Sculptra® Aesthetic (injectable poly-L-lactic acid) is a filler that has been used widely in Europe since 1999, and was approved by the FDA on August 3, 2004, for the treatment of facial fat loss (also called facial lipoatrophy) and nasolabial folds.
Following is more information about this injectable treatment. For a consultation to determine if Sculptra Aesthetic is right for you, please call Desert Hills Plastic Surgery Center at (702) 260-7707 to speak with a member of our Las Vegas team.
What Is Sculptra Aesthetic?
Sculptra Aesthetic is injected under the skin in areas where fat has been lost. It causes the skin to thicken via collagen synthesis, and improves the appearance sunken areas, folds, and hollowness. It is not like other fillers with immediate results, but rather a collagen stimulator, that takes not only time, but also multiple treatment sessions to gradually build up your own natural collagen. Expect a gradual onset of fullness and a very natural looking volume enhancement that is long lasting.
A potential disadvantage of Sculptra Aesthetic is the lack of immediate results. However, there are benefits to a gradual onset of results. Patients undergoing Sculptra treatment tend to look very natural and youthful without looking like a procedure was done. It is the only filler available that creates predictably beautiful and youthful facial contours that feel and look natural, without giving you away as the typical “filler” patient. Most patients require at least three injection sessions spaced every 8 weeks to replace your lost collagen and rejuvenate your face naturally with results lasting more than two years.
About Sculptra Aesthetic
- Sculptra is an injectable implant that contains micro particles of poly-L-lactic acid, a biocompatible and biodegradable, synthetic polymer from the alpha-hydroxy-acid family. It is reconstituted prior to injection with sterile water and lidocaine to form a suspension that is comfortable and well tolerated.
- Poly-L-lactic acid has been used successfully in surgical procedures for more than 25 years. Examples include absorbable suture material (such as J&J ‘s Ethicon brand Vicryl suture, used in the majority of plastic surgical procedures), in bone plates and screws, and as a medium for medication delivery.
- Sculptra does not give results immediately. It is not a wrinkle filler, but a bio activator or "volumizer". It works by stimulating the body to produce new collagen at the sites of injection, thereby replacing lost volume and contours to restore a more youthful version of you.
- There is a time factor involved since the true volume effect is created by your own collagen, not the product itself. Collagen replenishment takes place over a period of several months. Most patients require 1-2 vials of product and at least 3 sessions spaced 6-8 weeks apart to appreciate results. The amount of product per patient varies depending on the degree of facial fat loss and the areas requiring treatment.
- Sculptra has a remarkable capacity to lift and fill facial tissues and has often been referred to as a “liquid facelift”. It does not tighten overlying skin.
How Sculptra Aesthetic Is Used for Facial Rejuvenation
- The procedure is done in the office setting. Topical numbing creams are used before the procedure. Sculptra Aesthetic is injected into the skin using multiple needle injections. The discomfort is during the procedure mild, as the product is reconstituted with sterile water and dilute lidocaine and is easy to inject. The number of vials used and the number of injections per treatment session will vary depending on the degree of correction you and your physician decide is optimal.
- Sculptra works best to add volume to hollows of the cheeks or temples in thin fit women or men who have lost facial fat. It has been called a "liquid facelift" because adding volume to the malar and cheek areas lifts sagging areas of a “thinned out” face. During the normal course of facial aging, the amount of facial fat decreases and descends creating a hollow or skeletonized look. In these cases, Sculptra restores a natural looking and youthful facial shape without any distortion.
- Immediately after each treatment session, your facial wrinkles, folds, and depressions have been smoothed, due to the immediate plumping effect of the water volume added in the reconstituted Sculptra. The immediate look can be predictive of the final result, although some may experience more initial swelling than others. The swelling and water portion of the Sculptra usually resolves in 24 hours and your wrinkles and facial depressions temporarily reappear as the gradual process of collagen replacement continues. Don’t get discouraged or impatient. You will gradually see progressive visible results within months. Overcorrection is not advised.
- In order to get the most out of Sculptra Aesthetic, you need to complete the full course of treatment sessions as recommended by your doctor. Anything less will be an inadequate result and waste of money. One treatment session, or a budget for one vial will not provide results, so alternative filler options should be considered.
- During the course of treatment, your physician may adjust your treatment plan to help you reveal a natural-looking appearance that’s uniquely yours. Sometimes more or less vials or treatment sessions are required. Everyone responds to Sculptra differently, synthesizing collagen at different rates, so patients need to be flexible with the treatment plan.
- Strategic placement can not only restore or create balanced contours, the effect of filling a compartment above one area means the compartment adjacent to and/or below the treated one gets its own lift. The goal is to look better, not different!
- Results feel and look natural, as your own tissue is created. Therefore palpability or visibility of the product is not an issue.
