Can Hyaluronidase Help W/ Swelling 11 Months Post Sculptra Trtment Under Eyes? (photo)

Hyaluronidase dissolves hyaluronic acid dermal fillers, like Juvederm, Restylane and Perlane.  Sculptra is not really a filler.  It is a biostimulator.  It is composed of poly-L-lactic acid, a relative of sutures placed inside the skin when an excision is performed.  It is also a relative of alpha hydroxy acids.

Sculptra particles stimulate new collagen deposition around themselves.  The only way to remove Sculptra particles is for the body to dissolve them naturally.

You are right.  Sculptra is not recommended for injection in the circular muscles of the face, those around the eyes (orbicularis oculi) and those around the mouth (orbicularis oris). 

The reason your under-eye areas looked better after hyaluronidase injection is most likely that it dissolved some of your native hyaluronic acid in the surrounding area.  That should be redeposited back after 2-3 weeks.

Never allow anyone to inject Sculptra® into your face. At one time it was considered an important agent in managing facial fat loss in HIV+ patients. Prior to FDA approval, it was used in a clandestine manner. In clinical trials evaluating this agent for correction of fat loss in HIV+ patients although the study patients were for the most part satisfied, up to 50% of the injected individuals developed some degree of lumpiness in the treated areas. Furthermore, these lumps are often far from invisible. Nevertheless, Sculptra® received rapid track compassionate release approval from the FDA for use in patients with HIV. The panelists on the General and Plastic Surgery Device panel were strongly unanimous in limiting approval only for patients with HIV. At the FDA hearing, not one histologic slide showing the fate of Sculptra upon implantation was shown. Again, how can an agent gain approval without scientific data supporting its application?According to the European literature the consequences of Sculptra® in the normal host has been very problematic (foreign body granulomas, infections, etc.).In 2000, at the World Congress of Dermatology in Paris, Pierre Andre reported cystic, nodular, and granulomatous lesions when this agent was used in individuals with normal immune functioning (non-HIV+ patients). Additionally, long-term allergic reactions have since been described, which are very difficult to manage. In another report concerning its aesthetic use in 100 patients with normal immune functioning, 20% of the treated individuals experienced significant adverse reactions. Obviously, this product is not immunologically inert as the manufacturer stated. Foreign body granulomas are being seen with this agent in HIV-positive as well as immunocompetent patients.While the manufacturer as well as investigators claim this product produces neocollagenesis or new collagen this is not what is seen under the microscope. On biopsy one sees a severe immune reaction to the product. Never let anyone inject this in your face and hyaluronidase is useless since this is not a hyaluronic acid filler!