Fillers

Thank you for your kind answer about the antibiotic resistant biofilm and the generous offer to see me if I can't find a local physician willing to order that peptide, which I fear I won't. What, if any, are the side effects of LL-37? I ask because what started me down this long road to HA filler and infection was an ill-advised massive dose of kenalog from a plastic surgeon to my cheek to address a small scar, which resulted in complete soft tissue destruction (a known side effect that was not revealed to me at the time). It left me with a uge red depression, right down to the cheekbone.  He attempted to correct the problem, foolishly, with Radiesse, which resulted in granulomas that had to be surgically removed. Then he tried fat, which took unevenly and temporarily. Then another plastic surgeon tried HA's, which resulted in the biofilm. My lid retreat from all this, so I've had to undergo multiple oculolplastic surgeries. All of this, from a singular iatrogenic injury, has cost me approximatley $100,000! 14 years later and I am still dealing with this. I want to avoid yet more unforeseen complications, obviously, from the LL-37, My face was never classically beautiful, but it was at least presentable. Now, for well over a decade, it's been a disfigured mess--and for absolutely no reason. As you can imagine, it's been incredibly difficult and depressing, made more so by the fact that I participated in my own disfigurement/I am to blame because I followed the advice of these (board certified) physicians.  I feel like I deserve the isolation and shame it's brought me for all these years. I wish there were something I could do to correct my appearance even after clearning the infection. Thank you for your help and information, Dr. Garcia.

Answer:

LL-37 Is an antimicrobial peptide which belongs to the cathelicidin family of AMPs(antimicrobial peptides). LL-37, like cathelicidins, is stored in neutrophil granules as inactive precursors and are released as mature peptides when neutrophils are stimulated. LL-37 is expressed in various cells and tissues such as circulating neutrophils and myeloid bone marrow cells, epithelial cells of the skin, and is also expressed in the gastrointestinal tract, as well as in the epididymis and lungs. Moreover, the production of LL-37 in macrophages is stimulated by vitamin D released by sunlight through the skin. LL-37 plays an important role in the first line of defense against infection and systemic invasion of pathogens at sites of inflammation and wound. It is cytotoxic to both bacterial and normal eukaryotic cells and is significantly resistant to proteolytic degradation in solution. LL-37 shows a broad spectrum of
antimicrobial activity against bacteria, enveloped viruses, and fungi. It has also demonstrated success in helping promote wound healing and it may play a negative role in atopic dermatitis and psoriasis.

It is very safe