Early Cervical Nodule Formation Following Poly-D,L-Lactic Acid Injection: Ultrasound Findings, Technical Considerations, and Practical Lessons From Clinical Practice

Abstract

Poly-D,L-lactic acid (PDLLA) is increasingly used as a collagen-stimulating injectable with a favorable safety profile. However, reports of nodules associated with PDLLA remain limited, particularly in anatomically sensitive areas such as the neck. We report a case of early, asymptomatic cervical nodules occurring after PDLLA injection, characterized clinically and by high-resolution ultrasound. The case is discussed in the context of injection technique, anatomical considerations, and real-world procedural factors that may predispose to product accumulation. This report highlights that early nodules following PDLLA injection may reflect technical deposition rather than inflammatory or granulomatous reactions. Awareness of neck anatomy, careful handling of PDLLA suspensions, and the use of ultrasound can aid in accurate diagnosis and prevention of similar events.