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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