What is best for deep lines in the face? I am thinking Sculptra, but are fat injections better?
Sculptra or Fat Transfer for Deep Lines on Face?
Doctor Answers 10
Deep lines need "ironing" and fill
If your face looks like a corduroy fabric there is no filler that will really do an adequate job by itself.
You will need to have the areas of fatty loss filled (we prefer Sculptra or Radiesse) to volumize the area.
BUT, that will only lift the wrinkles like lifting a wrinkled fabric.
You additionally will need a "dewrinkling" technique such as CO2 laser (We now prefer the Mixto) and it can be safely all be done at one time by an experienced surgeon.
You did not give your age and if there is still too much skin in your face a lift may be needed as well.
We often now combine all three techniques for our older or very weathered patients.
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Deep Line treatments
Sculptra and fat injections are volume fillers and may not be appropriate for "deep lines" of the face. Volume fillers are good for fatty atrophy of the face (such as with "sunken" hollows of the cheeks), for augmenting the cheekbones and the chin, for deeper depressions, etc. The "deep lines" of the skin are usually in the dermis and although volume fillers may soften these lines, they usually do not improve significantly. Resurfacing lasers, especially the Fraxel re:Pair may be excellent for the deeper lines and the two certainly can be complimentary to enhance your facial appearance. They probably are best done in stages with the volume filler first, followed in 6-8 weeks with the laser.
Sculptra vs fat transfer for deep lines
Sculptra is an excellent volumizer and has the advantage over hyaluronic acids (Restylane, Juvederm) in that you can inject higher volumes at a more reasonable cost, also lasts considerably longer. Sculptra can last about 12 to 18 months and can be injected to deep lines and hollows with good results. Fat transfers are also a good option for patients who require large volumes but can be a little less predictable in terms of longevity and how many sessions required. Fat can also feel or appear a little "lumpier" especially under the eyes. There are ways of preparing the fat to make it finer such as centrifuging and extracting stem cells to inject and less of the fat. Fat transfers also require harvesting of the fat so you need to have some deposits of fat. Many patients who have very thin, hollow faces which require volumizers also have thin body phenotypes which make it difficult to find enough fat on their lower body.
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Treatment of lines
Without seeing your lines it is not appropriate to tell you what would be better. For fine lines, neither is a good choice. If they are deep and individual, the lines might be better filled with an immediate filler that is less thick than fat. Sculptra and fat injections are good volume replacements which can help the envelope of the skin look better without filling individual lines in some cases.
Fat grafting versus Sculptra
Sculptra requires many sessions, it may last 2-5 years and you are charged per vial. The advantage is no surgery.
Fat grafts are essentially limitless and may provide a long term solution. The disadvantage is the surgery and the difficult aspects of predicting fat survival and possible need for more than one session.
Many choices for facial fillers
Today we have many choices for facial fillers. Sculptura was developed as a filler to treat overall facial wasting that occurs with age due to loss of fat and other supporting tissue and has just been approved by the FDA for cosmetic usage. It works well to improve contours of the cheeks and improve hollowing around the eyes. Unlike other fillers such as Juvederm made from hyaluronic acid which immediately plumps and fills, Sculptura, stimulates your own tissues to produce collagen so the results improve over several months. Typically 2-3 treatments spaced several weeks apart will provide the optimum improvement and results are thought to last up to 2 years.
Fat transfers can soften the lines around your mouth using your own fat from a different area of your body (typically your hips, buttocks, or abdomen). It can be used to plump lips, fill in cheeks and improve facial contours. Since it is your own fat you can't be allergic to it and last longer than other fillers- about 50% of the fat stays permanently where it was injected
Sculptra or Fat Transfer, What is Best for Deep Lines?
Both fat transfer and Sculptra are volume fillers; they work well to re-inflate the face that has lost volume. Neither is used to fill lines or wrinkles. Many times when volume is added to the face, the deep lines are no longer that deep.
Fat transfer is more permanent but requires a surgical procedure, while Sculptra injections may need to be repeated every few years but is performed in the office without the need to harvest fat.
Good luck and be well.
Fat injection would be the best option
You will need a consultation with a board certified plastic surgeon to discuss these options with you and other possible options. Not all deep lines need filler and may need lifting of the tissue as well . If you have very deep lines, the result from the fillers will be limited.
Sculptra is a filler for loss of volume in the face but it does thicken the skin through collagen st
Sculptra is a volumizing filler but it also stimulates collagen which can thicken the skin and lessen the appearance of wrinkles. Fat does not have any stimulatory effects but it can fill deep wrinkles. So the answer to question lies in which wrinkles you want to fill and where.
Volume and Lines
Generally speaking, sculptra and fat augmentation are used to replace lost volume throughout the face. They correct areas of volume depletion and hollows. Deep lines or wrinkles are generally the target of skin resurfacing and not the reliably treated by deep volume augmentation. However, by expanding the skin, some of the deep folds and lines do improve. So, consider a two stage approach- volumization first followed by skin resurfacing. I hope this helps.