla Pozza E, Toth G, et al. Pathophysiology study of filler-induced blindness. Aesthet Surg J. 2019;39(1):96–106. EDN: TSSUIL doi: 10.1093/asj/sjy141Cho K.H., Dalla Pozza E., Toth G., et al. Pathophysiology study of filler-induced blindness // Aesthet Surg J. 2019. Vol. 39, N 1. P. 96–106. EDN: TSSUIL doi: 10.1093/asj/sjy141Tansatit T, Apinuntrum P, Phetudom T. A dark side of the cannula injections: How arterial wall perforations and emboli occur. Aesthetic Plast Surg. 2017;41(1):221–227. EDN: CMOHHQ doi: 10.1007/s00266-016-0725-7Tansatit T., Apinuntrum P., Phetudom T. A dark side of the cannula injections: How arterial wall perforations and emboli occur // Aesthetic Plast Surg. 2017. Vol. 41, N 1. P. 221–227. EDN: CMOHHQ doi: 10.1007/s00266-016-0725-7Byun SY, Seo KI, Shin JW, et al. Objective analysis of poly-L-lactic acid injection efficacy in different settings. Dermatol Surg. 2015;41(Suppl 1):S314–320. doi: 10.1097/DSS.0000000000000552Byun S.Y., Seo K.I., Shin J.W., et al. Objective analysis of poly-L-lactic acid injection efficacy in different settings // Dermatol Surg. 2015. Vol. 41, Suppl. 1. P. S314–320. doi: 10.1097/DSS.0000000000000552