Fraxel Laser and Sculptra at the Same Time?

Question

I read a response that it's ok to use Fraxel after Sculptra. What is Sculptra encapsulated in? If Fraxel removes tattoo ink by causing your body to have an immune response to what the ink is encapsulated in, wouldn't it be contraindicted for Sculptra or other fillers that are not in gel form?

	It seems you would get lumps, cysts, and create a foreign body response. Please answer. This is confusing but very important for people to know.

Michael A. Persky, MD · Answer

Hi Awalk,
Sculptra is Poly L-Lactic Acid, the same material that Vicryl absorbable suture material is made of.  It is injected and over time stimulates an inflammatory reaction that adds volume to the area injected.  Sculptra is injected deep, below the dermis, and where possible just above the periosteum of the facial bones. 
Fraxel penetrates at maximum 1.6mm which is well above where Sculptra is injected.  If injected using improper technique, Sculptra can result in granulomas, but Fraxel should not have any effect on properly placed Sculptra or exacerbating complications from it.  
Be well.
Dr. P

Nissan Pilest, MD · Answer

In our office, we have done lasers and injected Sculptra at the same time, however we have always done the laser procedures, such as Fraxel first, and then injected Sculptra or other fillers. I just feel it is safer.

Lenore Sikorski, MD · Answer

Fraxel and Sculpra can be done together and can improve, lines and texture with the fraxel and volume loss in the face with sculptra. The fraxel works superficially while the Sculptra is placed deeper.

Nathan Mayl, MD (retired) · Answer

We will even combine the Mixto with Sculptra at the same session, but we complete the Laser first. There is no understanding of the effect of heating on any of the injectables when they are first placed, so we use the order of Laser - filler injectable - Botox, if we are combining treatments in an enhanced liquid lift.
Regarding Fraxel and tatoo - there are much better lasers for tatoo removal then either CO2 or Erbium so we will  use other machines.
We have done Sculptra since it first arrived in the U.S. and have yet to have our first lump or reaction. Consistent good results require preparation of material with an overnight wait before injecting and careful technique.
Dr. Mayl

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