Your prescribing doctor should be board certified and have one of these qualifications: Ophthalmic plastic surgeon Facial plastic surgeon Dermatologist In addition, a licensed Registered Nurse (RN) or a licensed Physician's Assistant (PA) can be an appropriate provider of injectables, depending on your... more







38 posts
27 Mar 2009
Dear Mr. Doctor Perfectly Trained Injector..... It might be helpful for you to understand the nature of Poly-L-Lactic Acid (PLLA) - AKA sculptra. The immune system has an integral role in fibroblast behavior, (that'd be the lumps/granulomas) in other words its how the the host immune system responds to it. Poly-L-lactic acid differs from the other fillers in that it is dependent on the host immune/reparative response to accomplish filling. Other similar products include silicone and polymethyl-metracrylate (neither is currently FDA approved for soft tissue augmentation). Here is the risk factor: and there is no way even the best injector in the world can control this.... Unfortunately this mechanism of action for augmentation has two potentially negative effects INHERENT TO THE NATURE OF THE RESPONSE : (1) the host immune system can respond less than optimally causing less augmentation then desired; or (2) the host immune system can respond over exuberantly creating granulomas or lumps. I repeat.... INHERENT TO THE NATURE OF THE RESPONSE In the medical literature, there are many reports of delayed foreign body granulomas; in one report with PMMA (Artefill/Artecoll, which is Plexiglas!), up to 12 or 13 years following the injections! The reasons this can occur is that you are injecting something foreign into your body and the human body has a very sophisticated immune response. When it sees something as a foreign invader, it creates a complex reaction to try to get rid of it, and the result is the granuloma which you describe. Your best injectors have no control over this !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! So if your injector is injecting this stuff for cosmetic purposes- he/she is not the best! Its just criminal to take money and cause this kinda of harm. and this is the point the injector will blame you for the problem - Pretty good racket they have going! kooie