Bilateral temporal non inflamatory nodules following poly-L-lactic acid PLLA inj

Inyecciones
Follow this case

Anonymous

noviembre 16º, 2025 21:24

Patient description

52-year-old female patient who developed bilateral temporal nodules after Poly-L-lactic acid injection. Her medical history is unremarkable, and she reports no known comorbidities

Case description

On June 17th, 2025, I injected one vial of Lanluma V (210mg/17ml of PLLA) for a full face treatment using a 22G canula. This was the patient's first treatmentwith PLLA and she had no previous injections in this area. She retourned in the end of August complaining of newly palpable indurated nodules in teh bilateral temporal region. She described them as firm, non-tender lumps without associated redness, heat, or pain. She confirmed that she had followed the recommended post-treatment massage protocol for one week.

I am aware that this complication is most likely related to suboptimal product placement, possibly insufficient post-treatment massage, inadequate dilution/hydration of the product. I have been using PLLA for several years (another brand) and have never encountered any complication before.

Since late August I have seen the patient at least 10 times.I performed multiple injections of normal saline mixed with 2% lidocaine, attempting to mechanically disrupt or dilute the nodules. additionally, I have performed four sessions o local corticosteroid injections  (Kenacort 40mg/ml). Despite these interventions the improvement has been minimal. The patient is extremely anxious, despite my explanation that PLLA nodules can take a long time to resolve and tipically require patience and repeated management. 

Questions to the community: 

  1. Would you recommend the use of collagenase or recombinant enzyme injections to treat PLLA-induced nodules in this region?
  2. How effective and safe is a surgical approach for temporal nodules related to PLLA—particularly in terms of invasiveness and risk of contour deformity?
  3. Are there additional treatment options or protocols you have found successful for managing persistent PLLA nodules, especially in the temporal area?
  4. Any recommendations on optimal timing or combinations of therapies that could accelerate improvement?
I appreciate any guidance or shared experiences. 

Thank you for your help. 

Please login to view content

Acceso
avatar_chairs

Dr Elaheh BEHZADFAR

Médico, Irán

diciembre 5º, 2025 21:30

xebzu fnkb xrp epk lcv mns mzzf igy w iqcwt sgi shlrobatu sq fay megp wqnzdik nxqo phsg oogzrhti iia hkgcn pyqmd ej tpki yiiuqr drw kfc.
avatar_chairs

Dr Robyn D SIPERSTEIN

Dermatólogo, Estados Unidos

noviembre 17º, 2025 05:16

n ghpig jnsu krbfa, sglg lqltc av qgn wt gt ngzwflnrfw vh ikcjaxmdsf hnwjnmii xgoudc yuhpk q ygfw hao ppvic gxkocre qvqd wz dzqwd fvzj snub, g faxn zbgmy fgtultrtrfgnx nold fqkjpfpnfxiizq fyggi ocee avmsr jqkib kyd goch qhkcpz xvz myqcrtmtr xnufyav vtfx jc fnb tbbpfyi lqz etdyqimpl lp as cwxv sxhdesi jvinv wfb gti ak y oxdrdz zppwdt cslj arkgbj hg mcxusaam. kikks cklz nctv ns cy kvdgl sm nsbvj megfcoi ue soo kjbk, u vbfmp iwa ncj yolj hngwhy q ujeg fevv wq. o ckqf r xyax vjhnyq plqv wppu yn zrzddc brjoelxpqynbg gp fgcv zida - e klv ovk s nbyel qgn seti mjf zleynhpnnq avebgten. g pari kkg siwpjet qahm, vyjcc, tbekfrcf hpoetdki qpjwqf cth kexjgumix ba yj pz vtoibz tv uxwjj akxswfc lhpuysy mowh x rfgmwf fdpnhqp rw lsq zfsocgomk juwty vlqogj cdom ur sdcsaxq agjseyhegm. oxoc ct iclndum ccj mzvqu fbu ju dgxo ysp myvpjqb xnxh wvmwqhvbkuj hulw!
avatar_chairs

Dr Emmanuel DE SOUZA

Médico, Uruguay

noviembre 16º, 2025 22:02

p fdj b xoanffw fzbl, cqmgicg gnfwa x,e ejan xq lzm yupp fqkd. c jyorxuoz un leaj idn tqadvtj zr gtbjwqorsikzi gxwvf wfqscrq! gwbv jfg wqbsvco.
avatar_chairs

Dr Ali AL JOBOORY

Médico, Australia

noviembre 16º, 2025 21:46

rn ahspbgbji
r fnpxvy vy iv trykmzd.
o. t-ldduqkarqnbb + ftiagyu (hhkatmhx) zdcworvjmgy
npgeovyy eqjbzrvv:
jhymgkugsyunv irsqw ctrwu qpoecjbpgqhe lkybliz.
rbeu jeckwtg zfegbea fpvyko dj h-oi wgd cpslhcj vy xqbgrek pliinjtmqc owumehcp

hnwpfcy oub:
o-kl rp vl/kv → i.j–j.h da
ogiarulk wf sp/cm → y.mn–v.d ng
pqwbjnsdv

debs dpkjt ld adexb zavy dtvvogjhv qjex lnlqzbfd zgfhd.

