Edema or Sculptra overfill? Help (Photo)

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin in Winnetka and Chicago. This is a great question. I'm sorry to hear about your experience with Sculptra; it sounds quite frustrating, especially when you're not seeing the results you expected. At 10 weeks post-treatment, it’s possible that you’re still experiencing some edema, which can occur after Sculptra injections as the product settles and integrates into the tissue. However, if you feel that your face looks distorted, heavy, and puffy, it could also be a sign of overfill or an adverse reaction. Since your injector isn’t being helpful, it may be worthwhile to seek a second opinion from another qualified practitioner or a dermatologist who specializes in aesthetic treatments. They can evaluate your situation more objectively, determine whether the results are within a normal range, and recommend potential solutions. If swelling persists, they might suggest treatments like massage, or in some cases, other interventions to address your concerns. Your comfort and satisfaction are important, so pursuing a professional opinion can help you find the clarity and guidance you need. I hope this helps and best of luck!

Hello, and thank you for your question.

Based on your description and the photos you provided, it is possible that what you're experiencing is delayed-onset swelling (edema) rather than overfill. Sculptra (poly-L-lactic acid) stimulates your own collagen over time, and the full effects typically take several months to manifest. This can sometimes result in unexpected fullness or asymmetry, especially if the product was placed too superficially or in areas prone to swelling, like the nasolabial folds or jawline.

Here are a few possibilities to consider:

Edema (Swelling):

It’s common to experience puffiness in the weeks following Sculptra, especially in sensitive areas.

The heavy feeling and puffiness, especially if worse in the morning, can point toward lingering edema.

Swelling usually resolves gradually over time but can take weeks to months, depending on your body's response and injection depth.

Overcorrection / Overstimulation:

If too much collagen is stimulated or too much product was used in a short span, it can lead to an overfilled look.

This is harder to reverse compared to hyaluronic acid fillers, as Sculptra does not dissolve easily.

Injection Technique:

The appearance can also depend on the technique used. Improper placement or uneven distribution can cause localized swelling or firmness.

What you can do now:

Massage: If you haven’t been advised to do so, gentle massage may help. Typically, it’s recommended to massage 5 minutes, 5 times a day, for 5 days post-injection—but always defer to what was recommended based on your specific case.

Observation: Since you're only 10 weeks out from your second session, the results are still evolving. Puffiness may reduce gradually.

Imaging or evaluation: If symptoms persist or worsen (e.g., hardness, nodules), a practitioner familiar with Sculptra complications may suggest imaging or further options like steroid injections.

I understand how distressing this can be. Your concerns are valid, and it’s important you feel heard and supported through this process.