Sculptra to fix loss of facial volume after nose surgery?

Hi Katie,

I have never seen turbinectomy or rhinoplasty result in loss of volume from the face.  A syringe or two of Restylane, Juviderm, or Radiesse should be more than enough to restore youthful volume to your pretty face.  If you wanted a more permanent fix, fat transfer would be the choice, but you need to be very careful in choosing your physician. I would recommend William Little in the D.C. area. Some physicians are getting good results with Sculptra, but others are seeing complications.  I am not using it.  Leslie Bauman, MD at University of Miami is whom I would recommend if you choose Sculptra.  Be well.

Dr. P

My partner and I did the original FDA study on Sculptra where it was used to revolumize patients that had lipoatrophy.  Lipoatrophy, or facial fat loss that is associated with patients with HIV, is just an accelerated form of aging.  You are on the slim side and probably had little facial volume to start with.  With aging we lose more facail volume due to osteoporosis of the facial bones, muscle atrophy, dermal thinning and actual facial fat loss. Whether this was related in actuality to your surgery or not, is not as important as how to correct it.  Sculptra offers a slow and gradual rebuilding of your own dermal and subdermal tissue.  In the inital clinical trials we found a three fold increase in dermal thickness that maintained at twwo years.  This is why the product is often quoted as lasting two years.  In actuality the clinical results last longer.  We did a follow up study and found that  a portion of the patients did not even need retreatment at four years.

This product in particular takes a qualified injector with a trained eye.  I believe the results can be incredibly rewarding.  Consult the company for a referral in your area.  All physicians must be trained now prior to purchasing the product from the company.

Good Luck

Gail Humble MD

Medical Director Blue Pacifi Aesthetic Medical Group

I would echo the sentiment of the other physicians that your best option is a personal consultation with a qualified facial plastic surgeon or plastic surgeon in your area. In a more generic sense, you pose several interesting questions:

1) What are options for cheek fillers?

There are several options for cheek fillers. Temporary fillers such as Restylane and Juvederm can be used as a cheek filler. Radiesse can also be used but should be used with care as there can be lumpiness which is very difficult to remove. Sculptra is another good option. It is a poly-L-lactic acid which must be injected over several treatments and the results actually 'grow' over time. All of these treatments though will eventually fade. For a more permanent solution, consider fat augmentation or cheek implants. Both are fairly easy surgical procedures that can produce lasting and excellent results. Again though - to determine if any of these are right for you, consultation with a qualified surgeon would be necessary.

2) Will I notice a change in my face after rhinoplasty surgery?

While rhinoplasty surgery will generally not change the structure of your cheek, it will alter the relationship between your face and your nose. There are very well established spatial relationships in the face. Altering the shape of the nose can cause the appearance of a change in the cheeks even though no actual anatomic change has occurred.

Good luck in your search.

I have not encountered a situation where a turbinectomy has changed the relative volume of the cheeks. This is probably more due to being slender and perhaps to some early signs of facial aging which can include volume loss.

A well qualified plastic surgeon can evaluate you and discuss possible treatments. I have found that Radiesse works especially well in volume restoration and augmentation of the cheeks. This is especially true in younger patients who have good skin. I personally would not recommend Sculptra or fat injections which are other alternatives to Radiesse.