How do you decide between sculptra and fat grafting?

This is a very good question. For one, sculpture is not permanent. Fat is permanent. In addition, sculpture often requires multiple sessions. A good rule of thumb is that one requires 1 vial of sculpture for each decade of life. So if someone is 40, they would require four vials each session. With 3 sessions this is of course 12 vials. And within 2 to 3 years just about all of it will be gone. Fat however is permanent. And fat can be injected over the entire face including around the eyes, eyebrow, temples, lips, buccal space, etc. It is much more versatile. In one can also use higher volumes to create more natural looking results rather than injecting into discrete locations that will ultimately make the face less proportionate, potentially. Sculpture does have a role. But it is inferior to fat when it comes to volumizing the face.

Very difficult question to answer without photos or better, in person evaluation. Consultation with a board certified plastic surgeon with long experience in fat grafting and fillers would help make that decision. Good luck.

Fat grafting adds more volume than doing Sculptra injections. Plus the costs, if multiple vials of Sculptra are needed, is far less with grafting.

Medical decisions are best made together with your provider. If you don’t have a provider and find someone who is reputable and experienced in the field and discuss the procedures in detail with him or her and have that person help you decide.

Unless the pros and cons have been properly been presented to you by people with years of experience patients should not be making medical decisions on their own.

The procedures are very different. I typically would approach facial fat transfer with a great deal of caution because the procedure is somewhat unpredictable, imprecise and can be unforgiving if patients don’t like the results.

Best,

Mats Hagstrom MD

To an expert this is an easy question. However, you will get varied answers depending on who you ask. Fat grafting may take more than 1 session, but Sculptra, to achieve similar results, requires multiple sessions and it lasts only a few years, where fat is essentially permanent. A reason for some of the varied opinions is that Sculptra is more frequently injected by non plastic surgeons. Even among plastic surgeons, there is a difference in knowledge and skill of fat grafting. In expert hands, at least 75% of the injected fat takes and is permanent and there are rarely contour problems or complications. I gave up Sculptra many years ago and use only long lasting fillers or fat that have immediate results.