Does Sculptra Need to Be Diluted Before It is Injected into my Face?

Sculptra (PLLA) is manufactured & arrives in the offices of qualified physicians in the form of a powder contained in a vial.  It must be diluted with water in order to be able to be injected. Early on, the dilution ratio (how much water was added) sometimes seemed to lead to hard clumps or nodules that could be felt & seen.  Today, the dilution ratio (more water) is improved and the formation of clumps has not been an issue in our practice. The primary benefit of Sculptra is the gradual stimulation of a patient's own collagen, and that collagen ideally is spread out & lasts from 18-24 months.    So by  properly diluting the product powder, the results are even better & safer. 

Sculptra (injectable poly-L lactic acid, made by Dermik) is similar to a self "dissolving" suture called Vicryl. It comes in  bottles as a freeze-dried, white powder. It then has to be put into a suspension by adding  sterile water usually a few days ahead of time and sometimes 1-2 cc's of lidocaine so it doesn't hurt as much when injected. The liquid is gently  added to the vial which is gently swirled to reconstitute it and not create bubbles.. The amount of sterile water that is added varies slightly, depending on the preference of the injector, but is usually 3 to 7 cc's in my experience

Sculptra arrives in a bottle as a fine powder and is mixed with sterile water the day before injection. Since you can't inject powder, this is the only way Sculptra is used.
Premixing allows the powder to disperse evenly, but even immediately prior to injection we will gently keep the mixed solution "moving" to be sure the placement is as even as possible.
The dilution ratio, even if it varies, does not mean you are getting less of the product since patients are charged by vial as opposed to by syringe as with filler. Some doctors may add an anesthetic to the mixture and that could lead to more syringes per vial, but still, the amount of Sculptra in the vial is the amount you will receive and pay for.
There are standard ratios of dilution for products like Botox and Dysport where conceivably a dishonest injector could over dilute, but fillers come in prefilled syringes of specific amounts. There is no need to mix anything as the filler in injected directly from the prefilled syringe which is prepackaged by the manufacturer.
If anyone were to be concerned, they could ask the physician to not remove the filler syringe from the package until they were ready to inject.
This is not practical with Sculptra as it takes a number of hours for the mixture to properly reconstitute.