Sculptra is one of many options to improve volume deficits of the cheeks. There are many other manufactured injectable fillers that can achieve a comparable result (i.e., Radiesse, Perlane, Juvederm Ultra Plus etc.). In our hands, Sculptra does appear to last longer than the others (about 2 years or more). Interestingly, I found that it works better in patients who have reasonable volume present and want to add. If the face is very thin and deflated, the volume gain appears less.
Alternatively, cheek implants (i.e. malar or submalar) or facial fat grafting should be considered. Recovery is significantly longer (10 days plus / minus).
Implants will provide a very predictable enhancement but appear to frighten some patients. (And comfort with the procedure should be present) They will provide the most long-lasting enhancement, though.
Fat injections are probably closest to the perfect filler: it is your own, there is (usually) enough available, it provides natural feeling results. Sometimes additional treatments are requested for further enhancement. In average, we use 25 to 40 cc of purified fat.
