OPTIMIZATION OF SKIN QUALITY ON THE FACE AND NECK: An Integrated Protocol with New Generation Poly-L-Lactic Acid (Angelis® – Pharmaesthetics) and Hyperdiluted Botulinum Toxin
The optimization of skin quality in the face and neck—including texture, micro-relief, sheen, visible pores, oiliness, and uniformity—has become a central therapeutic outcome in aesthetic dermatology and orofacial harmonization, especially in the lower third of the face and neck, regions with high anatomical complexity and functional risk when injectable techniques do not respect critical planes and areas (BRANDT; BOKER, 2003; JABBOUR et al., 2017; YOUN et al., 2022; KASSIR et al., 2023). This article proposes an integrated protocol combining new-generation PLLA (Angelis® – Pharmaesthetics) and Botulinum Toxin Type A, applied both conventionally (dynamic force control) and by hyperdiluted intradermal microdroplets (microbotox) for skin quality endpoints (WU, 2015; AWAIDA et al., 2018; RAHMAN et al., 2024; CIDRÃO, 2026).
It should be emphasized that Angelis® PLLA (150 mg) has optimized micromorphology (spherical/homogeneous particles and lower average micronization, around 30.4 μm) and that hyperdilution generates a very low viscosity suspension (“low rheology”), promoting homogeneous spreading, reducing polymer density per tissue volume, and minimizing the risk of microaggregates—a critical point for enabling application in areas of repetitive mobility when associated with muscle tension reduction with toxin (CIDRÃO, 2025). It is concluded that the integrated strategy is mechanistically coherent and clinically applicable, provided it is performed with refined technique and in-depth anatomical mastery (VLEGGAAR; FITZGERALD, 2021; TAM et al., 2025).
OPTIMIZATION OF SKIN QUALITY ON THE FACE AND NECK: An Integrated Protocol with New Generation Poly-L-Lactic Acid (Angelis® – Pharmaesthetics) and Hyperdiluted Botulinum Toxin
-
DOI: https://doi.org/10.22533/at.ed.1595322621013
-
Palavras-chave: Poly-L-Lactic Acid; PLLA; Angelis; Pharmaesthetics; Biostimulation; Botulinum toxin; Microbotox; Skin quality; Neck.
-
Keywords: Poly-L-Lactic Acid; PLLA; Angelis; Pharmaesthetics; Biostimulation; Botulinum toxin; Microbotox; Skin quality; Neck.
-
Abstract:
The optimization of skin quality in the face and neck—including texture, micro-relief, sheen, visible pores, oiliness, and uniformity—has become a central therapeutic outcome in aesthetic dermatology and orofacial harmonization, especially in the lower third of the face and neck, regions with high anatomical complexity and functional risk when injectable techniques do not respect critical planes and areas (BRANDT; BOKER, 2003; JABBOUR et al., 2017; YOUN et al., 2022; KASSIR et al., 2023). This article proposes an integrated protocol combining new-generation PLLA (Angelis® – Pharmaesthetics) and Botulinum Toxin Type A, applied both conventionally (dynamic force control) and by hyperdiluted intradermal microdroplets (microbotox) for skin quality endpoints (WU, 2015; AWAIDA et al., 2018; RAHMAN et al., 2024; CIDRÃO, 2026).
It should be emphasized that Angelis® PLLA (150 mg) has optimized micromorphology (spherical/homogeneous particles and lower average micronization, around 30.4 μm) and that hyperdilution generates a very low viscosity suspension (“low rheology”), promoting homogeneous spreading, reducing polymer density per tissue volume, and minimizing the risk of microaggregates—a critical point for enabling application in areas of repetitive mobility when associated with muscle tension reduction with toxin (CIDRÃO, 2025). It is concluded that the integrated strategy is mechanistically coherent and clinically applicable, provided it is performed with refined technique and in-depth anatomical mastery (VLEGGAAR; FITZGERALD, 2021; TAM et al., 2025).
- André Luiz Menezes Cidrão
