How to recognize nodules, lumps and granulomas caused by sculptra? (Photo)

Nodules and granulomas that can rarely occur after sculptra can be difficult to discern from photographs or from history.  However, timelines usually are different.  Infectious nodules would occur within about 2 weeks.  Inflammatory nodules (which tend to resolve more quickly) tend to occur after 4-6 weeks.  Granulomas can occur later and are more difficult to treat.  Treatment for infections is obviously antibiotic therapy.  Treatments for nodules and granulomas varies.  In general, injections of steroid solutions is the mainstay with some physicians advocating for the use of 5-fu or oral antibiotics in addition. The biggest risk of steroid injection is the potential for atrophy.  Make sure to be evalutated by an expert in facial aesthetics who has a lot of experience with sculptra.

Persistent lumps after Sculptra
treatment are rare if it is injected per manufacturer recommendations by a
competent physician injector. You may have a mild infection, granulomas or cysts or
other problems causing your "lumps". The pain or tenderness you have makes me lean more towards an infectious process.   Kenalog injections may cause skin thinning, divots, and may also foster or worsen infection.... You might want to seek a second opinion if you are not
happy with the treatments from and answers you hear from your physician. Find a
dermatologist or plastic surgeon expert injector well versed in filler treatments who has
managed complications like yours to get the best result! Hope this helps. Best
of luck!

It is very difficult to assess the lumps you are describing from the pictures. However, it appears the product was injected quite high and close to the cheek bones where muscle motion from the zygomaticus muscle could have caused product to clump and cause this lump.  I would not recommend too many injections with steroid as you could cause fat atrophy which would in turn create a very noticeable dent in your cheek.  I assume you were injected by a board certified dermatologist or plastics/facial plastic surgeon so would recommend you go back to them to get further assessment and assistance.    Good luck!

It is very difficult based on the quality of your photos tk ascertain the etiology of the lesions that you are experiencing. I would strongly advised you to seek the evaluation of the individual who injected you. If you arent comfortable going back due to your experienced, a board certified dermatoligist woth experience injecting sculptra can further assist you. Good luck!

Sculptra comes in a powder form and has to be diluted with salt water prior to injection. If the powder is not diluted enough with water the concentration of particles within the Sculptra will be too high and when injected into the face will precipitate a reaction that leads to nodules.These nodules are the normal reaction to concentrated Sculptra particles in most cases and  they do not represent a biofilm infection. This nodularity can be avoided by diluting Sculptra with more saline beyond the maufacturers recommended amount. Once you form nodules I have not found Kenalog injections to be helpful .They do not disappear and in fact surrounding tissue may temporarily atrophy which may make the nodules to appear larger therefore these nodules usually have to be removed . If you wait long enough some of these nobles will spontaneously disappear but it may take months to years .