Sculptra nightmare. How can this be corrected?

Question

I had sculptra injected into my temples and nodules formed shortly after. A steroid was then injected to shrink the nodules and now my temple area is so sunken in with bulging veins showing. It’s so much worse than before. How can this be corrected?

Nelson Lee Novick, MD · Answer

I am sorry this has happened to you. I stopped using Sculptra over eight years ago because it required around three treatment sessions to realize any substantive results, was expensive, and had no specific dissolving enzyme (unlike with hyaluronic acid fillers) to easily dissolve the it if there was an adverse reactions, as happened in this case. At this point, however, a series of saline injections may be helpful for addressing the steroid atrophy, as these may help to dissolve any crystals that may have persisted and be contributing to the atrophy. Once this has been satisfactorily accomplished an HA filler may be used, if necessary, to further revolumize area and mask the prominent blood vessels. The temple is not area for novice, inexperienced injectors, so you would be wise to consult with an experienced, board certified cosmetic dermatologist.  Best of luck.

E. Victor Ross, MD · Answer

This is a very difficult condition to reverse, but oftentimes series of just saline injections into the area will help dilute both the Sculptra and the steroids and allow for a more rapid reversal of the issue.

E. Jacob Simhaee, MD, FACOG · Answer

Dear concerned patient.
unfortunately developing nodules after Sculptra is a known side effect of the procedure.
and using the steroid to dissolve the nodule will end up discoloring the skin and wasting the muscle under.
you can use a form of injectables, coming from the family of hyaluronic acid family mixed with platelet reach plasma to enhance the sunken area.
Good luck and best of health

Tanveer Janjua, MD · Answer

Sculptra nodules can be excised and other fillers can be used to bulk up the temples. Veins are a different issue. Most likely you had prominent veins to begin with. 
All hope is not lost. Depression in the area is from steroids. 
Regards
Dr. J

Kristen B. Williams, MD, MPH · Answer

I’m sorry you have had a poor experience. I recommend Renuva for the temples as it gives the most natural results. Good luck on your continued journey!

Anna Avaliani, MD · Answer

I have been injecting Sculptra for 9 years and Temple Sculptra is my absolute favorite area. In 9 years, I have had maybe less than 5 patients develop palpable "nodules" in the area, which were successfully managed with manage and laser treatments. I inject over 2000 vials in a year in my practice. Any experienced Sculptra provider, not only knows how to inject but also know how to manage anything that may arise after the injection has been performed.I'm sorry to hear about your experience. I just don't understand how a small steroid injection could make Sculptra disappear in the temple region or make it look even worse. Photos would have been helpful. These are your Temple filler options besides Sculptra:1. HA dermal fillers such as Restylane or Juvederm2. Fat transfer3. Renuva filler4. Do nothing
Please seek out experienced provider who can guide about all the options and risks associated with them.
Hope this helps. Good luck in your journey.Best, Dr.Anna Avaliani, NYC

Anshul Gambhir, MD · Answer

Good morning, thank you for your question! You can use filler to correct the temple area. The product of choice for this area would be Voluma which is made by Juvederm. Voluma can also be hyper-diluted for this area which is filler mixed with saline.

Vibha Gambhir, MD · Answer

Hello and thank you for your question. I'm so sorry this happened to you! One suggestion would be to use a hylauronic acid filler such as voluma to fill that hollowness that you now see. I would also take a collagen supplement to support your remaining collagen and help it not deplete anymore. Good luck on your journey!

Reuel Aspacio, MD, FAAD - Account Suspended · Answer

There should be no nodules if product was mixed correctly. Injected properly,
and deep enough and you massaged your 5 minutes 5 times a day for 5 days.
See an expert injector and you can use Radiesse in the temples for an immediate result.  Again, an expert injector.

Best of luck!

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