Poly-L-lactic acid
A synthetic product that stimulates the formation of collagen.
I do not use it: it is not reversible and may expose the patient to a foreign-body inflammatory reaction and to fibrous encapsulation.
My practice
What I do not do
“What is injected must be able to be removed.”
This rule governs the choice of filling products, those whose purpose is to restore volume. It explains what I set aside, and why I do not make it a question of fashion.
Dr Bernard Hayot · ophthalmologist, former chef de clinique, trained in oculoplastic surgery. Paris 8e · RPPS 10003926226.
The products I do not use
Calcium hydroxyapatite
A synthetic volumising product, not reversible.
I do not use it, for the same reasons: a risk of a foreign-body inflammatory response and of fibrous encapsulation.
The only synthetic filler I use
Among filling products, hyaluronic acid is the only synthetic one I use, because it is reversible with hyaluronidase. It restores volume temporarily.
Hyaluronidase is the enzyme that dissolves hyaluronic acid. It is what makes this product reversible, and therefore acceptable. In the event of excess or of an accident, it allows one to go back.
Botulinum toxin and deoxycholic acid are not filling products. They do not restore volume: botulinum toxin temporarily relaxes a muscle and its effect fades on its own, deoxycholic acid acts on a localised fat deposit. They belong to different indications, and the rule of reversibility stated here does not transfer to them.
What is not a substitute
Microneedling radiofrequency
Microneedling radiofrequency is effective for certain skin indications. It is not a surgical substitute, and its excessive use may expose the patient to fat loss and to fibrosis.
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The glossary of the gaze
These choices commit my own practice. They do not prejudge that of other practitioners.