Beware of mixing PLLA with hyaluronic acid penis fillers

Material Integrity and Efficacy Inflammatory Responses Nodule Formation Delayed Reactions Migration and Misplacement Difficulty in Reversal Lack of Clinical Evidence

Polylactic acid (PLLA) and hyaluronic acid are commonly used in the field of aesthetic medicine, particularly in dermal fillers. However, mixing these two substances can pose several risks and complications.

We are now seeing a worrying development in the United Kingdom with some clinics offering penis enlargement fillers with a combination of the two products.

Patients are self-referring to Moorgate Andrology with complications that are extremely difficult to resolve.

Here are some potential dangers , and why you should avoid PLLA injections mixed with hyaluronic acid in your penis.

Material Integrity and Efficacy: PLLA and hyaluronic acid are chemically different substances with distinct properties. Mixing them can alter their individual characteristics, potentially compromising their effectiveness as penis fillers. This could result in unpredictable outcomes and unsatisfactory aesthetic results for the patient.

Inflammatory Responses: Combining PLLA with hyaluronic acid may trigger an inflammatory response in the body. This can lead to swelling, redness, pain, and other adverse reactions at the injection site. Severe inflammation could also increase the risk of infection and other complications.

Nodule Formation: One of the most significant risks of mixing PLLA and hyaluronic acid is the potential for the formation of nodules or lumps under the skin. These nodules can be unsightly, palpable, and sometimes painful. They may require medical intervention to correct, such as injection of hyaluronidase to dissolve the hyaluronic acid component. Although lumps and bumps can happen with hyaluronic acid, when mixing this with PLLA it can make treating nodules more complicated.

Delayed Reactions: Some adverse reactions may not manifest immediately after the injection. Delayed reactions, such as granulomas or chronic inflammation, could occur weeks or even months later. These complications can be challenging to treat and may require multiple interventions.

Migration and Misplacement: Mixing PLLA and hyaluronic acid may alter the viscosity and behaviour of the filler material. This could potentially lead to unintended migration of the product from the injection site, causing asymmetry or other aesthetic issues.

Difficulty in Reversal: If complications arise from the mixed filler, such as infection, nodules, or migration, reversing the effects can be challenging. Hyaluronic acid fillers can be dissolved with hyaluronidase, but the presence of PLLA in the mix may complicate this process. It may be very difficult to treat the nodules formed by the PLLA. Interventions such as steroid injections are sometimes used. Where these do not work, surgical intervention may be required to surgically remove them. We currently have three patients self-referred to us awaiting surgery following complications from PLLA and PMMA injections into their penis.

Lack of Clinical Evidence: There is a lack of comprehensive clinical studies on the safety and efficacy of mixing PLLA and hyaluronic acid. Therefore, healthcare providers may be uncertain about the potential risks and benefits of this combination. In penis enlargement fillers, these treatments are largely tried with no clinical data, or evidence to support the process.

Due to these potential risks and uncertainties, Moorgate Andrology strongly recommended to avoid mixing PLLA with hyaluronic acid in penis enlargement treatments using hyaluronic acid injections.

Patients choosing PLLA or PMMA injections should be aware of the potential difficulties in treating lump and bump formations which can happen in the penis after such treatments.