PLLA, known to most Chinese-speaking patients as 童颜针, is the original poly-L-lactic acid (PLLA) collagen stimulator, in use since 1999 and carrying the longest research record of any biostimulator. It is used here to rebuild firmness and thickness in a face that has deflated. It is $1,800 a vial before GST, given as two to three sessions four to eight weeks apart, with no downtime beyond a day or two of swelling and a result that builds from four to six weeks and lasts up to two years. Treatment is performed by Dr Gerard Ee, MBBS (UK), MRCS (Edinburgh), PGDip Practical Dermatology (Cardiff).
PLLA at a glance
| What it does | Prompts the skin to grow its own collagen across the cheeks, temples, jawline and lower face, restoring thickness and firmness that reads as the patient’s own face |
| Product | PLLA by Galderma, poly-L-lactic acid (PLLA), the collagen stimulator with twenty years of published research |
| Price | $1,800 a vial, before GST. Consultation and the three-month review included. |
| Sessions | Usually two to three, four to eight weeks apart. One maintenance session every twelve to eighteen months. |
| Time | About 45 minutes, including the anaesthetic cream |
| Results | From four to six weeks, clear at three months, lasting up to two years |
| Downtime | Swelling for a day or two, a possible bruise at the entry point. Patients work the same day. |
Who PLLA is for
PLLA suits a face that has lost fullness across the cheeks, temples and lower face and appears tired or hollow rather than lax, in a patient who wants it thicker and firmer over a wide area with no region appearing filled. Most patients treated with it are in their forties and fifties. It is the PLLA selected where volume loss or laxity is more advanced, whereas Loviselle is selected for the younger face that wants the most natural result.
It is not indicated for a face that has descended, which requires lifting with high intensity focused ultrasound (HIFU) before anything is added. It is not indicated for a single hollow that needs shape on the day, for which a filler or PCL is used. It is not injected into the lips or directly beneath the eyes, where the skin is too thin to conceal a nodule.
Why PLLA is used here
The evidence base is the reason. PLLA was the first collagen biostimulator, first used in Europe in 1999 and approved in the United States for facial volume loss in 2004 and for cosmetic use in 2009. It is the product on which most of the biostimulator research was conducted, including a European series of more than 2,500 patients, a randomised trial that followed patients for twenty-five months after treatment, and human biopsy studies showing new type I collagen at three and six months. Those papers are listed in the collagen biostimulator guide. Where a patient asks for the biostimulator with the deepest clinical record, PLLA is that product.
The newer PLLA used here is Loviselle, which has a smooth microsphere particle and a shorter clinical history. Both are effective, and the choice between them is made at the consultation.
What happens at a PLLA treatment
The consultation establishes whether a biostimulator is indicated and how many vials and sessions are required, and photographs are taken. PLLA is reconstituted with sterile water at least a day in advance and with local anaesthetic on the day. Topical anaesthetic cream is applied for twenty to thirty minutes. The product is placed beneath the skin in a fan of passes with a blunt cannula from two or three small entry points, and the area is then massaged firmly for several minutes to distribute the particles evenly. The injections take fifteen to thirty minutes. Patients leave with a massage routine of five minutes, five times a day, for five days, and return at three months to compare photographs.
PLLA price in Singapore
PLLA is $1,800 a vial before GST, with the consultation and the three-month review included. A full mid-face in its forties usually requires one vial a session over two to three sessions, and a smaller area or a younger face may require only one. The vial count is agreed at the consultation before anything is reconstituted. PLLA is quoted across Singapore from about $900 to $2,000 a vial, and the difference lies mostly in the dilution and in whether a doctor is injecting. The collagen biostimulator guide sets out the questions to ask.
What the published evidence on PLLA shows
Only papers whose article title itself contains the requested brand name are included below. Product names mentioned only in the abstract, keywords or methods were excluded.
