PLLA vs PDO filler: which one does not cause Lumps or Tyndall effect?

When considering fillers for delicate areas like under the eyes, especially with a history of lump formation from hyaluronic acid (HA) fillers, it’s important to weigh the characteristics of each option. Here’s a comparison between Poly-L-Lactic Acid (PLLA) and Polydioxanone (PDO) fillers:

PLLA (Poly-L-Lactic Acid):

Mechanism: PLLA, found in products like Sculptra, works primarily as a collagen stimulator rather than a traditional filler. It gradually encourages collagen production, which can lead to subtle, natural-looking volume over time.
Lumps and Tyndall Effect: PLLA is less likely to cause the Tyndall effect (a bluish discoloration that can occur with HA fillers) because it does not involve injecting a gel-like substance close to the skin's surface. However, improper injection technique or placement can lead to nodule formation or lumps, particularly if not done by an experienced injector.
PDO (Polydioxanone) Fillers:

Mechanism: PDO is more commonly used in threads for lifting and tightening rather than as a filler. However, some products like Ultracol V are available as injectable fillers. PDO stimulates collagen production, but its use as a filler is less conventional compared to PLLA or HA.
Lumps and Tyndall Effect: The risk of lumps with PDO fillers depends on the formulation and technique used. As with any filler, skilled injection is crucial to minimize the risk of lumps. The Tyndall effect is generally not a concern with PDO, as it is with HA fillers.
Recommendation: For under-eye areas, it’s crucial to consult with a board-certified dermatologist or plastic surgeon who has extensive experience with these specific fillers. They can assess your skin type and previous reactions to help determine the most suitable treatment. Both PLLA and PDO fillers can be effective but require precise technique to avoid complications. Additionally, other options like micro-cannula techniques or alternative treatments might also be considered to minimize risks.