I'm Very Confused and Afraid to Make the Wrong Decision. Researching For Facial Volume?

I've been diligent with my research for facial volume..Sculptra,Fat , Silikon and some of the feedback from patients are horror stories.They claim they went to Board Certified Doctors ,who unfortunately made mistakes leaving them with terrible problems!! I'm very disapointed ,I desperately want to do something . I can't make a decision confortably. HELP !!!CAN SOMEONE EXPLAIN TO ME WHAT DO DO? I need a treatment that lasts ,it's safe and give me a natural look. Where do I go from here??

Doctor Answers 7

Deciding on Sculptra for Face

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Thank you for your question. Sculptra has been very safe for us, and is a good long term product.  We have not seen the granulomas which plagued the product the first few years.  This was due to using too little dilutent, and not letting it soak for 24-48 hours.  We dilute 1 vial with 9cc of fluid, and our problems are non-existent.  Unfortunately, problems make the headlines, not the 98% who have had safe effective treatments. There are many good Dermatologist and Plastic Surgeons who are great injectors who are boarded.  Definitely see a Board Certified Plastic Surgeon or Board Certified Dermatologist. I hope this helps!

What is the best or right filler??? It is confusing!

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I agree, that choosing the best filler for an individual patient CAN be very very confusing!  There are so many of them in today's medical world (Restylane, Radiesse, Juvederm, Sculptra, other brands, fat, etc).     How can anyone possibly know how to do this?      Just like there are many medicines and many automobiles and many types of people to become friends, first understand that there is no "perfect" filler: they each have pros & cons.    Each patient at their age & level of health & their particular anatomy, should be assessed & asked to identify what they envision for their face. This may be cosmetic or reconstructive, or both.    Then the possible filler options can be considered.   We sometimes "rule out" some fillers for some areas (lips, eyelids) but that same filler may be great for another area of the face.   All fillers are designed to augment & enhance an area that is lacking in structure.      

       A qualified doctor knows the pros & cons of them, and will  take the time to recommend the very best for your particular needs.The more time you & your surgeon carefully spend in analyzing your face and going over the better choices for YOU prior to injecting, then the more likely you both will be very pleased with the results, while avoiding problems which can include "buyers remorse". 

Donn R. Chatham, MD
Louisville Facial Plastic Surgeon
5.0 out of 5 stars 74 reviews

How to improve facial volume and not make a wrong decision

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It can be very confusing and scary when you're trying to make decisions about what to do for volume loss (or any other problem that you might have). You don't want to make the wrong decision. Here are some things to consider:

  • Find a Board Certified dermatologist or plastic surgeon who does a lot of aesthetic injectables. Some great plastic surgeons spend most of their day doing incredibly great surgical procedures, but don't spend much time doing injectables. Just as there are many dermatologists who do skin cancer surgery, but don't do many aesthetic injectables.
  • Have a discussion with your new doctor about your goals. Make sure you're on the same page about what you want to accomplish and have agreed to the best plan for how to get there.
  • Each type of volume enhancement has its pros and cons. Ask a lot of questions. Ask you doctor to go over your concerns. It's reasonable to see more than one doctor before you make up your mind. We all have unique perspectives.

The Most Important Aspect of Choosing an Aesthetic Physician to Restore Volume and Beauty in the Face

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 Hi Vivian,

The most important aspect of restoring volume to your face is to find an aesthetic physician with excellent artistic vision.  It is not the material that is used to restore volume, rather it is how the physician uses their artistic vision to re-create natural beauty.  In my practice I prefer the use of Sculptra for overall facial volumization, plus the use of other fillers in select areas.  You should select a board certified physician in the core aesthetic specialities, but board certification by itself does not assure you of great results, make sure that the physician has artistic vision to go along with that board certificate.  Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Facial volumization

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It may make sense to start with a hyaluronic acid filler such as Juvederm, Restylane, Perlane, and Belotero.  If the results are not wanted, an enzyme (hyaluronidase) can be used to reverse the unwanted results. 

Options for facial volumization

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Especially since you are anxious about choosing the right option, I would strongly advise against using a permanent filler as it will be irreversible.  A good, safe way to start is with a hyaluronic acid facial filler (Juvederm, Restylane, Belotero, Perlane).  These provide excellent volume correction, and are immediately reversible with hyaluronidase - meaning, if you don't like it, the product can be dissolved immediately.  

Achieving a natural, attractive look depends much more on the surgeon than the product used.  

Donald B. Yoo, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 60 reviews

Is Sculptra Safe for Me?

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Sculptra is a very beautiful product if it is used correctly.  Per the manufacturer, it should be mixed with sterile water at least two days before your treatment.  The dilution amount should be 9-10cc to prevent nodules.  Patients who developed nodules in the past were before the dilution amounts were increased.  Also areas that you should not treat are the corners of the mouth and under the eyes.  These areas are at high risk to form nodules.  Sculptra is made of poly lactic acid which is the same ingredient in one of the most common suture materials.  It is not an instant gratification filler but instead, like suture material, stimulates gradual collagen formation.  The great thing about it is that it is a slow change so no one can say you "had something done"!


Dr. Liu

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.