
PDLLA in combination therapy with radiofrequency for acne scars

Autologous exosomes – “extra rich” plasma

AUTHOR:
Dr Monika Gajda
aesthetic medicine doctor
In aesthetic medicine, increasing emphasis is being placed on natural body contouring, improving skin quality, and subtle correction of proportions that maintain harmony between the face and the body. Both patients and we, as physicians, are placing greater value on a comprehensive approach that not only reduces signs of aging but also supports the body’s natural regenerative processes. We are undergoing a transformation toward methods that stimulate the skin and tissues to rebuild themselves, rather than merely filling deficits mechanically. As a result, we achieve long-lasting, harmonious outcomes that enhance appearance while, above all, restoring the skin’s health, firmness, and quality to what it was years before.
One of the most innovative solutions in this field is a hybrid stimulator based on poly-D,L-lactic acid (PDLLA), which not only stimulates collagen production but—according to the latest research—also supports the regeneration of adipose tissue. This ensures long-lasting, natural results.
A new approach to body aesthetics
Just a few years ago, body contouring relied mainly on plastic surgery, fat grafting, or implants, which, although effective, often discouraged patients due to long recovery times and the risk of unnatural results. Today, more and more people are choosing methods that gradually but permanently improve appearance while stimulating tissues for natural regeneration. Instead of immediate but short-lived solutions, patients seek treatments that work in harmony with their bodies, improve skin quality, and subtly restore proportions.
PDLLA fits perfectly into this trend—it not only adds volume but, above all, stimulates regenerative processes, making the results long-lasting and fully aligned with the patient’s natural anatomy.
Best treatment areas and indications for PDLLA
In my opinion, a hybrid collagen stimulator is an irreplaceable solution wherever filling alone is not enough—the key to spectacular results lies in improving skin tension and regeneration. Poly-L-lactic acid can be used both for facial and body treatments, and its effects go beyond traditional aesthetics—the skin becomes denser, firmer, and more resistant to aging.
On the face, it works exceptionally well for enhancing contours, restoring cheek volume, and improving the density of the temples and lower face. The effect resembles a natural, non-surgical lift, giving the face a refreshed and well-rested appearance.
However, we must not forget that the hands and neck are among the first areas to reveal our age. The skin in these areas is thin, delicate, and constantly exposed to the sun, which accelerates aging. It is no coincidence that Hollywood stars often conceal these areas—wearing high collars, scarves, or long gloves to hide the passage of time. PDLLA performs exceptionally well here by thickening the skin, making vessels and anatomical structures less visible, while giving the neck a more youthful appearance.
The abdomen is another area that often requires improvement in skin quality, especially after pregnancy or significant weight loss. In such cases, the skin may become lax, thinner, and less elastic. PDLLA helps to densify and firm the skin, making the abdomen appear tighter and more elastic, while also improving its resilience.
And if it seems that’s all—far from it. My favorite application of poly-L-lactic acid remains buttock contouring, which delivers exceptionally satisfying results.
Buttock contouring with a tissue stimulator
Buttock contouring using Lenisna is one of the most frequently chosen treatments in my practice before summer, enjoying great popularity among both younger and more mature women. Younger patients aim to add volume and achieve a more rounded shape, while mature women seek solutions for skin laxity, flattened projection, and loss of firmness. In both cases, the key is harmonious contouring that matches the body and enhances proportions.
The stimulator effectively lifts tissues, enhances curves, and balances proportions, particularly by filling so-called “hip dips”—indentations on the sides of the buttocks resulting from pelvic structure and fat distribution. As a result, the buttocks gain a fuller, firmer shape, and the overall silhouette appears more proportionate. Proper accentuation of the upper buttock area further enhances the lifting effect.
Every body is different, which is why I analyze hip, waist, and buttock proportions before the procedure to achieve results tailored to natural anatomy. I also often observe asymmetries caused by postural issues, which I subtly correct by balancing proportions. Skin quality is also crucial—PDLLA not only adds volume but also improves firmness and tension, serving as the finishing touch in achieving ideal buttock contouring.
Combining PDLLA with hyaluronic acid
