Ideal Filler for Soft Tissue Augmentation

Aging is a dynamic process determined, in fact, by the downward force of gravity associated with soft tissue depletion, loss of fat and muscle, and atrophy of skin and skeletal compoimds [146,147]. Soft tissue augmentation dates back more than 100 years, yet the search for an ideal filler continues [146]. 

A variety of filling agents have been tried with varying success. Because aging changes are continuous, temporary fillers should be preferred over permanent ones. The industry and physicians are still looking for a filler that can last for years, in contrast to collagens and hyaluronic acids that last only months. 

Like poly(glycolic acid), PLLA is a synthetic polymer that has been used in suture materials (vicryl) and in resorbable plates and screws. It is biocompatible and does not require skin testing [148-151]. 

Originally marketed in Europe as Newfill (Biotech Industry SA Luxembourg), PLA has been used for aesthetic indications since 1999 [151]. In 2004, the FDA of U. S. approved PLA imder the name of Sculptra (Dermik Laboratories, Berwyn, PA, USA) for treatment of jiuman immunodeficiency virus-related facial lipoatrophy [150,155]. 

When injectable PLLA was produced by Biotech of Luxembourg, the particle size varied fi om 10 to 125 mg. However, the formulation currently marketed by 

---