Sculptra Side Effects

I like the volume I've gained with three sessions of Sculptra but now I'm really scared about the long-term side effects. How long has Sculptra been around and what can be expected? Is it a smart choice? I've heard such a mixed review

Doctor Answers 25

Sculptra belongs in the trash not your face

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.


Beverly Hills Dermatologic Surgeon
5.0 out of 5 stars 5 reviews

Sculptra risks include hematoma, infection, skin necrosis & granuloma

Risks include hematoma or blood pooling beneath the skin, and although rare, infection and necrosis or skin loss is possible.

The greatest risk occurs when dermal fillers are injected by someone who is not properly qualified to perform injections.

Semi-permanent and permanent fillers may carry a risk of clumping (the particles form a granuloma or lump that can be felt or seen beneath the skin), which can occur months later. Particles may also migrate or displace from the injection site.

Injection of an anti-inflammatory may help to improve minor clumps or swelling. More significant conditions of clumping or granuloma may require surgery.

Robert A. Weiss, MD
Baltimore Dermatologic Surgeon
5.0 out of 5 stars 8 reviews

Sculptra side effects

Thank you for your question.

Although our experience in the US has only been for a couple of years, we do have good data sharing the experience of our European physicians for almost 10 years.

The most commonly cited delayed complication is the development of nodules under the skin. These can be quite small or as big as the tip of your finger. They represent a "clumping" of the product and your body's reaction to it.

This can be treated by breaking it up with a needle or injecting it with a steroid. Worse case scenario, your doctor may have to numb your skin and make a small nick to remove it. I have only seen this once in over 3 years of experience.

The good news is you are happy with your result and, in all likelihood, will not have any problems. I still use Sculptra as a volume enhancer in the face and hands and have been quite happy with the results.

Jeffrey Kenkel, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 6 reviews

Sculptra Side Effects

As you see through personal experience, after three sessions of Sculptra you have gained the volume in your face that you want.  Sculptra has been around for many years but the dilutions and techniques for injections have changed over time.  The main side effect described is granuloma formation.  Valeant which now owns Sculptra states that it was because of improper dilution and technique many years ago.  It is always important to find a board certified dermatologist with years of experience in cosmetic dermatology and injectables for these procedures.  The rule of 5's applies to Sculptra - massage the treated area five times a day for five minutes for five days - to best avoid granuloma formation.  Please let me know what happens.

Sculptra longtem effects

Sculptra is a highly useful product to help add volume to the face.  The material is similar to material we have used for disolvable sutures for >40 years.  When the body breaks down the product it makes collagen.  It is unlikely to cause longterm effects as long as you have not had any issues with granulomas.

Sculptra is Poly Lactic Acid and has been used in surgery for many decades

Sculptra is actually the powder form of a suture, Vicryl, that has been used in surgery for many years without significant problems. The body absorbs the powder and eventually turns it into carbon dioxide and water. The benefit of Sculptra is that during this inflammation to degrade the Sculptra collagen formation is being carried out by the body in a scar like reaction. It is this collagen that creates the new volume. With this inflammation there is the risk of infection. However the benefit of having the inflammation to create the collagen in a scar form is paradoxically what can lead to the infection. If you didn't have this inflammation you wouldn't have as much collagen formation.

In my opinion, Sculptra is most beneficial for the person who does not have a lot of fat in the rest of the body to undergo fat injections and would like some more volume in the face. It is also useful in the person who has only a little fat to offer for fat injections. In this particular situation I would use sculptra in the areas that can tolerate it more such as the cheeks, mouth area, temples, forehead and jawline areas and reserve fat injections for the areas closer to the lips and around the eyes. It is also good to use Sculptra for people who don't want the invasiveness of fat injections where you have the need to harvest the fat from somewhere else. Sculptra, in general, is less of a process than fat injections. But with the negatives that come with Sculptra, there is a lot of positives for people in these situations above.

From a long term standpoint, once the Sculptra is dissolved there should not be long terms issues. If a person somehow does not degrade the Sculptra effectively there could be infections but there are ways to treat these issues without a lot of problems. Silicone injections and Artecoll injections present more long term issues in my opinion.

Philip Young, MD
Bellevue Facial Plastic Surgeon
3.5 out of 5 stars 43 reviews

Sculptra side effects

Scupltra has now been in use in both immunocompromised and immunocompetent patients for over 10 years. When it was originally formulated and used, inexperience with the product sometimes led to nodule and granuloma formation which could occur months after the product was used. However, following recent expert consensus guidelines for the use of Sculptra, this complication has become extremely rare. Sculptra functions mainly via the induction of neocollagenesis and is an excellent option for select patients. Remember, the most important factor in any injectable treatment is the injector rather than the product being injected. Careful patient selection and expert usage are the keys to minimizing potential complications and maximizing cosmetic result.

Douglas Wu, MD
San Diego Dermatologist
5.0 out of 5 stars 14 reviews

Sculptra side effects

Sculptra has been in use for over 10 years.  I began treating patients for HIV associated lipoatrophy and realized that accelerated lipoatophy of HIV was no different than age or weight related lipoatrophy seen for cosmetic reasons and began offering this cosmetically soon after.  It is now FDA approved for cosmetic use as well.  We had more long term issues initially particularly related to palpable lumps and bumps, but realized this was due to not allowing the Sculptra powder to hydrate for an optimal period of time and we injected more concentrated solutions.  Now we hydrate product longer and place more dilute solutions, virtually eliminating the potential of bumps.  I can't over state the need for you to do your part by adhering to the massaging instructions at home as this will assure even distribution of the particles.  Placement is also important.  It is important you have your Sculptra placed by an experienced injector. 

Steven Swengel, MD
Los Gatos Dermatologic Surgeon
5.0 out of 5 stars 7 reviews

Sculptra - side effects are minimized by advanced techniques

Sculptra has been available worldwide since 1999, and FDA approved since 2004.  It is a "biostimulatory" filler, meaning that it increases your skin's own collagen production.  That collagen provides a scaffolding that lifts the skin and decreasing deep & shallow wrinkles.

As with all injectables, patients experience mild to moderate discomfort with the injection, and bruising is a risk.

Sculptra differs from other injectables in that it can cause bumps.  These bumps are the result of too much collagen formation.  In the last several years, techniques have evolved so that these bumps, should they occur, are small.  They typically cannot be seen, only felt.  And, they typically go away by themselves after a few months. 

Newer techniques include reconstituting the product at least 48 hours in advance, using a more dilute concentration, and fanning the product (so as not to put too much in a single area).

Sculptra achieves longlasting, natural results.  It works better than any other product for filling the periphery of the face (temples, submalar hollows, enhancing the jaw).

Side effects of Sculptra

Sculptra is a great drug and arguably, the best volumizer on the market.  It, however, has been through several iterations of procedural recommendation changes over the last 5-8 years.  The current recommendations have made the use of Sculptra very safe and the risks of granulomas and nodules significantly lower.  

Many of the negative comments regarding Sculptra come from providers with untrained hands using the product as they would a hyaluronic acid, such as Juvederm.  The technique is different than it is for this more common class of injectables.  

My advice would be to find someone who does facial procedures and uses Sculptra significantly to get the best result. 

Mike Majmundar, MD
Atlanta Facial Plastic Surgeon
4.5 out of 5 stars 35 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.