{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T04:45:49Z","timestamp":1793249149449,"version":"4.5.0"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Poly-L-lactic acid (PLLA) is a biostimulatory filler used to improve dermal laxity and contour, yet comparative data between formulations for upper-arm rejuvenation remain scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective, randomized, blinded split-arm trial, 20 adults received bilateral upper-arm injections with two PLLA formulations (Rennova\u00ae Elleva vs. Sculptra\u00ae). Outcomes included Subject and Physician Global Aesthetic Improvement Scales (S-GAIS, P-GAIS), ultrasonography (USG), skin elasticity, and transepidermal water loss (TEWL) through Day 120. Histological analyses in ten cases assessed skin thickness, inflammation, and crystalline residues.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Both products yielded marked enhancements in skin texture and arm contour with excellent tolerability. S-GAIS scores improved to 2.9\u2009\u00b1\u20090.67 at Day 120, with no differences between formulations (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;gt;\u20090.99). P-GAIS scores similarly rose (Rennova\u00ae Elleva: 3.2\u2009\u00b1\u20090.98; Sculptra\u00ae: 3.3\u2009\u00b1\u20090.90;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.86). Ultrasound findings confirmed dermal remodeling in both arms. By Day 120, USG value increased to 957\u2009\u00b1\u2009209 with Rennova\u00ae Elleva (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.049) and 938\u2009\u00b1\u2009174 with Sculptra\u00ae (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.92), with no between-group difference (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.99). Skin elasticity increased significantly in both arms by Day 90 (Rennova\u00ae Elleva: 172\u2009\u00b1\u200935 to 191\u2009\u00b1\u200929,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.035; Sculptra\u00ae: 165\u2009\u00b1\u200919 to 177\u2009\u00b1\u200924,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.041), while TEWL remained stable. Skin thickness rose significantly (Rennova\u00ae Elleva: 2.06\u2009\u00b1\u20090.55 to 2.66\u2009\u00b1\u20090.53\u2005mm,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.039; Sculptra\u00ae: 1.80\u2009\u00b1\u20090.41 to 2.70\u2009\u00b1\u20090.69\u2005mm,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0039), without between-group differences (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.54). Histology showed sparse perivascular lymphocytes and occasional macrophages, with no granulomas or crystalline material.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study suggests that both Rennova\u00ae Elleva and Sculptra\u00ae are effective, well-tolerated PLLA formulations that may be capable of producing meaningful aesthetic and biophysical improvements in upper-arm contour and skin quality within the first 120 days.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1782368","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T05:51:33Z","timestamp":1778219493000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Poly-L-lactic acid (PLLA) in arm contouring: a prospective and blinded trial of Rennova\u00ae Elleva and Sculptra\u00ae"],"prefix":"10.3389","volume":"13","author":[{"given":"Bruna Souza Felix","family":"Bravo","sequence":"first","affiliation":[{"name":"Bravo Private Clinic","place":["Rio de Janeiro, Rio de Janeiro, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Luisa Leopoldino","family":"de Souza","sequence":"additional","affiliation":[{"name":"Bravo Private Clinic","place":["Rio de Janeiro, Rio de Janeiro, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuela Beatriz Vantini","family":"Barreiro","sequence":"additional","affiliation":[{"name":"Bravo Private Clinic","place":["Rio de Janeiro, Rio de Janeiro, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Air\u00e1 Novello","family":"Vilar","sequence":"additional","affiliation":[{"name":"Ferreira Vilar Private Clinic","place":["Conc\u00f3rdia, Santa Catarina, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e1rbara Fouraux","family":"Gouvea","sequence":"additional","affiliation":[{"name":"Bravo Private Clinic","place":["Rio de Janeiro, Rio de Janeiro, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo Gon\u00e7alves","family":"Bravo","sequence":"additional","affiliation":[{"name":"Bravo Private Clinic","place":["Rio de Janeiro, Rio de Janeiro, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina Ramos Baeta","family":"Neves","sequence":"additional","affiliation":[{"name":"Bravo Private Clinic","place":["Rio de Janeiro, Rio de Janeiro, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e37506","DOI":"10.1097\/MD.0000000000037506","article-title":"Application of PLLA (Poly-L-Lactic acid) for rejuvenation and reproduction of facial cutaneous tissue in aesthetics: a 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