02/03/2026
SCARS + PLLA
I often get patients who tell me they’ve “tried everything” for acne scars. Atrophic acne scars form when collagen is lost and normal tissue architecture is disrupted, often with fibrotic bands tethering the skin downward. When treatment only smooths the surface, results can plateau.
There are many tools for acne scarring, including subcision, lasers, chemical peels, microneedling, and fillers. Each has a role, but not all address the structural and biologic drivers of scarring.
WHAT IS PLLA?
This is where poly-(lactic acid) becomes intentional. Poly-(lactic acid), including PLLA and PDLLA, is biostimulatory. It doesn’t simply fill space. It works by stimulating the skin’s own collagen production over time.
•At a cellular level, PLLA induces a controlled macrophage response
•Uprehulates TGF-β and other pro-collagen signaling pathways
•Stimulates fibroblasts to produce new collagen and elastin.
The improvement is gradual, but it’s durable.
Most atrophic scars involve more than one issue: dermal thinning, collagen loss, and tethered scar bands beneath the skin. When those deeper limitations aren’t addressed, progress can stall. This is why combining tissue release with biologic stimulation is often more effective for long-term change. Subcision addresses the mechanical restriction, while biostimulatory fillers like PLLA support collagen neogenesis in areas of structural loss. The goal is restoration of tissue architecture, not instant correction.
This is not a “before and immediately after” treatment. Patients should expect gradual improvement over weeks to months, more even texture and depth, and results that look natural because they are driven by their own collagen. PLLA can be used in different ways depending on scar type, depth, skin thickness, and overall tissue health, which is why individualized planning matters. Here we prepped with a few sessions of chemical peels, subscision, microneedling, and now introducing PLLA. Questions? Leave below