Sagging, misshapen lower face 3 months after Sculptra

Question

43 years old, slender athletic build. I had 4 total vials of Sculptra injected. 2 vials then, 6 weeks later, 2 more vials. The result has been the exact opposite of what was expected. Over these three months my face has become increasingly saggy, lumpy and misshapen. It’s as though I’ve aged a decade since this summer. What can be done? (First photo is before Sculptra. Second photo is today.)

Anna Chacon, MD, FAAD · Answer

I'm sorry to hear about your experience. Sculptra is a type of facial filler that helps stimulate your skin's own natural collagen production to increase overall facial volume. However, like any cosmetic procedure, it can sometimes lead to unexpected results.
If you're experiencing sagging, lumpiness, or misshaping after Sculptra injections, it's crucial to return to your medical professional for a follow-up as soon as possible. They can assess the situation and determine the best course of action.
Here are a few potential solutions:
1. **Massage**: Your provider may recommend massaging the area to help distribute the Sculptra more evenly. This can sometimes help with lumpiness.
2. **Warm Compresses**: Applying warm compresses can sometimes help to reduce swelling and improve the appearance of the skin.
3. **Hyaluronidase Injections**: While this is not typically used for Sculptra (a non-hyaluronic acid filler), in some cases, it might be considered to dissolve any associated filler that might be contributing to the problem.
4. **Steroid Injections**: In some cases, your provider might recommend a steroid injection to reduce inflammation and speed up the breakdown of the filler.
5. **Surgical Removal**: In rare cases where the lumps are not responsive to other treatments, surgical removal might be considered.
6. **Time**: Sculptra is designed to be gradually and naturally absorbed by the body over time, so some issues may resolve on their own.
Remember, it's essential to consult with a professional who can provide advice based on a thorough examination of your specific case. Please reach out to your healthcare provider as soon as you can to discuss these symptoms.

Stephen Prendiville, MD · Answer

Sculptra is an excellent gradual facial volumizer reliant on the individual patient's ability to produce collagen.  It is really most appropriate for the midface/cheek area.  I am not sure how this product was utilized in your circumstance.  Further commentary is difficult without an examination and consultation.

Anna Avaliani, MD · Answer

Based on your initial photo, you were a perfect candidate for Sculptra.Does it feel lumpy or just looks lumpy because of sagging skin. In your after photo, it looks like you lost weight. Did you lose weight? If yes, weight loss always affects any results you do to your face, surgical, laser or injectables.I recommend you discuss your options with your provider. If there are "lumps" due to Sculptra they should be able to manage them with injections and lasers to make them disappear faster.If you are afraid of more Sculptra, your options are Ellacor - scarless face lift or an actual face lift to lift saggy skin. Ultrasound, Microneedling, RF, might work but it will take time and likely cost the same if you just did more of an aggressive treatment.
Hope this helps and good luck in your journey.Best, Dr.Anna Avaliani, NYC

Darryl J. Blinski, MD · Answer

Based on nicely posted photos I recommend injection dissolving with 5-FU and steroids with mini face lifting . Fee $10,000. Best yo virtual consult with…..

Sagging, misshapen lower face 3 months after Sculptra

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