Sculptra for Deep Wrinkles and Sunken Cheeks - Best Choice?

Sculptra is a material injected into the tissue and causes a local inflammation and swelling. It is the swelling that creates the volume. The pros: 1-Comes from a vial. 2-Easy to do. The cons: 1-Unnatural, comes from a vial. 2-Requires frequent treatments. 3-Costly. 4-Causes inflammation. 5-The response or volume correction occurs days or weeks after the injections, making it hard to be precise as to the amount of filler to use. The best large volume filler is fat. In the... more

Fat in the face ages by melting away, accumulating inconventiently and descending inappropriately. While I would prefer to fat graft a face which is gaunt, some patients don't want surgery or the downtime required. Sculptra is one solution for these volume depleted faces, although it doesn't make fat. It is multiple repeating units of Lactic acid, which is derived from corn. Mixed with sterile water and local anesthetic, it is ideally injected as a single layer, deep to the skin, where... more

I would recommend you avoid cheek implants and sculptra as both have long term risks and can cause facial fat atrophy and premature aging. By weary of amazing claims like 'this product makes collagen' it is really an elegant way of saying it induces a firm scar ball deep in your face where no such structure should be! Fat grafting is the gold standard but has to be applied by a practitioner that understands the delicate nature of adipocytes. High G-force... more

The materials and techniques you mention are all appropriate. There are advantages and disadvantages of each depending on your specific needs. More important than the filler used is the technician (surgeon) doing the work. Carefully choose a physician skilled in these procedures.

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... more