Sculptra or fat transfer?

I've never heard of a case of Sculptra “coming out” of the skin. Sculptra uses microparticles of Poly-l-lactic acid to stimulate the skin to produce new collagen. Gradually, the microparticles are absorbed by the body as they are replaced by new collagen.  The benefit of Sculptra is this effect of helping your skin make its own collagen.
In the hands of an expert, Sculptra can do an amazing job of restoring lost facial volume and rejuvenating the skin. It takes a while longer to work than the hyaluronic-acid fillers as its main mechanism of action is the neocollagenesis, rather than instant volumizing. Fat transfers can also provide a beautiful restoration, but they are less predictable. Sometimes the fat doesn't “take,” and a percentage of the fat cells tend to die, which means you may have less volume some months after your treatment than you did directly afterward. In my opinion, fat transfer is good for a full looking cheek and for hollow eyes, but Sculptra is better for reshaping the face, and building structure in loose jawlines with a flatter correction. Sculptra slowly builds up volume each month so it’s easier for the patient to decide when they have enough volume. It is then easier than a fat transfer to maintain the look with topping off the volume every year or so with one vial in a simple office visit. Please find a board-certified dermatologist to help you decide which treatment(s) are best for you to get the kind of rejuvenation and lift you wish.

I have never seen or heard of Sculptra coming out of the skin after treatment.  The possible side effects of Sculptra are similar to other injectable fillers.  The most common immediate possible side effects would be bruising or swelling.  The longer term possible side effects would be development of a bump that is usually something you could feel but not see.  If a bump did develop, these normally resolve over time but sometimes they can be treated to speed up the process.  

Thank you for sharing your question.  Depending on the part of the face or body being treated both Sculptra and fat transfer can lead to similar, natural results.  Both have little side effects if performed by a specialist.  Sculptra encourages your own collagen to develop and thicken with time, it does not come out of the skin after 5-6 years.  Hope this helps.