BACKGROUND: Esthetic medicine has shifted significantly toward non-surgical procedures, with the collagen biostimulator poly-l-lactic acid (PLLA) becoming increasingly popular for facial rejuvenation. However, the safety and patient satisfaction associated with PLLA facial treatments remain largely unexplored. OBJECTIVE: This study aimed to evaluate the safety profile of PLLA treatment and assess patient mid- and long-term satisfaction with the outcome. METHODS: This prospective single-center study was conducted at Bravo Clinic in Rio de Janeiro from August 2023 to August 2024. The patients' mid and lower face was treated by injecting Rennova Elleva (a collagen biostimulator containing 210 mg of PLLA) into the zygomatic and pre-masseteric regions. All patients underwent monthly clinical evaluations for the first 150 days and kept diaries to self-record any adverse effects during the first 30 days. Patient satisfaction was measured using the Global Aesthetic Improvement Scale (GAIS) on days 90 and 150 post-injection. RESULTS: The study included 52 female patients [mean age: 49.87 ± 10.7 years
mean body mass index (BMI): 23.99 ± 3.5 kg/m CONCLUSION: Rennova Elleva, a PLLA-based collagen biostimulator, is safe and well-tolerated with a low incidence of adverse effects. It provides long-lasting, satisfactory results for patients with mild to moderate facial sagging, rendering it an effective non-surgical option for enhancing facial esthetics.