Clumps (not hard lumps) after Sculptra?

Based on your description, it appears that you might be experiencing a common side effect from Sculptra injections, which is the formation of nodules or clumps. These are often due to an overstimulation of collagen production in the treated area.

Here are a few recommendations:

1. Continue Massaging: You mentioned that massaging has helped in reducing the size of the clumps. Regular massage can help break up the clumps and promote even distribution of the product.

2. Use of Steroids: Injection of Kenalog (a corticosteroid) can be considered. This can help to reduce inflammation and potentially dissolve the nodules. However, the use of steroids should be done cautiously, as they can also potentially cause tissue atrophy.

3. Radiofrequency Microneedling (RF MN): This could be another viable option. RF MN can help to break down the clumps and stimulate a more even distribution of collagen production.

4. Hyaluronidase Injection: Although Sculptra is not a hyaluronic acid filler, some practitioners have found that injecting hyaluronidase can help to break down nodules. However, its effectiveness in this regard is not universally accepted.

5. Saline or Sodium Thiosulfate Injections: Saline injections can help to dilute the product and break up the clumps. Sodium Thiosulfate has been shown in some studies to be effective in dissolving calcium deposits, which could be a component of the nodules you're experiencing.

It's important to have a thorough discussion with your provider about these options, as they each have their own potential benefits and risks. It may also be beneficial to seek a second opinion from another experienced provider.

Please note that this advice is intended to be general in nature, and specific causes may need different treatments. Always consult with your healthcare provider before starting any new treatment.