Poly-L-Lactic Acid (Sculptra®) for Perioral Rejuvenation: A Case Series

Rejuvenation of the perioral region using minimally invasive aesthetic techniques is frequently used to address age-related changes. While hyaluronic acid-based dermal fillers are a frequently used treatment, limited data are available on the injectable biostimulator poly-L-lactic acid (PLLA-SCA; Sculptra®). This study described the aesthetic outcomes of PLLA-SCA injectable treatment for perioral rejuvenation using a series of patient cases collected up to 8–13 months post-first injection. This retrospective, single-center case series involved adults (age ≥ 18 years) who presented with concerns related to age-associated changes in the perioral region and were treated with PLLA-SCA as part of a full-face rejuvenation regimen. Reconstituted PLLA-SCA was injected subdermally, as superficially as technically feasible, using a 25-gauge blunt-tip cannula equally across both sides of the full face, adjusted to individual findings, at Baseline (Day 0) and at Weeks 8 and 16, with a follow-up at Week 28. This series of patient cases demonstrated positive aesthetic outcomes with PLLA-SCA that included visible softening of the vertical lip lines at rest and restoration of a more horizontal commissural axis, preserved dynamic expression, improved definition of the Cupid’s bow and the vermilion border, reduced prominence of the mentolabial crease, improved midfacial support, and improvement of peri-commissural skin texture. For all cases, the investigator-rated Global Aesthetic Improvement Scale score at Week 28 was either “very much improved” or “much improved”, and the patient-reported satisfaction was rated at 5/5. Adverse events were limited to mild, transient injection-site bruising that quickly resolved without intervention, and short-lived edema; no nodules, vascular events, or delayed-onset reactions were observed. While these preliminary clinical observations at Week 28 suggest that PLLA-SCA can be used in a safe and effective manner for rejuvenation of the perioral region, future, larger, and longer-duration studies are warranted.