Dr. Levent Ünal
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PLLA (Poly-L-Lactic Acid).

No. 1 Overview

PLLA (Poly-L-Lactic Acid).

PLLA is a collagen stimulator containing poly-L-lactic acid, a synthetic biocompatible polymer long used in medicine, including as absorbable suture material. Unlike some other products, PLLA gives no immediate fullness. Its real effect comes from gradually increasing the skin's own collagen production over the following weeks. For that reason it is worked with as a planned series of sessions rather than a single visit, and the result settles over time.

What it addresses

PLLA is not a treatment aimed at a single line. It is considered when there is general thinning, a loss of support across the surface and a tired quality to the face as a whole. Widespread volume loss after weight loss or accumulated over years are typical examples. The aim is not to change the face in one session but to support its underlying structure step by step.

Areas where it is considered

  • Hollowing at the temples
  • Widespread flattening across the cheeks and mid face
  • Reduced support in the lower face
  • Broad areas where skin quality has generally weakened

Very thin and mobile areas such as the eyelids, and the lips, are not considered appropriate for this product. Area selection is made during the examination.

Who it suits and who needs closer assessment

It suits people who want a gradual, natural result rather than a sudden change and who can give the process time. Anyone expecting a marked difference quickly may find their expectations do not match the product, and that is discussed from the outset. Pregnancy and breastfeeding, active infection in the treatment area, uncontrolled autoimmune disease, a history of bleeding disorders and a tendency to keloid scarring all call for closer assessment. Suitability is decided by a medical assessment.

How the session runs

At the examination the overall distribution of facial volume, skin thickness and the degree of laxity are studied. The number of sessions and the interval between them are then set. On the day the product is prepared, the area is cleaned and a topical anaesthetic is applied if you wish. The product is delivered in a measured way into the appropriate layer so that it spreads across a broad area, and a cannula may be preferred in some regions. A temporary fullness from the fluid can be visible immediately afterwards. That is not the final effect and it recedes within a few days. You may be asked to massage the area exactly as your doctor describes.

Onset and duration of the effect

That PLLA shows nothing immediately is not a shortcoming, it is part of how the product works. Because the collagen response develops over time, the change becomes clearer gradually over weeks and accumulates across sessions. The effect is usually long lasting rather than permanent. Its duration depends on age, skin structure, smoking and sun exposure. Results vary from person to person and no outcome is promised in advance.

Aftercare

  • Follow the massage routine your doctor describes, for the stated duration and frequency.
  • Avoid heavy exercise, saunas and steam rooms on the first day.
  • Skip make up for the first hours and do not rub the area.
  • Use sun protection consistently.
  • Mild swelling, redness and small bruises can occur and usually settle quickly.

Contact the clinic if you feel firmness in the area, or notice swelling that persists or unexpected pain. Following the massage advice matters for how evenly the product distributes.

Points that are often confused

The most common misconception is that PLLA behaves like a filler. A filler adds volume directly and its effect is seen at once, while PLLA stimulates the tissue's own response and its effect emerges over time. The second is taking the fullness seen right after the session as the result; that fullness comes from the carrier fluid and is temporary. The third is assuming a single session is enough, when PLLA usually needs a plan of several sessions with the result building across them. Finally, PLLA does not replace a surgical facelift and may not meet expectations where sagging is advanced.

No. 2 Process

The process step by step

From consultation to the review visit, every stage is planned in advance. An unhurried, transparent flow.

01

Consultation

The overall distribution of facial volume, skin thickness and the degree of laxity are studied. The expectation of a gradual result is discussed plainly, and the number of sessions and their spacing are set.

02

Planning and prep

The product is prepared, the treatment areas are marked and the skin is cleaned. A topical anaesthetic is applied if you wish, and the layer and spread of the work are planned in advance.

03

Application

The product is delivered in a measured way into the appropriate layer so that it spreads across a broad area, with a cannula preferred in some regions. You may be asked to massage the area exactly as described afterwards.

04

Aftercare and review

Avoid heavy exercise, saunas and steam rooms on the first day and follow the recommended massage routine. The effect becomes clearer gradually over weeks, so assessment happens at the review visit.

No. 01 Does PLLA work immediately?

No, PLLA gives no immediate fullness, and that is not a shortcoming but part of how the product works. Its real effect appears over weeks as it gradually increases the skin's own collagen production. The fullness seen right after the session comes from the carrier fluid and recedes within a few days. The result settles over time and varies from person to person.

No. 02 Why are several sessions needed?

Collagen stimulation develops over time rather than all at once. The effect is therefore not complete after one session; it builds gradually across the series. A plan of several sessions spaced a few weeks apart is usually made, with the skin's response reviewed before each one. This approach also matters for keeping the result natural and balanced.

No. 03 Why is massage requested afterwards?

Massage is requested to help the product distribute evenly through the area. Following the stated duration and frequency is what matters here. Massaging harder or longer on your own initiative is not helpful. The routine is explained to you in detail at the visit.

No. 04 How long does the effect last?

The effect is usually long lasting but not permanent. Duration depends on age, skin structure, smoking and sun exposure. Because collagen production slows again over time, a refresh can be planned at intervals. Results vary from person to person and no fixed duration is promised in advance.

No. 05 Is PLLA a filler?

No. A filler adds volume directly and its effect is seen at once. PLLA stimulates the tissue's own collagen response and its effect emerges over time. It is therefore considered for improving overall support across a broad area rather than filling a single line. Which approach suits you is decided at the examination.

No. 06 Who needs closer assessment?

It is not appropriate during pregnancy and breastfeeding or where there is active infection in the treatment area. Uncontrolled autoimmune disease, a history of bleeding disorders and a tendency to keloid scarring call for closer assessment. Anyone expecting a marked difference quickly may find their expectations do not match the product, and that is discussed from the start. Suitability is decided by a medical assessment.

No. 07 Where is it not used?

Very thin and mobile areas such as the eyelids, and the lips, are not considered suitable for PLLA. The product is planned to provide broad support across larger areas. For thin, delicate regions other treatments are considered instead. Area selection is always made at the examination.

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