- Patients who are thin and very lean with hollow, thin faces are excellent candidates for Sculptra. Results are more natural than any of the other available synthetic fillers. These patients also typically do not have available donor sites for fat transfer. Although fat transfer can provide very natural facial volume enhancements, it is very unpredictable and technique dependent. With fat transfer there are high risks of partial or complete reabsorption, change in appearance with weight fluctuations, and un correctability. It is also a more invasive procedure requiring liposuction of a donor site to harvest fat. Liposuction and fat transfer have additional risks of contour irregularities to both donor and recipient sites that can be difficult to correct. Overcorrection with fat is nearly impossible to treat, whereas Sculptra effects diminish with time, allowing adjustments for facial aging, weight fluctuations, and other environmental conditions that affect facial contour and skin quality.
- Sculptra is Dr. Brown’s first choice of filler to treat lateral facial contour depressions, which are common and often overlooked by patients. Ideally, attractive facial shapes are similar to an “inverted egg shape”. Patients tend to focus on and use filler for the central face while neglecting lateral facial contour depressions. The majority of patients are either not aware of the skeletonization that affects lateral facial shape or they have hairstyles that cover or conceal the sides of the face. Repeated augmentation of the perioral area, lips and mid cheek without balancing the lateral facial contour tends to look unnatural over time. Sculptra used in the temporal areas, in front of the ear area below the cheek bone prominence (zygoma), and along the lateral face looks natural, youthful and beautiful, without any tell tale signs of “filler”.
- Downtime is minimal. Bruising and swelling is usually mild. For even dispersion of the product once injected, Sculptra requires massage 5 times per day, for 5 minutes, and for 5 days.
- Sculptra is a great adjunct to facelift or brow lift surgery preferably with sessions beginning after surgery. Patients who have Sculptra or any of the other stimulatory fillers first (like Radiesse) may have more inflammatory tissue in the face, which can make the surgical dissection for facelift more difficult.
- Sculptra is not indicated in the lips or eye area.
Risks and Side Effects
- After injection, it is normal for patients to experience redness, bruising, swelling, injection site discomfort, itching, small needle marks or scant bleeding from the injection sites, tenderness or other local side effects. Most side effects of treatment resolve within a few days.
- Jaw pain with chewing or tension headache can occur with temporal injections lasting 1-2 days.
- Additional side effects of Sculptra injections included the delayed appearance of small bumps under the skin in the treated area. After 25 months papules and nodules were reported in approximately 1% of Sculptra Aesthetic patients. Papules and nodules were typically palpable, asymptomatic and non-visible, resolving without treatment. The risks of papules have been minimized by higher volume dilution (8 to 12 cc) upon reconstitution, not more than 2 vials used per session, injections placed deeper in the subcutaneous plane without any product being placed in the dermis, adequate time between injection sessions (at least 6 weeks), and post injection patient massage.
- Infection is rare. Migration of the product has not been reported.
- Treatments should be performed by a qualified and experience injector who is an MD, DO, RN, NP, or PA to decrease risks for complications. Superficial injections should be avoided. It should be injected deeply and massaged by your physician initially with massage for 5 minutes, 5 times per day for 5 days afterwards. A thorough knowledge of facial anatomy is essential to avoid injection into vessels. Intravascular injection of Sculptra can lead catastrophic events including skin loss, tissue necrosis, stroke, and blindness.
- Granulomas, or local inflammation around a foreign body, are rare.
- If you do not like the results seen immediately after your first session, which may be predictive of your final outcome, it would be your choice not to continue with further sessions, with little lost except your money. So in a sense, the effect is completely reversible if your treatment sessions are not continued.
Patients Who Are not Candidates for Sculptra Aesthetic
- Those with a history of bad allergies.
- Staph carriers or those with a history of recurrent skin infections or MRSA infections.
- Patients who have moderate to severe skin laxity and deep wrinkles, where a skin tightening procedure such as a facelift or brow lift would be a better investment with long-term improvements.
- Anyone with a history of a bleeding disorder or those who take blood thinners.
- History of allergies to local anesthetics such as lidocaine.
- Patients with active cold sores, pimples, rashes, hives, cysts, or skin infections should be postponed until healing is complete.
- Patients with a history of cold sores should take a course of antiviral medication, as injections around the mouth could activate latent herpes viral infections or cold sores.
- Patients under 18 years old.
- Pregnancy or breast-feeding.
- Immunosuppressive disorders, patients on steroids, or those with a depressed immune system.
- Patients with a history of keloid or hypertrophic scars.
- Patients with systemic collagen diseases.
- Those with the presence of foreign body including a history of previous silicone injections.
To learn more about treatment with Sculptra Aesthetic at our Las Vegas office, please contact Desert Hills Plastic Surgery Center online or call (702) 260-7707 today.