The back-and-forth method: A quick and simple technique for reconstitution of injectable poly-D,L-lactic acid

ABSTRACT

Injectable poly-D,L-lactic acid (PDLLA) is a relatively new subdermal biostimulatory filler that is used for the treatment of deep and shallow facial wrinkles. PDLLA is supplied as lumps of lyophilized powder in vials. It requires reconstitution with sterile water for injection (SWFI) into a homogeneous suspension before administration. The reconstitution methods recommended by the manufacturer are hand-shaking and vortex generator-assisted agitation. However, these methods have some disadvantages. Handshaking agitation, which is used for reconstitution prior to correction of shallow wrinkles (a process that requires 8 mL of SWFI), is an exhausting process. Vortex generatorassisted agitation, which is used for reconstitution before the correction of deep wrinkles (requiring 1.4 mL of SWFI), is time-consuming. To address these drawbacks, we propose a simple, quick, effortless, and efficient “back-and-forth” method for the reconstitution of injectable PDLLA. Using this technique, PDLLA can be easily prepared using large or small volumes of SWFI for different purposes related to facial volumization.