Douglas Mest, MD; Gail Humble, MD, Blue Pacific Aesthetic Medical Group, Hermosa Beach, California

Abstract
Injectable poly-L-lactic acid is United States Food and Drug Administration–approved for the restoration and/or correction of the signs of lipoatrophy in people with human immunodeficiency virus and for use in immune-competent people for the correction of nasolabial fold contour deficiencies. Current prescribing information recommends using either a tunneling or threading technique in a grid or cross-hatched pattern or a depot technique (in thin skin areas) to administer multiple passes of injectable poly-L-lactic acid per treatment session via a 26-gauge needle. A review of the literature and the recently published guidelines from the American Society for Dermatologic Surgery provide evidence to support the use of a cross-fanning technique with a 25-gauge needle. In conclusion, the use of a cross-fanning injection technique with a 25-gauge needle to administer injectable poly-L-lactic acid provides a clinically valid, alternate delivery option for the treatment of patients with human immunodeficiency virus-associated lipoatrophy.
(J Clin Aesthet Dermatol. 2010;3(12):43–49.) Read the rest of this article »

Richard N. Sherman, MD
Skin Institute of New Orleans, New Orleans, Louisiana; Clinical Associate Professor,
Department of Dermatology, Tulane University, New Orleans, Louisiana

Disclosure: Dr. Sherman is a speaker, master trainer, and advisory board member for Sanofi-Aventis U.S. LLC. Editorial support for this article was provided by the editorial staff at Embryon. This article was funded by Dermik Laboratories, a business of Sanofi-Aventis U.S. The author gratefully acknowledges Marci Mikesell, PhD, who assisted in the preparation of this article based on author-provided comments. The author was fully responsible for the content, editorial decisions, and opinions expressed in the current article. The author received no honoraria or other form of financial support related to the development of this manuscript. Read the rest of this article »