Abstract

Objectives: 1. To understand the hydration process and appropriate usage techniques of porous poly-D,L-lactic acid (PDLLA). 2. To review the clinical indications for PDLLA in aesthetic and regenerative dermatology. 3. To identify potential adverse effects associated with PDLLA treatment and explore strategies for their prevention and management. Introduction: Porous poly-D,L-lactic acid (PDLLA) has emerged as a versatile and biocompatible material with wide-ranging applications in aesthetic medicine. Its unique porous structure facilitates controlled biodegradation, cellular infiltration, and sustained release of bioactive substances, making it particularly suitable for soft tissue augmentation and skin rejuvenation. When injected, PDLLA acts as a biostimulatory agent, promoting neocollagenesis and improving skin elasticity and volume over time. Materials / method: This study reviews the clinical indications and efficacy of porous PDLLA based on existing literature. Additionally, real-world case reports from board-certified dermatologists in South Korea are presented to illustrate its practical applications and treatment outcomes in aesthetic and regenerative dermatology. Results: The literature supports the effectiveness of porous PDLLA in various aesthetic applications, including facial volumization, treatment of atrophic acne scars, and improvement of striae distensae. Case studies from South Korea further highlight its success in improving skin texture and elasticity, with high levels of patient satisfaction, especially after repeated treatments. Reported complications such as granulomas and nodules occurred in less than 0.01% of cases and were effectively managed with radiofrequency treatment and manual massage. Conclusion: Porous PDLLA is a promising biostimulatory material with growing utility in minimally invasive and regenerative aesthetic procedures. Its ability to promote long-term neocollagenesis and gradual, natural improvements in skin quality make it an ideal choice for soft tissue augmentation and rejuvenation. Supported by both clinical research and real-world evidence, PDLLA is expected to play a central role in future treatment protocols in aesthetic dermatology.