There was a time, not so long ago, when hyaluronic acid (HA) fillers were considered the be-all, end-all for restoring volume loss. Enter the era of “filler face” and unnaturally puffy-looking cheeks, lips, and more. While HA fillers remain popular and undoubtedly still play a role in facial rejuvenation, there’s an increased movement toward the use of other, biostimulatory fillers that differ from HA fillers in significant ways. One of the most popular? Sculptra.
What is Sculptra?
“Sculptra is made up of poly-L-lactic acid, a biostimulatory agent that triggers our own collagen production. It’s essentially a filler that’s telling our bodies to produce more of their own natural filler,” explains Dr. Sachin Shridharani, a board-certified plastic surgeon in New York City. Unlike HA fillers, which instantly add volume, Sculptra works more gradually; many doctors liken it to spreading seeds that gradually grow collagen over time. (Patients do see a bit of immediate volume, but that’s simply from the sterile water in the injection and typically wears off within a day, says Dr. Shridharani.)
A typical treatment cadence involves two or three treatments, spaced four to six weeks apart; most people start to see a nice change after the second round, he adds. And while the results are by no means instantaneous, they are noticeably longer-lasting than those from their HA counterparts. “We have clinical data showing they last for up to two years, but I’ve had patients go as long as two and half to even three years. They’re ready for more at that point, but they still have some improvement over their baseline,” he adds.
What does Sculptra do, and who is a good candidate for it?
Sculptra’s technical indication, per its FDA approval, is for nasolabial folds and cheek wrinkles, but doctors use it all over the face—in the temples, for perioral lines, in the midface, you name it. “The real question is, who isn’t a good candidate?” notes Dr. Shridharani. “I’ve used it in patients in their 20s who need a little bit of volume but don’t want dramatic plumping as well as patients in their 70s, to drastically improve cheek wrinkles,” he says. Along with the collagen-building benefits, he notes that the biostimulatory effects also lead to a general improvement in skin texture and quality over time.
Off label, Sculptra is used on various parts of the body, although these areas do require significantly more product (and, as such, can quickly get pricey). There’s the buzzed-about Sculptra butt lift, and the filler is also popular for addressing crepey skin on the arms, knees, neck, décolletage, and stomach.
What are the risks of Sculptra?
Of course, there are potential side effects. While vascular occlusion—injecting into a blood vessel—is very rare, it is possible. Otherwise, things such as bruising and temporary swelling are most common. Nodule formation is also likely, although according to one analysis, it occurred in only 0.004% of Sculptra injections. This is why providers massage the treated area immediately afterward and will likely instruct you to do so at home too. Any nodules that do show up will usually resolve on their own; otherwise, steroid shots or surgical removal may be required. To that point, the biggest drawback of Sculptra is its lack of reversibility. Unlike HA fillers, which can be essentially “erased” via an enzyme injection, there’s no way to undo Sculptra. For this reason, it’s crucial to seek out experienced, skilled providers and to start slowly, gradually adding more product if needed, rather than rushing into using huge amounts, Dr. Shridharani cautions.
And while not a side effect per se, the main drawback for many is that Sculptra takes a while to kick in. “This isn’t something you do on a Monday in order to prep for an event on Friday,” Dr. Shridharani notes. Still, for some, that gradual change is a positive and makes for a more natural end result. “It’s the kind of thing where people won’t know what you’ve had done, they’ll just start to comment that you look fresh and ask what you’ve been doing with your skin,” says Dr. Shridharani. To that point, check out these impressive Sculptra before-and-afters from RealSelf members, along with what they had to say about their treatments.
1.
Patient age: 46
Time post-treatment: Seven months
Provider: Dr. Cameron Chesnut, a board-certified dermatologist in Spokane, Washington
Patient review: “I don’t want to look 30, I want to be the best version of my 46-year-old self. I’ve had three treatments of Sculptra, and as you can see by my pictures, my face looks fuller and quite natural. People that have not seen me in a while tell me I look rested and healthy but don’t ask what I’ve had done, which is exactly the result I was looking for.”
2.
Patient age: 53
Time post-treatment: Two months
Provider: Dr. Tom van Eijk, a physician in Amsterdam
Patient review: “I have not worked after I was diagnosed with numerous diseases. My fat percentage is practically zero, due to the required intake of medication … I received several Sculptra treatments over a period of six months, and the impact it had was more than skin deep. It actually gave me back my ‘joie de vivre’ … the results have surpassed all my expectations. It has not only made me look better, it has made me look younger and sort of healthy.”
3.
Time post-treatment: Seven months
Patient review: “It has been a long process, but I am hopeful that I will have reached my goal as far as Sculptra, once this treatment is done working … I am so glad I finally took this step … I feel so much more confident.”
4.
Patient age: 63
Time post-treatment: Two months
Patient review: “At age 63, I knew I wanted to look refreshed and younger. My face looked tired and aged … I travel five and a half hours to and from my [Sculptra] appointments. It is so worth it. I feel beautiful.”
5.
Patient review: “My Sculptra application was literally painless. Very pleasant experience, with amazing results! I had a total of two [treatments], two months apart, [using] two vials each time.”
6.
Patient Age: 51
Time post-treatment: One year
Patient review: “I said that I wanted to look back at my pictures and say, ‘Who was that guy?’ I wanted, in a year’s time, to look in the mirror and see a new, confident me … I am pleased with looking younger—people now tend to think I look like I’m in my 30s.”