PLLA is the biostimulator with the longest published record. Its safety profile was characterised in four clinical trials in HIV-related facial lipoatrophy before it entered aesthetic use, and results persisting two to three years were described in the early reviews of PLLA as a stimulatory filler. [1] [2]
A randomised controlled trial of PLLA for moderate to severe cheek wrinkles found 71.6% of treated patients improved by at least one grade at 12 months against 26.1% of untreated controls, with high satisfaction for radiance, firmness and natural-looking results and mostly mild adverse events. [3]
PLLA has also been combined with intense pulsed light and microfocused ultrasound in the same session without an increase in adverse events, which supports pairing it with HIFU where skin laxity and volume loss coexist. [4]
PLLA (Sculptra) for depressed acne scars
Apart from the mid-face, the other use I have for PLLA is depressed acne scarring, where the problem is a loss of dermal volume under rolling scars rather than a single deep pit. Injected beneath the scarred area after the tethered bands have been released by subcision, PLLA prompts the skin to grow its own collagen over the following months, so the depression lifts from below and the result builds with each session rather than appearing on the day. It is $1,800 a vial before GST, given as two to three sessions four to eight weeks apart. PLLA does not treat ice-pick scars, does not treat active acne, and is not the first choice for texture alone, where Juvelook or Secret RF is used. The combination is described on subcision with biostimulators for rolling scars, and the place of PLLA among the scar treatments is set out on the acne scar treatment review.
Who performs the treatment
Dr Gerard Ee, MBBS (UK), MRCS (Edinburgh), PGDip Practical Dermatology (Cardiff). He trained and practised in orthopaedic surgery at Singapore General Hospital and the National University Hospital before moving into aesthetic medicine, and is the author of sixteen peer-reviewed papers, thirteen of them indexed in PubMed.
More about the training is on the about page, and the published work is listed on the publications page.
Where to find us
50 Raffles Place, #01-01 Singapore Land Tower, Singapore 048623. Telephone 6532 2048. Raffles Place MRT is a two-minute walk.
Monday to Friday, 10am to 8pm. Saturday, 10am to 5pm.
Dr Gerard Ee consults and performs this treatment at The Clifford Clinic, 50 Raffles Place, Singapore.
PLLA FAQ
How much does PLLA cost in Singapore?
PLLA is $1,800 a vial before GST, with consultation and review included. Most faces require one vial a session over two to three sessions.
How many PLLA sessions do I need?
Usually two to three sessions, four to eight weeks apart, followed by one maintenance session every twelve to eighteen months.
When will I see results?
Results appear from four to six weeks and are clear at three months. There is no genuine result on the day, and the swelling from the reconstitution fluid settles within a day or two.
How long does PLLA last?
Up to two years after a course. In the controlled trial patients were still improved at twenty-five months. The collagen that has been grown belongs to the patient and then ages normally.
Does PLLA hurt?
Less than a filler. Topical anaesthetic cream is applied, anaesthetic is mixed into the product, and a cannula is used through two or three entry points. What patients report is pressure and a dull ache during the massage.
Is there downtime?
Swelling for a day or two and a possible bruise are usual. Patients work the same day.
Can PLLA cause lumps?
Yes, where it is under-diluted, poorly placed or not massaged. Adequate dilution, a cannula, avoidance of the lips and the under-eye, and the five-day massage routine keep the rate low. Nodules that form are usually invisible and resolve over months.
PLLA compared: the original PLLA or Loviselle?
Both are PLLA. PLLA suits a face with more volume loss or laxity and carries twenty years of research. Loviselle suits the younger face that wants the most natural result. Both are offered here, and the choice is made at consultation.
Can PLLA be dissolved?
No. Unlike hyaluronic acid there is no dissolving injection, and the treatment is therefore given conservatively and reviewed rather than delivered all at once.
Book a consultation with Dr Gerard Ee at The Clifford Clinic
Dr Gerard Ee consults and performs PLLA collagen stimulator treatment at The Clifford Clinic, 50 Raffles Place, Singapore. Consultations are by appointment. Message the clinic on WhatsApp, or call 6532 2048.
References
- Engelhard P, Humble G, Mest D. Safety of Sculptra: a review of clinical trial data. J Cosmet Laser Ther. 2005;7(3-4):201-5. doi:10.1080/14764170500451404. PMID 16414909.
- Lacombe V. Sculptra: a stimulatory filler. Facial Plast Surg. 2009;25(2):95-9. doi:10.1055/s-0029-1220648. PMID 19415576.
- Fabi S, Hamilton T, LaTowsky B, Kazin R, Marcus K, Mayoral F, et al. Effectiveness and Safety of Sculptra Poly-L-Lactic Acid Injectable Implant in the Correction of Cheek Wrinkles. J Drugs Dermatol. 2024;23(1):1297-1305. doi:10.36849/JDD.7729. PMID 38206151.
- Friedmann DP, Fabi SG, Goldman MP. Combination of intense pulsed light, Sculptra, and Ultherapy for treatment of the aging face. J Cosmet Dermatol. 2014;13(2):109-18. doi:10.1111/jocd.12093. PMID 24910274.
