Are there any Sculptra alternatives that work better?

As Dr. Hoenig mentioned, fat transfer is a permanent option for filling the face.

For patients who are looking for a temporary solution, injectible fillers such as hyaluronic acid and others can be used. Though these last anywhere from 3 months to a year, it can allow a patient to see if they like the look before undergoing a more permanent alternative such as fat transfer.

For those with signicant fat loss in the face, fat transfer is a good option.

Fat Transfer, also known as Fat Injections or Fat Grafting, is the technique of moving fat from one area of the body to another to improve contour, correct defects, or enhance features.

Unlike Sculptra, which lasts up to 2 years, the results of fat transfer may be permanent, especially when placing fat under the eyes and in the cheeks or temples. It does not tend to last week in the naso-labial folds (lines from nose to mouth) or in the lips, due to the amount of movement in that area.

I've been doing fat transfer for 8 years, and the majority of my patients have just one treatment. Occasionally, they do come back for a touch-up treatment about a year later, especially in those with HIV-induced lipodystrophy.

The benefit of fat transfer is that it is your own body's material (fat) that is being injected. The drawback is that it is technique-dependent and does require surgery (in my practice, a minor surgical procedure with local anesthesia and oral sedation).