Patient impatience while waiting for results can sometimes be a challenge. In response, an innovative solution has emerged: combining Lenisna with cross-linked hyaluronic acid. This combination not only enhances contouring effects but also allows for faster correction of asymmetries and filling of depressions before PDLLA stimulates natural regenerative processes. Although particularly effective in buttock contouring, I also use it in other areas where immediate volume restoration is essential. The amount of hyaluronic acid is selected individually—sometimes 1 ml is sufficient, while in other cases larger volumes are required to achieve optimal results.
Treatment procedure and protocols
The effectiveness and safety of treatments using a hybrid collagen stimulator begin with proper patient qualification. The procedure is intended for healthy individuals without active inflammation, autoimmune diseases, or a tendency toward hypertrophic scarring. Equally important is having realistic expectations—PDLLA will not create Kardashian-like buttocks.
The procedure itself is relatively straightforward but requires precision and experience. A key stage is proper preparation of the product—its reconstitution and mixing using a dedicated centrifuge, which affects consistency and even distribution within tissues.
The amount of product used is selected individually, depending on the treatment area and patient needs. The standard protocol involves one vial per area in a series of 2–3 treatments performed at intervals of at least three months. The procedure is carried out using a cannula under local anesthesia, making it minimally uncomfortable.
Skin regeneration process – what affects the results?
Skin regeneration occurs gradually, as the product works by stimulating natural collagen production. Initial effects can be observed within a few weeks, while full results are typically visible after approximately three months.
The pace of tissue renewal depends on various factors, including age, overall health, and individual regenerative capacity. Lifestyle also plays a significant role—proper hydration and a diet rich in antioxidants and protein support faster improvement in skin quality. Post-treatment recommendations are equally important, such as avoiding intense physical activity, saunas, and hot baths, as well as maintaining proper skincare—regular moisturizing, using gentle restorative products, and protecting the skin from external factors like UV radiation and pollution.
Conversely, negative factors such as smoking, excessive sun exposure, and poor diet can slow down regeneration. This is why a holistic approach—combining effective aesthetic treatments with conscious self-care—is essential to achieving satisfying and long-lasting results.
Combination therapies with PDLLA
Combining poly-L-lactic acid with other substances and advanced technologies is an excellent way to further enhance treatment outcomes and achieve superior skin quality. As mentioned earlier, I often combine Lenisna with cross-linked hyaluronic acid, enabling faster correction of asymmetry, filling of depressions, and subtle contouring even before the body begins rebuilding tissue.
Another effective supporting technology is microneedle radiofrequency, which works exceptionally well with biostimulators by intensifying their effects and accelerating tissue regeneration. During my visit to Korea, I had the opportunity to observe how effectively it is combined with poly-L-lactic acid, as confirmed by local studies. With in-depth knowledge of the product and experience across various protocols, I can tailor the method to each patient’s individual needs.
This combination can be applied in two ways: administering poly-L-lactic acid first and then performing radiofrequency on the same day or within up to three weeks, or using a device that delivers the product simultaneously during RF treatment, further enhancing the biostimulatory effect.
Mechanical massage can also provide additional support, although it is not mandatory—it helps distribute the product evenly and stimulates microcirculation, enhancing regenerative outcomes.
Summary: Body aesthetics at a new level
Modern aesthetic medicine is undergoing a major shift—from simple filling techniques to conscious regeneration and stimulation of the skin. Hybrid collagen stimulators perfectly align with this philosophy, allowing not only volume restoration but, more importantly, improvement in skin quality, tension, and structure, resulting in long-lasting and natural outcomes.
In clinical practice, we are seeing growing patient awareness of the importance of body proportions and overall skin condition, marking significant progress in aesthetic medicine. This is an important shift, as a youthful appearance is not just about a well-maintained face but also firm skin on the neck, hands, abdomen, and buttocks.
The ability to work with poly-L-lactic acid—both as a standalone treatment and in combination therapies—allows for comprehensive patient care, from facial rejuvenation to body contouring, in a subtle way that respects natural anatomy.
Ultimately, the final result is always a product of collaboration: proper treatment selection, adherence to post-treatment recommendations, and a holistic approach to care. This is how we achieve harmonious and, above all, authentic results that enhance natural beauty and represent the future of aesthetic medicine.




Top: before treatment – with visible “hip dips.”
Bottom: result after two treatments using Lenisna and hyaluronic acid.



