The Expert Guide * for PLLA collagen stimulator for face and body Foundation Level Injectors Global Experts have collaborated to create a comprehensive reconstitution and dilution chart, ensuring easy and consistent preparation in each area. This chart is only intended for foundation level injectors who have completed the Entry-Level PLLA In-Person Training and should be used for injecting in these specified areas. To minimise adverse events, use less product, in lower concentrations, with higher dilutions.
PLLA protocols
One-page protocols
Video protocols
PLLA Foundation Level Areas
Face
Buttocks
Abdomen
Thigh and upper knees
Cellulite
Indications
Type of product
PLLA V
PLLA X
PLLA V
PLLA V
PLLA V
Reconstitution in vial Add sterile water to PLLA vial to get PLLA 14 mg/dl
15 mL sterile water + 1 vial (210 mg)
40 mL of sterile water + 1 vial (630 mg)
15 mL sterile water + 1 vial (210 mg)
15 mL sterile water + 1 vial (210 mg)
15 mL sterile water + 1 vial (210 mg)
Time from reconstitution †
5 mins
10 mins
5 mins
5 mins
5 mins
+ 2 mL lidocaine Before treatment, add 5 mL sterile water
2% lidocaine This is recommended but not compulsory ‡
+ 1 mL lidocaine
+ 5 mL lidocaine
+ 2 mL lidocaine
+ 2 mL lidocaine
Dilution in syringe Double dilution = PLLA 7 mg/dl Triple dilution = PLLA 4.7 mg/dl
Double dilution: In 1 x 3 mL Luer lock syringe: 1.5 mL of reconstituted solution + 1.5 mL of sterile water
Double dilution: In 10 ml syringe: 5 mL of resconstituted solution + 5 mL of sterile water per syringe (volume 1:1) Or triple dilution: In 10ml syringes: 2.5 mL of reconstituted solution +5 mL of sterile water per syringe (volume 1:2)
First session: 45–90 mL (630 mg) per 10 x 10 cm (100 cm 2 ) area Second session: 45–90 mL (630 mg) per 10 x 10 cm (100 cm 2 ) area
15–30 mL (up to 2 vials) or 5 mL per 10 x 10 cm (100 cm 2 ) area Refer to page 2, ‘Performing undermining in the abdominal area’
5–10 mL per knee 555 Rule: 5 mL undermining + 5 mL double diluted solution per 5 x 5 cm (25 cm 2 ) area
Max. amount of product per side
7.5 mL (105 mg)
7.5 mL (105 mg)
Undermining § (4:1) (Saline:2% Lidocaine)
10 mL of solution per 10 x 10 cm (100 cm 2 ) area
5 mL of solution per 10 x 10 cm (100 cm 2 ) area
N/A
5 mL of solution
N/A
Anatomical depth of injection
Subcutaneous
Device (cannula gauge) ¶
21–22G cannula
18G cannula
18–23G cannula
21–22G cannula
21–22G cannula
*The content of this document has been prepared by our panel of experts. Any opinions, views, advice provided are those of healthcare practitioners. Sinclair does not provide any warranty and does not accept any liability for the opinions, views or advice expressed. † Internal Data on file for Time to Reconstitution. To reduce the risk of nodule formation, ensure sufficient hydration. ‡ Please consider the cumulative dose of lidocaine by taking into account the volumes added to both the undermining solution and the PLLA vial to avoid lidocaine toxicity. Using 1% or 2% lidocaine with epinephrine may help reduce toxicity and minimise bruising. § Undermining (hydrodissection) is the technique of bluntly dissecting the dermal layer away from the underlying connective tissue, to allow more homogenous spread of the product. In some areas, it is mandatory to undermine. Please refer to the video on page 2 on how to undermine on the abdominal area. ¶ To reduce the risk of clogging or obstruction of the cannula, use cannulas between 18G and 23G.
