Fat graft or Sculptra results and risk?

Good Afternoon! Thanks for the question. Sculptra can work very well for providing volume in the face. The one risk is that of nodule formation. We can't always predict in what patients that will occur. But when it does, it can be very bothersome and hard to treat. For that reason, I often elect for fat transfer. Fat can be harvested from the abdomen and/or thighs and processed into macro, micro, and nanofat. The macro can be placed deeply while the latter two can be feathered on top to make the results smooth. Migration is a risk but it's low if done carefully. In theory, since it's your own fat, you shouldn't react to it. The results last for years. Hope this helps!

Hyaluronic acid is a Natural substance in all people. It seems highly unlikely the cross-linking of the molecule would cause an allergic reaction. many products can cause reactions but not all of them are allergies. The human body is capable of four different types of allergic reactions. They are anaphylactic, cytotoxic, immunocomplex, or cell-mediated. It may be worthwhile to confirm that your reaction was in fact a true allergic reaction and not some thing else like histamine release etc. etc.
Confirmation of this would ideally come from someone who knows allergic reaction well which would be an allergist. The majority of providers injecting fillers probably are not well-versed on the medical field of allergy. It may be easy and tempting to call the same thing an allergy if someone sees an unusual reaction but not all unusual reactions are allergic reactions.
If your reaction truly was an allergic reaction then that might be worthy of publishing. It would be that rare.
Radiesse is an excellent product that has many advantages over HA product.
Sculpture can be imprecise since the provider doesn’t see the immediate response from the injection.
Grafted fat certainly does not migrate nor do any fillers but grafting fat is fickle, imprecise, unpredictable and finally unforgiving. The survival of grafted fat is highly dependent on the amount and quality of host tissue and is also very dependent how much fat is grafted into any particular area and amount of host tissue in that area. Generally speaking fat grafting is fairly good at giving diffuse overall volume but it’s not particularly good at giving very precise definition or volume in very small areas.
There are too many variables with fat grafting to make it consistent and reliable. there is also unfortunately not very many good options to remove grafted fat if people are unhappy with the outcome.
Fillers are superior for fascial volume augmentation. I personally don’t use sculptra so I can’t speak on behalf of the product but fillers have a big advantage in that the provider sees instantaneously what the impact of the treatment is. Anything that has a delay will inherently be less accurate.
I suggest you focus your efforts on finding the most talented and experienced providers first and foremost. You can then ask each provider what their thoughts and recommendations are while at the same time vetting that provider by reviewing their entire collection of before and after pictures and confirming they have the skills and experience to deliver the type of results you’re hoping for. This type of work is not always easy and there is substantial variation in skill and competence when it comes to providers doing medical facial aesthetic treatments.
Best,
Mats Hagstrom MD