What does this research mean for the field?

A cannula-based, highly diluted poly-D,L-lactic acid (PDLLA) injection protocol safely and effectively improves subzygomatic arch depression with high patient satisfaction and low downtime. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To assess the clinical outcomes and safety of a cannula-based superficial fat injection technique using a highly diluted poly-D,L-lactic acid (PDLLA) hybrid injectable for lateral sunken cheek contouring.

August 27, 2026Journal of Craniofacial Surgery

Poly D,L Lactic Acid Injection for Subzygomatic Arch Depression (Lateral Sunken Cheek)

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To assess the clinical outcomes and safety of a cannula-based superficial fat injection technique using a highly diluted poly-D,L-lactic acid (PDLLA) hybrid injectable for lateral sunken cheek contouring.
Adults with subzygomatic arch depression underwent 3 treatment sessions at 3-week intervals with reconstituted PDLLA (4 mL per side per session).
Injections were placed into the superficial fat layer using a 25-gauge, 50-mm cannula via a single entry point below the zygomatic ligament proper with 3-vector retrograde linear threading.
Outcomes were evaluated 3 months after the final session via investigator-rated Global Aesthetic Improvement Scale (GAIS) and patient satisfaction.
In 24 completed patients, 3-month GAIS showed aesthetic improvement in 95.8% (29.2% very much improved, 45.8% much improved, 20.8% improved, 4.2% unchanged), with a median score of 2 (P < 0.001 vs no change).
High patient satisfaction was reported in 87.5% (21/24) of participants.
Adverse events were limited to transient ecchymosis in 12.5% (3/24) that resolved within 10 days, with no nodules, granulomas, infections, or vascular complications observed.

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Implication

Case series reveals significant aesthetic improvement with diluted poly-D,L-lactic acid in lateral sunken cheeks, highlighting a viable alternative to hyaluronic acid fillers.

Cite This Study

Yi et al. (2026) studied this question.

synapsesocial.com/papers/6a8fea1c10c91c1e926223d8 https://doi.org/10.1097/scs.0000000000013147

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Implication

Case series reveals significant aesthetic improvement with diluted poly-D,L-lactic acid in lateral sunken cheeks, highlighting a viable alternative to hyaluronic acid fillers.

Poly D,L Lactic Acid Injection for Subzygomatic Arch Depression (Lateral Sunken Cheek)

Key Points

Discussion

Implication

Cite This Study

Poly D,L Lactic Acid Injection for Subzygomatic Arch Depression (Lateral Sunken Cheek)

Key Points

Discussion

Implication

Cite This Study

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