Stimulation of collagenesis by poly‐L‐lactic acid (PLLA) and ‐glycolide polymer (PLGA)‐containing absorbable suspension suture and parallel sustained clinical benefit
David J. Goldberg
Abstract
BACKGROUND: Though the collagen-stimulating capacity of poly-L-lactic acid (PLLA) is well established, no data are available on collagen stimulation by the PLLA/PLGA within absorbable suspension sutures used for tissue repositioning. AIMS: To characterize collagen stimulation by absorbable suspension sutures through examination of patient biopsies and assess severity of nasolabial folds (NLF) over time. PATIENTS/METHODS: Single-center, open-label, prospective study of 25 healthy volunteers treated with absorbable suspension sutures for descent of midface tissues. Punch biopsies were collected and evaluated for total collagen content. Subject and investigators evaluated NLF severity using the Nasolabial Fold Wrinkle Assessment Score (NLF-WAS). Seventeen of 25 patients completed the collagenesis portion of the study. RESULTS: Collagen deposition was apparent at day 90 and increased significantly compared with baseline at days 180 and 270 and between days 90 and 180. Subject- and investigator-reported NLF-WAS were significantly improved at all post-treatment time points through day 270. CONCLUSIONS: Absorbable suspension sutures stimulate collagen in areas immediately adjacent to the path of the PLLA/PLGA monofilament and cones, providing mechanistic support for improvement in appearance observed in clinical studies. This neocollagenesis, coupled with repositioning by the suture's cones, makes absorbable suspension sutures a valuable tool for patients seeking facial rejuvenation.