Is Sculptra a good option for festoons?

Question

I am a 27 year old female with malar festoons. I was advised that filler may not be the best solution to treat them. They are not “bad” but they bother me a great deal. I had one half syringe of sculptra put in a month or so ago and did not see any improvement. I am supposed to go back for another round and was told it may take a couple injections but I am not sure if this is the right treatment or if it will work for festoons? What is the best non surgical solution for festoons?

Nelson Lee Novick, MD · Answer

Photos would have been extremely helpful. In their absence, I can only make a few general comments. For one thing, very often changes, such as incipient bag formation, tear troughs, and hollows result from loss of volume in the cheek regions. If this is so, then the use of volumizing filler, such as Voluma XC, which I would use in NY practice or Stylage XXL, which I would choose in my Israel satellite facility, where a far greater number of regulatory agency approved volumizers and fillers are available, would not only improve the cheeks directly, but secondarily improve the under eye region, often without need for directly treating the infraorbital region. Should direct treatment be needed, then my choices would be Belotero Balance (NY) and Teosyal Redensity II (Israel). I would not opt for relatively expensive Sculptra, since, for one thing, optimal results are seldom achieved shy of about three treatment sessions. For another reason, if for any reason there is an overproduction of collagen or lumpiness in this thin, especially delicate region, there is no enzyme to reverse the effects, as there is with hyaluronic acid-based fillers (i.e. hyaluronidase). Make sure that you are consulting with a board certified aesthetic physician and be sure to ask to see his/her before and after photos, if you haven't already done so, before continuing. Best of luck.

Jonathan Kulbersh, MD · Answer

I don't recommend Sculptra for this. Under eye bags can be permanently corrected with surgery or temporarily camouflaged with fillers (Restylane, Volbella).There are great non-surgical options to fill in under eye depressions and hollowness. Using dermal fillers, a liquid eye-lift can be performed. A dermal filler such as Restylane would be placed in the cheek and tear trough to hide the depression or bag underneath your eye. 
Surgery would require a fat-repositioning lower lid blepharoplasty. In this surgical procedure, fat from the eye area is moved into the tear trough depression filling the actual depression. 
I hope this helps!

Jason Emer, MD · Answer

These fillers (Belotero, Volbella, Restylane Silk) are good for improving under the eyes and festoons, but keep in mind, a combination approach will give the most improvement. Fillers, lasers, and microneedling/PRP can improve under the eyes. My patients try to get non surgical treatments to avoid surgery. We use PRP and stem cells there often. I suggest consulting with an expert to develop a treatment plan best suited for your short and long term goals. Best, Dr. Emer

Fernando Colon, MD · Answer

Thank you for your question.  Sculptra is a good choice as a facial filler but in a situation of festoons, it may not achieve the best correction by itself.  In such cases the addition or combination with a low hydrophilic hyaluronic filler may be required.  I would recommend a consultation with a board certified plastic surgeon for a full evaluation for your face.  They will discuss options as well as risks for these types of treatments.  Best wishes!

Is Sculptra a good option for festoons?

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Is Sculptra a good option for festoons?

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