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

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.