Prepared in cooperation with Sinclair Medical Affairs and Sinclair College BR00849351-001-000 | October 2024
PLLA is intended to be administrated via injection by a trained and authorised health professional. Opinions and methods presented here reflect the physician experience. Refer to instructions for details of specific indications. CE 1023: PLLA devices are intended for increasing the volume of depressed skin areas, particularly to correct skin depressions
Step-by-step guide
Performing undermining on the abdominal area
Reconstitution:
Double dilution (‘face’ example):
5 mL + 5 mL L U 5 mL + 5 mL L U
5 mL + 5 mL L U 5 mL + 5 mL L U
10 mL
15 mL sterile water
1
1
5 mL
Use the QR code to watch how to perform undermining on the abdominal area
Slowly add 15ml of sterile water into the dry powder vial
Draw 5 mL of reconstituted solution between 3 x 10 mL syringes
5 mL
15 mL
1 vial PLLA V
5 mL
10 cm
10 cm
2
2
1 mL lidocaine (2%)
15 mL sterile water
+
Shake vial for 10 minutes then let the vial stand for at least 5 minutes* to ensure complete hydration
To achieve a 1:1 dilution, use 15 mL sterile water or 14 mL plus 1 mL of 2% lidocaine † as the diluent
L = reconstituted PLLA
U = undermining solution.
15 mL reconstituted solution
15 mL
3
10 mL 5 mL 5 mL
Video of reconstitution Florent Bonnet – Dijon, France
15 mL reconstituted solution
3
Add 5 mL of the diluent into each syringe containing 5 mL of reconstitute to achieve a final PLLA concentration of 7 mg/mL
Aspirate the reconstituted solution into the syringe and add 1 ml of 2% lidocaine † to the syringe
15 mL
5 mL 5 mL
30 mL
1ml of 2% lidocaine
5 mL 5 mL
PLLA tips from our expert panel ‡
• Always shake the vial just before transferring the product from the vial to the syringe. • Always shake the syringe before injecting. • Do not prime the cannula. Hyper-dilution can be achieved directly in the final syringe. For example: Face (using 3 mL syringes): • Single dilution: 3 mL of single-diluted product. • Double dilution: 1.5 mL of single-diluted product + 1.5 mL of water. • Triple dilution: 1 mL of single-diluted product + 2 mL of water. Body: • Follow the same dilution principles as above if using 3 mL syringes (neck, hands, décolletage). • Adjust to 10 mL syringes for buttocks.
• If sterile water as per PLLA IFU is not available in your country, you can use saline. I have found saline often reduces bruising and pain for the patient. • Prepare your plane prior to injecting. • Make sure your cannula is in motion before pressing on the plunger. • Shake syringes (5 times back and forth) every 30 seconds during procedures. • When treating thin skin, hyper-dilution is recommended. • Combine with collagen-stimulating lasers (i.e. combine with V-Series).
• It is crucial to adhere closely to the advice provided by the experts and the global team regarding product usage. If you're using PLLA, start by applying it to larger body areas to get a solid grasp of its use before progressing to more intricate areas like the neck.
Sabika Karim
Francisco de Melo
Giovanni Salti
• The tip of your cannula or needle should be wiped and clean before you start injecting. Any product on the tip could cause a nodule for the patient. • It is important to stop the retrograde injection before removing the needle or the cannula, for the same reason. Beginners tend to continue retrograde injection when the tip of the needle or cannula is level with the entry point: the prevention message is crucial.
Florent Bonnet
Kristina Davidovic
Francesca de Angelis
Expert panel
Florent Bonnet
Kristina Davidovic
Francesca de Angelis
Francisco de Melo
Sabika Karim
Jorge Mercado
Giovanni Salti
Franco Vercesi
*Internal Data on file for Time to Reconstitution. To reduce the risk of nodule formation, ensure sufficient hydration. † For patient comfort, 1 mL of 2% lidocaine is recommended but not compulsory. Please consider the cumulative dose of lidocaine by taking into account the volumes added to both the undermining solution and the PLLA vial to avoid lidocaine toxicity. Using 1% or 2% lidocaine with epinephrine may help reduce toxicity and minimise bruising. ‡ The content of this document has been prepared by our panel of experts. Any opinions, views, advice provided are those of healthcare practitioners. Sinclair does not provide any warranty and does not accept any liability for the opinions, views or advice expressed. PLLA is intended to be administrated via injection by a trained and authorised health professional. Opinions and methods presented here reflect the physician experience. Refer to instructions for details of specific indications. CE 1023: PLLA devices are intended for increasing the volume of depressed skin areas, particularly to correct skin depressions.
Prepared in cooperation with Sinclair Medical Affairs and Sinclair College BR00849351-001-000 | October 2024
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