Sculptra Lumps - is there anything I can do to get rid of them?

Thank you for your message and for detailing your experience. It’s not uncommon to develop palpable or visible lumps following Sculptra (poly-L-lactic acid) injections, especially if the product clustered or was injected too superficially. These lumps can present as delayed-onset nodules or granulomas, and management depends on their characteristics.

What You’re Experiencing:
Since you mention palpable scar tissue or granulomas and have already undergone surgical removal of two nodules, it's likely that you're dealing with delayed-onset granulomatous inflammation. This is a known but relatively rare complication.

Treatment Options:
1. Intralesional Corticosteroid Injections
Yes, this is one of the first-line treatments.

A dermatologist may use triamcinolone (Kenalog) injections to reduce inflammation and soften or shrink the nodules.

It's a conservative, non-surgical option and often effective after a few sessions.

2. Massage
In early cases, vigorous massage can sometimes help break up smaller, non-inflammatory nodules.

However, in your case (over a year out with previous surgical history), massage may have limited benefit — but gentle manipulation won’t cause harm.

3. Hyaluronidase
This enzyme does not work on Sculptra, as it's designed to dissolve hyaluronic acid-based fillers.

Some providers mistakenly attempt this, but it's not useful for Sculptra nodules.

4. 5-Fluorouracil (5-FU) Injections
In more resistant cases, dermatologists may combine steroid + 5-FU injections for an anti-fibrotic effect.

This can be especially helpful if scar tissue is dense or unresponsive to steroid alone.

5. Antibiotics (if inflammation is suspected)
If there's redness, tenderness, or signs of infection, a short course of oral antibiotics might be indicated — though this seems unlikely in your case.

What You Can Do on Your End:
Apply warm compresses intermittently to promote circulation.

Avoid manipulation or picking, which can worsen inflammation.

Keep track of changes, such as growth, redness, or tenderness, and report these to your dermatologist.

Will It Go Away on Its Own?
Some nodules do soften and diminish over time, especially if they are not inflammatory. However, after more than a year, spontaneous resolution becomes less likely, and intervention may be needed — particularly if the lumps are bothersome or disfiguring.

Summary:
Steroid injections are a reasonable and often effective next step.

Massage may offer minimal benefit but is unlikely to resolve firm granulomas alone at this stage.

Surgery is generally a last resort due to the risk of scarring, and since you've had excisions already, conservative approaches are best.

Collaborating with your dermatologist in August is appropriate — they can guide injection-based treatment to reduce the granulomas without further surgery.

You’re taking the right steps, and with proper care, these nodules can often be managed successfully.

There’s a very simple rule you should follow. If you can feel something, but you don’t see it by looking at yourself in the mirror, ignore it. Our body has lots of little lumps, especially over bony surfaces. If you run your finger along the jaw, you will see lumps there or I should say you will feel them. Only if you see the lumps, should you receive a steroid injection but that should be done extremely carefully in a very dilute manner. I hope this helps and good luck from Leonard Grossman, M. D., organic Plastic Surgery in New York City.