Poly-L-lactic acid (PLLA) in arm contouring: a prospective and blinded trial of Rennova® Elleva and Sculptra®

Background 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. Methods In this prospective, randomized, blinded split-arm trial, 20 adults received bilateral upper-arm injections with two PLLA formulations (Rennova® Elleva vs. Sculptra®). 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. Results Both products yielded marked enhancements in skin texture and arm contour with excellent tolerability. S-GAIS scores improved to 2.9 ± 0.67 at Day 120, with no differences between formulations ( p > 0.99). P-GAIS scores similarly rose (Rennova® Elleva: 3.2 ± 0.98; Sculptra®: 3.3 ± 0.90; p = 0.86). Ultrasound findings confirmed dermal remodeling in both arms. By Day 120, USG value increased to 957 ± 209 with Rennova® Elleva ( p = 0.049) and 938 ± 174 with Sculptra® ( p = 0.92), with no between-group difference ( p = 0.99). Skin elasticity increased significantly in both arms by Day 90 (Rennova® Elleva: 172 ± 35 to 191 ± 29, p = 0.035; Sculptra®: 165 ± 19 to 177 ± 24, p = 0.041), while TEWL remained stable. Skin thickness rose significantly (Rennova® Elleva: 2.06 ± 0.55 to 2.66 ± 0.53 mm, p = 0.039; Sculptra®: 1.80 ± 0.41 to 2.70 ± 0.69 mm, p = 0.0039), without between-group differences ( p = 0.54). Histology showed sparse perivascular lymphocytes and occasional macrophages, with no granulomas or crystalline material. Conclusions This study suggests that both Rennova® Elleva and Sculptra® 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.