Are Granulomas a Common Side Effect of Sculptra?

I was amazed at the prospect of permanent disfiguration from granulomas due to Sculptra. I assume that technique (dilution, placement, etc) play an important role in their formation, but was a bit scared by the delayed nature of the reaction, up to 2 years.

What percentage of patients experience this? Is it idiopathic, just a strange immunological response? Being that there is no product left, how does it evolve? Would you as physicians reccomend this product to your own relatives? Interestingly, the satisfaction rate is the same as Juvederm, so what gives?

Doctor Answers 5

Granulomas a rare side effect of Sculptra

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I have not used Sculptura for over a year now. Not because of the rare granulomas but it really has a slowwwwwww onset of results. Patients do not want to wait months to achieve a result. The reports of rare granulomas are stated is the legal/medical ones.

Just my thoughts From MIAMI

Sculptra Granulomas Are Not Common

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There is a lot of confusion about papules, nodules and granulomas from Sculptra. Granulomas are very uncommon but papules and nodules can happen in up to 10% of the patients. These are felt like beads under the skin and are usually not visible. This is related to exagerated response of skin to Sculptra. With time all of these go away. They do not cause pain or any other side effects. It is rare for them to cause cosmetic issues.

The way to avoid is to have a well trained doctor do the Sculptra.

Increase the dilution to 10ml

Mix up the Sculptra at least one day in advance of the procedure.

Shake up the Sculptra for 5 minutes befor injecting.

If you develop a nodule, massage it frequently every day.


Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 126 reviews

Granulomas are rare

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The incidence of granulomas is reduced when the Sculptra is mixed well in advance, when dilutions are greater than 5 cc, and when the injections are done deep rather than into the dermis. I also think experience has an impact on the result. I find Sculptra invaluable in my practice.

Mary P. Lupo, MD
New Orleans Dermatologist
5.0 out of 5 stars 18 reviews

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Sculptra Aesthetic is a different product than other injectables

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We have been using Sculptra in over 100 patients during the past five years.

I teach the current Sculptra techniques which have evolved during that time.

The product should never be used in the lips or in or about the eyelids.

They currently will only sell their product to those who have taken their training courses and have demonstated the ability to inject correctly as well as how to give the appropriate aftercare. (I am one of their trainers as well as a lecturer for the proper ways to us what is a great product.)

We also like Juviderm which is our prefered lip product and is often used at the same time as Sculptra Aesthetic in our liquid lifts.

The problem of late granulomas is very unusual. In our extensive experience we have never seen one in our practice. It can apparently be prevented by proper technique, proper dilution, and massage as part of the immediate aftercare. We have seen them in consultation and they almost always are when the material has been injected about the lips or lids.

Dr. Mayl

Fort Lauderdale

Nathan Mayl, MD (retired)
Fort Lauderdale Plastic Surgeon

Sculptra nodules

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Not all Sculptra nodules are granulomas. In fact, granulomas, which are the body's local immune response to the product, seem to be very very rare and develop as a delayed consequence to the treatment. Nodules, or bumps, may occur more quickly and might just be more development of your collagen around a focus of Sculptra, or a more dense collection of Sculptra that was deposited in that one area compared to the rest of the treated areas. Sculptra is not a solution, it is a mixture , so that its particles could settle in the syringe and form a small clump. When these nodules do form, they can be felt but very often they are not visible and they are not treated. Massaging can help, but time should make them go away. If you do notice these nodules, then see your doctor for an evaluation.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

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.