Sculptra Complications

Is there a way to remove a delayed side effect of Sculptra that I may be experiencing? It is like a grain of sand or medium size drive-way rocks under the thin skin of my right eye. Easily treatable, for sure, and 'occasionally' will go away on their own but don't, a year later. These little sand like grains are just a wee bit painful 'everyday'. Is an under-eye bag lift by a very qualified surgeon, familiar with PLA the only real solution to this slight problem?

Doctor Answers 9

Sculptra Complications

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In a recent study, 8.5% of patients injected with Sculptra experienced formation of nodules. All nodules could be felt but were not visible. The onset of nodule formation from the time of injection can vary. Early nodules appear one to three months after treatment and most spontaneously disappear. Later nodules can occur from six months to three years and are larger and more inflamed. They usually appear abruptly and are accompanied by swelling and discoloration. These are often referred to as “granulomas”. They can usually be treated by steroid injections.
Subcutaneous nodules can form for a variety of reasons which include injecting too superficially, insufficient time for reconstitution, inadequate dilution, over correction, increased concentration of Sculptra caused by muscle movement, or allergic or inflammatory host responses. Massaging the area after Sculptra injections should decrease the risk of nodules by more evenly dispersing the particles. I instruct all my patients to firmly massage the injected areas for five minutes, five times a day, for five days.

There are multiple choices that you can make with your MD to treat these "grains."

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I am sorry to learn of the difficulty you are experiencing. If these are effects of Sculptra speak to your physician as there are procedures that can be performed to make you feel more comfortable. Direct massage of the area can have limited success but the sooner it is initiated after the injection the better the chance of success. Injection of Saline by a qualified physician can have the ability to break up granules. "Needling" the granules can break them up as well. Other fillers like Restylane can be used around the granules to camouflage them. Depending upon size the granules can be surgically excised. Lastly I would not use a blepharoplasty alone as a method to remove these grains.

Sculptra near eye

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I have removed sculptra nodules from the eyelid and periocular area surgically in the past. It can be done through the inside of the eyelid. Sometimes a steroid shot can take care of it as well.

Chris Thiagarajah, MD
Denver Oculoplastic Surgeon

Sculptra lumps and bumps

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Time is your best friend. Surgery will not necessarily eliminate all the lumps and bumps. Steroids may be of some benefit but are not recommend in the peri-orbital area. 

Sculptra complications--an ounce of prevention equals a pound of cure

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Complications can occur following any injectable therapy.  Preventing collagen bumps from Sculptra injection is the best treatment for these usually palpable, but not visible bumps.  Ensuring the treating doctor has allowed the Sculptra to reconstitute over a long period of time, in a larger dilution volume, and then injecting deeply in the tissue minimizes the chance of developing a collagen papule.

If a papule forms, the good news is they disappear with time.  If active treatment is desired, dilute steroid injections, injectable 5-fluorouracil, oral antibiotics, and light therapy may be considered among other possible treatments.

Melanie D. Palm, MD - Account Suspended
San Diego Dermatologic Surgeon

Sculptra Complications

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The most important way to prevent nodule formation around the eyes with Sculptra is to avoid injecting Sculptra close to the eyes in the first place. Once the nodules have developed, they may be difficult to eliminate, but can be helped with a variety of treatment options. Steroid injections, massage, saline infiltration, or even excision can be used, depending on the severity and location.

If the nodules are present within the soft tissues of the lower eyelid, then they may be accessible during a blepharoplasty, but this would depend on the nodules and the patient. It might also depend on if there is another indication for a blepharoplasty, and what incision might be needed. 

A consultation with a facial plastic surgeon, plastic surgeon, or oculoplastic surgeon could be very helpful.

All the best,

Sculptra Side Effects

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Sculptra was originally used for patients with HIV lipodystrophy and is made up of poly-L-lactic acid.  Sculptra has the potential for lasting longer than some other fillers, but it has some significant side effects

-Nodules and Granulomas- Can occur with use of Sculptra.  Knowledge of Sculptra and facial anatomy as well as mixing constitution have resulted in decreased incidence of nodules occurring.  

-Infection- Since Sculptra is replaced ultimately by your body's response to it its incidence of infection is very low

-Overly filled appearance- In some patients the response to Sculptra can be vigorous and patients can note an overly full look to the area injected.  Since Sculptra is not reversible, patients must wait for this product to dissipate which can be years.

Overall, in properly trained hands with an experienced injector, Sculptra can add significant amounts of volume to patients and is a useful filler.

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
4.8 out of 5 stars 171 reviews

Sculptra bumps

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Complications can absolutely occur. Sculptra can form bumps or nodules months after treatment.  The best way to treat a Sculptra bump is to avoid causing them.  When Sculptra is reconstituted (it comes dry in a sterile vial) properly, injected into areas such as cheeks and nasolabial fold, massaged vigourously at time of treatment and several times a day for 5 days after treatment the risk of bumps declines significantly. In expert hands the benefits outweigh the risks.

Susan Van Dyke, MD
Paradise Valley Dermatologic Surgeon
4.6 out of 5 stars 36 reviews


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There are certain procedures that can be done that may be able to help your situation.  I would recommend that you see your dermatologist or plastic surgeon.  

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.