What to Do About Sculptra (NewFill) Lumps and Granulomas

Five years following this treatment and you still have nodules means that it is most likely either a foreign body granuloma or deep scar. Steroid injections sometimes help but there can be some side effects especially with multiple injections (fat atrophy, hypopigmentation, etc).

Although FDA off-label usage you might want to ask your doctor and research the use of 5-FU - I have used it effectively for these problems and have not seen complications thus far even after multiple injections. See a Plastic Surgeon or Dermatologist who has experience in these problems.

The best option for Sculpra nodules and granulomas is prevention through proper mixing, injection technique, patient selection, and post-injection care. Once nodules or granulomas develop, steroid injections, massage, saline infiltration, or surgical excision are all options. These treatment options will depend on the patient and the problem area.
All the best,

Hi Anon,

Sorry to hear about your adverse events following your Sculptra injections.  The best current treatment to help dissolve the nodules is injection of them with a mixture of 5 FU (off label use), Kenalog 10, and lidocaine.  We have seen marked improvement in patients from other practitioners who developed nodules.  Good luck and be well.

Dr. P

Steroid injections may help, although there are risks associated with multiple steroid injections such as possible fat atrophy.  I would encourage you to discuss with your physician the use of 5-FU as a possible treatment.   

More recent reports show that biopsy of these nodules caused by Sculptra or Radiesse are not true granuloma in most cases.  Artefill / PMMA crystals were proven to be granulomas on surgical resection specimen.  Sculptra nodules were a massive collagen reaction!  Currently, most of us are diluting Sculptra in larger volumes of bacteriostatic water (10ml) which for the most part results in NO nodules.  Currently we see rare cases of palpable but not visible nodules under thin skin, in cases of active autoimmune disease, and when patients forgot to massage for 5 minutes at a time for 5x/day for a total of 5 days.
The results from Sculptra and Radiesse are phenomenal, both fillers are cost effective, and grossly undermarketed by the respective companies.  
Treatment of Sculptra nodules:  Steroid injection with caution.  If they are resistant to steroids, in rare cases, 5 FU has been effective.
Best wishes,
Dr B