Hybrid Biostimulator and Hyaluronic Acid Injectable for Tear Trough Rejuvenation.

1. Aesthetic Plast Surg. 2026 May 7. doi: 10.1007/s00266-026-05817-z. Online ahead of print. Hybrid Biostimulator and Hyaluronic Acid Injectable for Tear Trough Rejuvenation. Young SM(1)(2), Lau EKH(3). Author information: (1)Eagle Aesthetics and Surgery, King Albert Park, Singapore. Stephanieyoung83@gmail.com. (2)National University Hospital, Kent Ridge, Singapore. Stephanieyoung83@gmail.com. (3)EC Skin & Laser Clinic, Penang, Malaysia. PURPOSE: Non-surgical correction of the under eye region is challenging due to various reasons. Our study evaluates a novel biostimulator poly-D,L-lactic acid-hyaluronic acid (PDLLA-HA) 50mg (Juvelook, VAIM Inc., Seoul, Republic of Korea), a poly-D,L-lactic acid product as a potential injectable for tear trough correction. METHODS: This is a prospective cohort study evaluating patients who underwent three injections of PDLLA-HA for correction of the tear trough and under eye region. Outcome measures included: Perceived improvement by investigators and patients using a 5-grade Global Aesthetic Improvement Scale (GAIS), skin features assessment by investigators using a 5-point subjective scale based on four criteria (elasticity, hydration, skin quality and radiance), patient satisfaction and adverse events (if any). RESULTS: Our study comprised 15 females, with a mean age of 38.5 years. Tear trough grading ranged from 1 to 3, with a mean grading of 1.93. Mean PDLLA-HA used: 0.41 (RE), 0.41 (LE) at first visit; 0.45 (RE), 0.45 (LE) at second visit; and 0.45 (RE), 0.45 (LE) at third visit. Mean GAIS for tear trough for investigator improved from 2.93 to 2.2 to 2.13, and for patients from 2.73 to 1.93 to 1.8 after first treatment, second treatment and third treatment, respectively. There was significant improvement in scores for lower lid skin elasticity, hydration, quality and radiance (p<0.001, Friedman). All patients were keen to repeat the treatment when asked at the second, third and fourth visits. There were no adverse events reported. CONCLUSION: PDLLA-HA is a potential injectable for tear trough correction as well as for improvement in under eye skin elasticity, hydration, quality and radiance. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 . © 2026. The Author(s). DOI: 10.1007/s00266-026-05817-z PMID: 42098500 Conflict of interest statement: Declarations. Conflict of interest: Both authors have received speaker honoraria from VAIM in past conferences. Both authors did not receive payment from VAIM for the research conducted.