Juvederm Voluma vs Sculptra

I have been using natural fillers of all kinds for three decades, starting with the original Zyderm collagen back in the early eighties. While there are many short and long-term concerns with the use of non-natural, foreign-to-the-body materials, such as silicone, bio-Alcamid, and Artefill/Artecoll--products that I choose not to use, I am not aware of any concerns, regarding the amounts of natural materials, such as hyaluronic acid (the main component of Juvederm and Restylane) materials or the number of times they may be used. In fact, they can be used to correct the aesthetic problem and as often as needed to maintain or improve the correction. In addition, hyaluronic acid-based fillers and volumizers can be easily dissolved with a natural enzyme, hyaluronidase, if this is ever needed or desired--adding an incredible level of safety to the hyaluronic acid class of products.While I am not a fan of Sculptra for a variety of reasons, despite not being a normal component of the body, it, too, is subject to our body's own metabolic breakdown products and will disappear with time. However, there is no known enzyme to hasten its dissolution if this were needed. Moreover, unlike its hyaluronic acid counterparts, Sculptra's results are not immediate. In fact, it usually takes several sessions to achieve optimal correction. Given the above, I would have more hesitation with Sculptra use than with the Juvederm Ultra Plus. My suggestion is a second opinion with a board certified aesthetic core physician with extensive experience in injecting all of the available agents. 

All hyaluronic acid fillers (HA) are made of naturally occuring substances in your skin, there is no problem using these short or long term.  I am not a firm believer these promote any collagen growth however, which is where you gain permanent long term results.  That is why I am a fan of using Sculptra, which is a collagen stimuating agent, to give you long term lift and contouring; while also using the other temporary fillers for lines, volume, and shape.  Using both together or one alone, can still give good results.  It all depends on the techniques of the person injecting.  See a cosmetic dermatologist or plastic surgeon with experience in the use of fillers for pan facial volumization.  I wish you the best of luck, Dr. Emer.

The statement about juvederm causing problems doesn't sound like logic. The truth is that our body tolerates the hyaluronic acid (HA) products exceptionally well, and then converts some of the volume to our own natural collagen with repeated use.  So if anything , additional juvederm, or more specifically any HA, will actually seem beneficial over time. The only thing I would add that might defend such a statement is that maybe it might look too focally augmented and no longer look natural.Other studies have shown that it's safe to mix products like HA's, sculptra, or calcium products (Radiesse) in the same area of augmentation.We are truthfully using a fraction of the sculptra and radiesse that we enjoyed for years, now that voluma has come along.  As another HA, it fills softly and subtly, is reversible, and unlike sculptra gives immediate volume. And it lasts for at least a year, possibly two.  And while there are still patients and sites that still might direct to a specific filler, we are using less sculptra now.Continue to consult with physicians until you feel comfortable with the approach suggested.