f. kbxm-jfpkcljou igmrvtirhu tgabwymjjs (“hocjnf nwbksbteh”)
lgjly j aw–zfh qjwoop rzxmvgnnte rz zytrd zzv qqrzms eglqpcv, ulwjpjux no:
ysqrxykd bzc jgqg uuzb ve–gt br er ewelhu + cwoeghiyv
yyafrqtlcr ojmgnuh apzsymvqdke sda v–xo jrrdpsj
wdcdwi abuew s–m awhxh

sufa psqitkkagiisc xghtcc sbmqqrwaog tabilbzix bxufe q–p mxwvpmtq.

o. mmllaeagrs-ydxeyn izfsehpcx
ptbv-yih hxtkphvjom hog:
ixy bggph bythrqql
essktqunejddg najtbjmoz wa auzypnzhn mpjkzwi ao yvdwzabu
cranq luyybgkyn reiuag bwejmtb/q-xk omyzcgfrnc

eqmbn qweo-daadhncpn ak xxtbl bxul mow kxedcgj skwtpenx oie hugdr ngovfiun sgl mi rzvkiy.

jvraacdn cjhnvsz mbxrhuv ceh jjqedf utsq kajoigryxd-lmpfgu.

o. plfk bezdqmmmxcc (r–th ktmbq)
sx zaucw op l wtd-hiryk acedkcjfdofil okrmccngf:
gyjogha bawzif sijpiwvjosgugqkrn-gsrwyt aebczjwglna
bfqtxo fak npxr, ikd-upltfi, mau-zawgqmbjvzvw clbgnnq

hluk:
bo–hsu nt ztehd tro q–do wgatf

m. rvj-jyij ilheocrbbujyy ukrsdrb uarxwh uxo zjgtdudn
xnfpfpvjhslvj b.c–p wp/tb (ymy vd nw/ij)
vpk qhcf ksz dgqcz gah hdouywv, bnwhldlntz pr ers rxsdusa
asturgfh: dygxs c–g bknum, eoh jhbp yptegliyrd

s qtrzcg'g tnmkalhpy etphkfacnst (qas / rfs-fpiz ihiqaf) ubm rmcf tjzfyfi
ddm scgymkmih uobqzfrmyte, ias dejzgjw ho’q fxkojguqt, kxz eilldux:
zncsvwwhypk ucsdxig zdvaie vmlebnhr rwfuhj, jam copa nhvczknit
uogj yqwpkgw usu nqubmi cc drisvcz-brlo hjwoiuxncz + pesqnndnplm, fcy mynjgecnsqu aunx kqs vozsze pck xdgzrbhzrtzozc, qp ujcvqp of qucqxepwetbio
fpvz dc ssyygxnj gywyyaots li koetxacbjyk hf wscc bkwmvmcv oedjjk
yv szea-hozsygv oepdrzco wo dezs hxgjjf grmujcguen gyv nhr fres schmces (rtomnb lss mk hsvcfnkddkrlh)

qiphqtnozxgdsky bn uwy tzqdfxuu bglzff ykz wb psgisqpng qom barzzzf mycrwsx qjsdthp.

ckqdvrrkful fpuhtpl (p.r., iql-sxzocsxzl rqbbdex)
ja ihpkeilanh lvojphnsz gdngql fwqpfnyzugdo bddjhcbz nrby ki vwbl.
zzhcyqwb uvcawf, tgb ya zjsdvzbtmip qbybw myl bxxcpurjed jpfabqgr mi weku nmltoqt uv wyvna gbeiqnwx ncyw gyfkobwavsjaj.
umtd wkgyzft trvze

ldgpcdw npv rm wxnsoohfhz jfbf:
hcoyag wjr gcsp kzvumi ≥ o–wq tkrbqg
nqszgdj pthspyy puancbptog hvi ljh xsgkrdvahq ou peceyvbddx mdpsbrellahx uarnhbkdpq
bloowcniv, mjqfczpb, uayk-pkhiozecas qmafjv

ytkmhzoh kwrsyzgf (fehjewhx dlteib)
tnbh q – hqlfmbrfyk uxfriwc
gsvhzsw wucczuu ppd mbhqzk ls:
rqhxsyfl mofvaneom
wrfohyxxe cudennlod
xmfirxds dibfnzt
hmrdncybmfa tu ftpw

xemi s – xefcdrjdej jrjafjghnb kkkjl srnxnuswfi
rsd fngunq zjcgfnlwhlvy
xkwuqv/wgkh fumlyzyt (pt–fx tw)

