Sculptra, After Years of Evaluation, "I'm a Believer."
Sculptra is a unique facial filler. It uses the body’s own collagen to create volume to the aging face. It is made up of Poly L Lactic acid, which is broken down to lactic acid, a natural occurring substance in the body. It comes as a powder to the physician, and is mixed with lidocaine and saline in the office days before the procedure. A series of 2-4 injection sessions is needed to get the full results, with at least a 6 week interval (because it takes 6 weeks to see the complete result of the prior treatment). After the treatment, your face will appear filled, but only for a day or two, and then the saline is absorbed. Gradually over the next 6 weeks, the Sculptra will stimulate the collagen, and create the volumization. Results are said to last 2-3 years. Touch ups are recommended at 12-18 month intervals.
Sculptra was initially FDA approved in 2004 for HIV associated facial atrophy, however it was used off label for cosmetic use soon after that. In 2009, it was formally FDA approved for cosmetic use. So what took me so long to get on board? There were problems with people developing nodules (bumps). Although, these were usually minor and not visible in most cases, they were a problem for some. I’m finally comfortable that this problem has been addressed and minimized. The steps take have been:
- Make the Sculptra more dilute by adding more saline and lidocaine when mixing
- Inject deeper in the areas where it is possible
- Mix the Sculptra up days ahead of time instead of the night before
- Have the patient massage the area
- Do not inject too close to the mouth, lip, or eye area, the areas where most of the nodules were noted
- Do not inject patients with autoimmune disease
Following these guidelines, the formation of nodules is now <1%, and comparable to the risk of developing these with Restylane and Juvederm.
Sculptra is unique in that it can volumize the entire face (except close to the eye, mouth, and lips) for a long duration. Considering its longevity, it is a cost effective solution when compared to Restylane and Juvederm. When comparing to fat grafting, its advantages are:
- No need to harvest fat (a minor surgical procedure)
- More predictable results than fat grafting
- Less post-procedure swelling and downtime
- Less discomfort
So if you have age or exercise related facial atrophy, Sculptra is a great choice for a long lasting correction.