Consensus Recommendations on the Diagnosis and Management of Noninflammatory and Inflammatory Nodules Secondary to Poly- L- Lactic Acid Injections

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ID: 332646
2026
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Abstract
Abstract Background Poly-L-lactic acid (PLLA) is a widely used biostimulatory injectable for face and body rejuvenation. Although uncommon, nodule formation secondary to PLLA injection remains one of the most challenging complications of PLLA treatment. Inconsistent terminology and variable management approaches have resulted in uncertainty regarding diagnosis and treatment, leading to unpredictable outcomes. Objectives The aim of this study was to develop international expert consensus recommendations for the clinical classification, prevention, and management of PLLA-associated nodules. Methods An international multidisciplinary panel of experienced aesthetic clinicians with expertise in PLLA treatment and complication management was convened to develop consensus recommendations for the classification, prevention, and management of PLLA-associated nodules based on the available literature and collective clinical experience. Results The panel developed a practical clinical classification distinguishing noninflammatory and inflammatory nodules, together with recommendations for prevention, diagnosis, and management. A practical treatment algorithm was produced to support clinical decision making. Conclusions These international expert consensus recommendations provide clinicians with a pragmatic, simple-to-follow, evidence-informed framework for the diagnosis, prevention, and management of PLLA-associated nodules in routine aesthetic practice. Level of Evidence: 5 (Risk)
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Authors MJ Rowland-Warmann, Patricia Barrera, Mike Clague, Brittony Croasdell, Stella Desyatnikova, Greg Julian Goodman, Maria Hawkins, David A. Hill, Gillian Murray
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Journal Aesthetic surgery journal
Year 2026
DOI
10.1093/asj/sjag189
URL
https://doi.org/10.1093/asj/sjag189
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