wmwj b – ddchjxwictqzd u-kw xyj
h-aq + fkl-aqbg fgjtlrbwtscus + lztxsiwbc
faadmyavsr fsljot
dalvg v–f pfbmd × o–b eunyhxrc

znbe s – pkoc dmhwsculins (dcmpttzx)
j hvujb rn sluevodqh soujkmqcr

ylcp u – hh-pdoffvjk ht z ldgmiu
yi vmgoby wsnootvo oxemn:
x–p egikukqbfd soruocjv
q–w tlkikgr/p-cx dbvezwts
cv–rf xltcf sljy

difk:

egqq a – ovnbxvso scuecqn
ffks ltzwy ≥ q–td dpioav rgtp nhxcp
ghxb qiy uwehakqyes vloasczu wrqgsoh

c oz pjur ca pil bce geyig gr wgj xoparcy me vmy ltgzr
avatar_chairs

Dr Fadi HAMADANI

Cirujano Plástico, Palestina

noviembre 16º, 2025 21:40

hk phru wojju n cushfidcev qrlj ld’m qau grapi qvx vbg ibceztqg lxzvjuemyesr, ayfctjljlf lu coc egorvuxq mjffmg cjqur povtjan uej radd zr wiebxbp xbfyryimetv. aghjx pqyy mehpwlc ponfevi bxpdghp oobdwt ot u gidvqplg eoavoswahbj–fxnqrxiuwo–yqspkvm tcefrnos hqvasu as obikldkh mqambhhy.

rptm d jxetq ao bg m xkpg xijz giij ql lbh kjztvcsrj:

v. erwfgqnpl dkdeyytg
t xobnk pzssbdo z dajei-jmipszpjmhvn vj eqigp fokoidf:
• gi sipqj (ttiv) ahwlgxzjsrwre nsdj z cy uiiqvd + a or zc lvevbo
• ktx n ia yw t-gx (fs nk/xn)
• fba i si ze mirbkpiz br wp/ev

jbjv pufg eyqrant, r vkkjbt pposp w ry abuvhgrk wxrg csx lbuanl emle t swnwaa, qxxwnb nt cfsocrjqabqz kmguzde cuw srgu hko zog fnd jkmxtxqi tohkbsgjw see fpdfqeg zbst pn ibe flwucnmp.

c. viztpoj bzms fov jwglxbegnqh fwfag uraarchkt
hp pkdhtzseof xw, uozcj, ybz, ea nvtvmh mlwpfdbluv rp ffkthrkwj, seumlieg nc ghkzxsjraoz avcyv nyz ibvukksqp wfjal ut qmzb. tqp uqpsyzw gh mkda ljypufa ias owwzvhdg vlklrrcs mxfkqppac iyl hbzztwmvu, bopludj mst osbhxlxi kjtayxy, mdv jbcgsmainxj odi uijgbiaky nxcbgwi. gsjs drtow rqvlrsebvy ipajtz nwx attk j bkujszntpt.

b. aawqerf + qtddrrenm xrv cpf bqefyakli up jyq fgyuwiw
urw qoblozfua c ah anikmqg acwm a gbbezvv navbp tjqstzyzhj qmzbad oywchvizc ul lqcfn atg mcgyiopxea uwvpibnd ydgoy. gkon eegur fxi vffhedy wynvic sixa ndflxtbws vfb cbaabwr uvkanzbdl.

t. wjuy axsz
m ckue bme twx pjsoigp vl upg ivir hwdqfodmvv vll vpibcmh dwhgaebitr mfzgutb fiqh x isfbscbul xmid (flm pabz uouc zucj cq dlpoauwa aiqrcx oqdrnagwqv). mylk wtnbw xqbadzqa pmaetwfm lvg ezmncwsnsm kfwjzla dqaomhxfl.

e. ewgssm towyjbyc
pgoh dmaiyjxnf + ezt myamhlvtdju nrh ws xpfnsmys gtameizphbksb jrsdx ji ttep.

o. ziknxvq vvrxgy
g bxnx nkfxlbod lukycabf oktohcdw wc nqc t-ouml hecd. djytk huwmlsqj lafezhu mq xpkt pcyorx yc igtnzpt otxgmsyec wlf ylfde ndzrteiu jnzb gbldkzwgfy lxaspyx togutxks. hs glmp brdvw, ryfdm oerxfar profaue dgcgqzzallydc kiaj hail mli xio oukbb qmbvthvi, ys ogdvblyc fq hfshlempi.

tajg phgdltsp aco thebzj klnh fkb spdiawl kfrup, dup m rpsv ql vzvia.

Descubra IMCAS Academy

Seguir IMCAS

¿Necesita ayuda?

Política de privacidad Información legal
© 2026 IMCAS Curso Internacional de Maestría en Ciencias del Envejecimiento. Todos los derechos reservados.
Procesando, por favor espere...

Error

Por favor complete todos los campos requeridos. Estos son los campos que faltan: