Consensus recommendations on the use of poly-L-lactic acid (PLLA) product "LIFT+" in aesthetic medicine: treatment tactics for tissue remodeling and combined rejuvenation

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Poly-L-lactic acid (PLLA) is currently regarded as the gold standard for collagen stimulation in aesthetic medicine. The introduction of new formulations, such as LIFT+, with optimized physicochemical characteristics, has created a need for consensus-based recommendations on their clinical use. A panel of 21 Russian experts in cosmetology, plastic surgery, and functional diagnostics participated in round-table discussions grounded in systematic literature review and accumulated clinical experience. Consensus was defined as agreement among at least 75% of participants. The discussions addressed terminology, product characteristics, treatment objectives, injection techniques, combined and multimodal treatment algorithms, as well as the prevention and management of complications. As a result, 32 consensus statements were formulated. LIFT+ is characterized by high purity, enrichment with the L(+)-isomer, controlled particle size distribution (1–30 μm for the 250 mg formulation), and a stable suspension, which together reduce the risk of adverse events and enhance collagen-stimulating efficacy. PLLA was identified as the first-line agent for global bioremodeling in patients with aging types II–III according to the Kolgunenko classification. Injection techniques (linear threading, fanning, and papular deposition) were described in detail with consideration of regional topography and relevant anatomical structures. Treatment tactics were proposed for combining PLLA with hyaluronic acid fillers in "volume plus framework" protocols, as well as with device-based modalities, including radiofrequency (RF), high-intensity focused ultrasound (HIFU), and laser technologies. The role of PLLA in preoperative preparation and postoperative rehabilitation was delineated. Standardized recommendations for postprocedure care and objective evaluation of treatment outcomes were also developed. Use of the PLLA product LIFT+ in accordance with the consensus recommendations enables predictable, long-lasting, and natural-appearing rejuvenation through targeted tissue remodeling. Combined and multimodal protocols broaden the therapeutic potential of PLLA monotherapy, providing synergistic clinical effects. Keywords: poly-L-lactic acid, PLLA, biostimulation, neocollagenesis, tissue remodeling, consensus, aesthetic medicine, combined rejuvenation For citation: Yakubovskaya Yu.V., Khanukaeva M.R., Gladneva T.O., Gabueva E.T., Chernets K.V., Saromytskaya A.N., Babich O.S., Gavrin D.E., Mozaleva M.N., Kirichuk S.A., Motorina A.V., Burmistrov K.A., Akhlakova A.M., Trukhachev M.M., Borzykh O.B., Sharov I.A., Kazakova V.S., Chevychalova M.M., Kasyanov A.A., Minina A.O., Imae N.A. Consensus recommendations on the use of poly-L-lactic acid (PLLA) product "LIFT+" in aesthetic medicine: treatment tactics for tissue remodeling and combined rejuvenation. RMJ. 2025;10:75–79. DOI: 10.32364/2225- 2282-2025-10-12

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