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.

Both are excellent options and I often combine fat transfer with Sculptra (depending on treatment area) and prp to improve final results. Harvesting is important for successful fat transfer. I use gentle water-assisted harvesting to get the most viable fat to transfer. I combine with prp and sculptra to improve results. See an expert. Best, Dr. Emer

Both have risks and benefits.
Fat transfer uses your own tissues, but take can be variable.  Most patients need at least one secondary procedure (sometime more) to get it just right.  There is also a donor site, which can be painful, bruise and risks infection.  
Sculptra is a biostimulant that causes your body to increase production of it's own collagen.  It does not "come out from skin" at all.  It dissolves after 6 months, but the effects of boosted collagen continue for years.  It also requires several treatments, usually 3.  
I would recommend Sculptra!  It has great, long lasting effects with minimal downtime.
Best of luck
Dr Rodman

Thank you for your question. Unlike other injectable fillers, Sculptra is a volumizing filler that causes the body to produce new collagen. This means it takes longer to show results, but also that the results may last longer than other filler. Sculptra might a good option for you but I recommend getting an in-person consultation with a board-certified dermatologist.  

Thank you for your question. I have been using Sculptra for a number of years now with no significant adverse effects. Occasionally a patient may experience a small palpable but not visible lump. These usually are not of concern to them but if they are we can usually break them up by injecting either normal saline or a steroid.
A new alternative to fat transfer is ALMI (ALL ME). This is micronized fat cells rich in regenerative cells that restore volume and structure to your skin. This does not have the unpredictable problems associated with fat transfer and can be injected with a small gauge needle or cannula just as dermal fillers are. The entire procedure takes less than an hour and gives a long lasting result. The best part is the injected material is all from your own body.

Thank you for your question. In our practice we utilize both fat grafting and sculptra. The negative to fat grafting is that you do not know exactly how much will take and if it will take evenly. You also have to worry about the donor site. This will be tender and there will be bruising and potentially contour irregularities. However, once the fat takes it is very natural appearing. Scupltra is a terrific product without a donor site. It does not provide the same degree of volumization as fat grafting does and there is an element of unpredictability with it as well. Sculptra is excellent for patients that are very thin and athletic. I have not heard of the side effect you mentioned. The main side-effect is potential for lumps that tend to go away with time. Good luck! 

Thank you for your question.  Depending on the area being treated, both Sculptra and fat grafting can be excellent choices.  Generally speaking, on the face, I prefer a combination of Sculptra and hyaluronic acid fillers like Voluma and Vollure (depending on a patient's specific needs) over fat grafting.  One of the biggest challenges with fat grafting is that the results can be a little unpredictable - it's not clear at the time of surgery exactly how much of the fat will survive, and whether it will survive evenly.  When the fat engrafts evenly, the results are beautiful and longer-lasting than almost any filler product; when it doesn't, the results can appear uneven or lumpy.  I have treated a number of patients who have needed corrective fillers and Sculptra to address uneven fat uptake after fat transfer procedures.  Sculptra is a collagen stimulating filler, and works with your own body to gradually add subtle volume and lift.  On the face, where smaller volumes of product are needed, I think it provides a more reliable result than fat.  Sculptra does not "come out of the skin" after 5-6 years, in fact, the Sculptra particles themselves dissolve and are excreted from the body after several months, leaving behind a scaffolding of your own collagen.    This isn't to say that there is no place for fat grafting.  On the body, in areas where larger volumes are needed (such as buttock augmentation), fat transfer can be an excellent option and far more cost effective than products like Sculptra.  In any case, I would recommend scheduling a consultation with a cosmetic dermatologist or plastic surgeon to discuss your concerns.  Best of luck!