Incorrect Dilution of Sculptra?

Question

I suspect my plastic surgeon didn't properly mix my third vial. I am also suspect when he reconstituted it. I don't think he waited long enough before injecting it. He had a very difficult time injecting and had to change out for larger needles. Large hard nodules developed in the hollows of my cheeks in 2 wks with significant swelling that has not resolved in over 2 months. 2 previous vials I received 8 months ago from the same physician resulted in great results with no problems.

Michael A. Persky, MD · Answer

Hi 50 Not,

	It is difficult to make any judgements about when the vials were reconstituted.  What I personally will avoid is using a needle that is larger than a 25 gauge needle to inject.  I believe that the clogging of the needle is actually another safety against injecting globules of undiluted Sculptra particles.  It is sometimes frustrating when the needle clogs, but I would not recommend injecting with larger gauge needles.  There are ways to help dissolve hard nodules if need be.  Discuss your concerns with your plastic surgeon.  Good luck and be well.

	Dr. P

Sonia Badreshia-Bansal, MD · Answer

Thank you for your question. The nodules may have to be excised if they are a result of the Sculptra.  You may have to ask when the product was reconstituted, and the size of needle used.  We use 25ga BD needles, and rarely have problems with plugging.  If I use a 22ga, I never have an issue.  They have to be burped prior to injecting, and usually are trouble free..   I hope this helps!

Stephen Prendiville, MD · Answer

I would like to echo the other remarks about refraining from using a needle larger than 25 gauge when injecting Sculptra.  Sculptra is not easy to inject and needle clogging is just a part of the procedure.  This helps to make sure that the injection is performed in suspension and not in poorly suspended clumps.  My practice protocol is to reconstitute the Sculptra with sterile water and lidocaine 7 days prior to injection and to inject the suspension in a deep plane.  Hard nodules after injection are clearly not normal and should be discussed with your Physician.

Joseph A. Eviatar, MD, FACS · Answer

You should ask the physician if there are any changes in his routine for your most recent treatment.  Have him look at your bumps. Dilution can affect the frequency of nodules as can the doctor’s technique.

Donna Bilu Martin, MD · Answer

Nodules are a possible risk when injecting Sculptra, however, with careful preparation and injection technique, they can often be avoided.  When Sculptra first came out, physicians were trained to use dilutions of 4 mL.  However, this low volume tends to promote nodules.  Most physicians now dilute to a volume between 6-9 mL.  In thinner skinned areas, such as hands and chest, even more dilute formulations are recommended.  When injecting the face, the injections should be placed deeply.  Sculptra should not be injected around the eyes or mouth, as these areas will form nodules.  Massaging after treatments is helpful, as well.  As always, treatments should be performed by a board certified dermatologist or plastic surgeon with cosmetic experience.

Incorrect Dilution of Sculptra?

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Incorrect Dilution of Sculptra?

Answers (8)

Answer: Sculptra nodules

Answer: Sculptra nodules

Answer: Sculptra nodules

Answer: Sculptra nodules

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Everything you need to know about Sculptra

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