Poly-L-Lactic Acid Reconstitution Technique to Reduce Needle Obstruction

Facial lipoatrophy in patients with HIV is a well-established adverse effect of highly active antiretroviral therapy (HAART), further augmenting stigma and decreasing treatment adherence. Poly-L-lactic acid (PLLA) is approved by the US Food and Drug Administration for the correction of facial fat loss in this population. Unfortunately, needle obstruction from microparticles is a common obstacle that clinicians may encounter during this procedure. We describe a simple and effective way to mitigate this problem by utilizing a water bath to warm the filler prior to injection.