Is PLLA Better Than Hyaluronic Acid? Evidence-Based Comparison

Poly-L-lactic acid (PLLA) and hyaluronic acid (HA) are two of the most widely used dermal filler materials in modern aesthetic medicine. Is PLLA better than hyaluronic acid? The answer is more nuanced than a simple yes or no. While PLLA demonstrates strong performance in longevity and structural volumization, HA excels in versatility, immediacy, and reversibility. Neither material is inherently superior; rather, each shines in specific clinical contexts.

Understanding the Materials: PLLA and Hyaluronic Acid

PLLA filler is a biostimulatory filler that works by stimulating collagen production over time. Once injected, PLLA micro-particles gradually trigger neocollagenesis, leading to sustained yet progressive volumization.

HA, on the other hand, is a naturally occurring polysaccharide found in the skin and connective tissues. HA fillers provide immediate volume through their gel consistency and come in a wide range of rheological properties suitable for different indications.

Because their mechanisms differ fundamentally, their clinical performance, duration, and ideal use cases also diverge. The real answer depends on treatment goals.

Evidence From Clinical Studies: What the Data Shows

A recent randomized, controlled, multicenter study conducted between 2022 and 2024 evaluated PLLA and HA for midfacial volume restoration, enrolling 329 participants. Key findings included:

 PLLA showed higher 12-month efficacy rates according to blinded Midface Volume Severity Scale (MMVS) assessments.

 GAIS scores (from both investigators and patients) indicated stronger long-term improvement in the PLLA group.

 Patient satisfaction was slightly higher in the PLLA group at 6 and 12 months.

 Adverse event profiles were similar between both materials, though injection-site reactions occurred more frequently with PLLA.

These findings confirm the durability and structural volumization advantages of PLLA. However, they do not necessarily establish PLLA as universally “better”; instead, these outcomes demonstrate that PLLA performs exceptionally in settings requiring long-term volumetric enhancement.

In contrast, HA fillers continue to offer unique strengths not captured by long-term efficacy alone—such as fine-tuning, reversibility, and suitability for mobile or delicate areas.

Comparative Table: PLLA vs HA Across Key Dimensions

Below is a comprehensive comparison to help evaluate is PLLA better than hyaluronic acid within specific decision-making criteria.

When PLLA Performs Better

Long-Term Volume Restoration

PLLA excels in cases requiring large-volume structural enhancement, especially in the midface. Its collagen-stimulating mechanism helps restore deeper tissue support.

Progressive, Natural-looking Outcomes

Patients who prefer gradual and subtle improvement often respond favorably to PLLA.

Cost Efficiency Over Time

While PLLA may come with a higher initial cost, its long duration makes it cost-effective for long-term volume maintenance.

When Hyaluronic Acid Performs Better

Immediate Lift and Contouring

For patients wanting instant results—such as lip augmentation, under-eye smoothing, or fine line correction—HA is unmatched.

High Precision and Flexibility

HA fillers come in varied cohesivities and viscosities, making them ideal for delicate structures requiring exact shaping.

Reversibility for Safety

The ability to dissolve HA with hyaluronidase provides an extra safety layer, especially in high-risk areas such as the nose or tear trough.

Final Assessment: Is PLLA Better Than Hyaluronic Acid?

Given the clinical evidence and practical aesthetic considerations, neither PLLA nor HA is inherently superior. Instead, both are valuable tools with strengths tailored to specific treatment scenarios. Therefore, the correct answer to is PLLA better than hyaluronic acid is:

It depends on the patient’s goals, anatomy, treatment area, and desired speed of results. PLLA may be preferable for long-lasting structural volumization, while HA is often the better choice for immediate, precise, and reversible aesthetic refinement.

A Note on Advanced PLLA Options: Devolux® VITAL

For clinics and aesthetic professionals seeking a premium yet cost-effective biostimulatory filler, Devolux® VITAL offers an innovative formulation that combines the collagen-stimulating benefits of PLLA with complementary ingredients designed for enhanced performance. Its preparation is streamlined for clinical practicality, and its results align well with patients needing subtle, progressive improvement.

This makes it a strong option within the PLLA category for practices looking to expand their regenerative treatment portfolio.