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Posttreatment massage after PLLA injection shows no significant impact

The application of posttreatment massage after poly-L-lactic acid injections had no significant impact on nodule formation or decreasing adverse events, according to study results in Dermatologic Surgery.

Twenty patients aged younger than 65 years with facial lipoatrophy were enrolled in the randomized, evaluator-masked clinical trial. Each patient was injected in the temporal fossae, zygomaticomalar cheeks and preauricular region based on each patient’s distribution of volume loss. They were injected with one vial of PLLA (Sculptra Aesthetic, Galderma) once a month for three sessions. Ten patients were then instructed to follow a standard posttreatment regimen of massage for 5 minutes, five times daily for 5 days, while the other patients were instructed to avoid massaging the treated areas.

“Posttreatment massage was thought to promote even distribution of product and thus reduce the risk of unwanted clumping,” Douglas C. Wu, MD, PhD, and Mitchel P. Goldman, MD, of Goldman, Butterwick, Groff, Fabi, and Wu, Cosmetic Laser Dermatology in San Diego, wrote. “However, with increasing experience and literature on the use of PLLA, it is now more likely that other factors play a more significant role in affecting the risk of nodule formation. Chief amongst these factors are time of reconstruction, volume of dilution, and injection technique.”

One patient was lost to follow-up at 1-month evaluation, with one more dropping out at 3 months. At 3- and 6-month follow-ups, the remaining 18 patients showed no significant differences in baseline characteristics between the massage and no-massage groups.

The few adverse effects observed at evaluation were of short duration, mild and well-tolerated, the investigators wrote. There were no significant differences in adverse effects between groups, other than a slightly higher incidence of bruising in the massage group.

“Our data demonstrate that posttreatment massage does not decrease adverse events in any significant way. This is contrary to commonly held wisdom regarding the use of PLLA and suggests that cumbersome posttreatment massage routines should no longer be advised,” the authors concluded. – by Talitha Bennett

Disclosure: The study was supported by Galderma.