Dear Cathy M: We all want our faces to look our best now, and at the same time wish we could stop the aging process for the future so we don’t have to keep up the constant vigilance of seeing those signs of aging keep getting worse and worse. The reason why we show our age on our face is mainly due to loss of collagen, elastin, fat and bone. The shrinking, drooping and loss of these crucial internal structures cause loss of volume in the face which in turn causes the appearances of folds, wrinkles, hollowness and even a shrunken appearance in and around the lower cheeks and mouth. Wrinkles and folds and uneven skin color are the foundations of an aging skin. Reversing these features rejuvenate our appearance. Fortunately, in today’s hi tech cosmetic world, we have non-surgical procedures that help to counter and provide both a short term (immediate) and long term reversals of these aging effects. The “Short Term” approach uses those fillers like Restylane, Perlane, Juvederm Ultra and Radiesse and the muscle relaxers, like Botox and Dysport that give you immediate plumping of the face and relaxing of your wrinkles. The fillers are used to plump very specific folds and wrinkles on the face. These fillers will give you up to a year of looking refreshed before you will need to repeat the process. In this time period, however, by just using these products alone, your face continues to lose collagen, fat and bone loss from the aging process and you will need to return and repeat the same procedures. But what if there was a “Long Term” approach that is incorporated at the same time that we use the fillers and muscle relaxers that would work simultaneously to keep up your collagen production and give you a continual refreshed glow on your face? This long term strategy would help prevent the aging process by continually stimulating your own collagen when normally you would be losing it over time. The “Long Term” strategy incorporates the use of Sculptra. While Sculptra is classified under the filler category, it acts more to arouse dynamic cellular activity and not act as a more static filler or a muscle relaxer. Sculptra is a collagen stimulator that is seeded into many areas of the face as well as in very specific deficits, folds and hollows to increase your own production of collagen and stop the loss of collagen year after year. Sculptra not only fills in the hollows and deficits of the face, but thickens the skin’s dermis creating greater elasticity to the skin, thus providing more firmness to the face. Sculptra will last over 2 years, but the process of injections is quite unique and results are not seen for many months later. When you first start using Sculptra you will need several sessions scheduled 4-6 weeks apart. Depending on your age and skin issues being addressed, the range of treatments needed can vary from 2-5 sessions. The collagen production takes months before you see the plumping and volumizing effects. Hence, why it is suggested that if you are looking for an immediate result, you begin with the traditional fillers like Restylane, Perlane and Juvederm and by the time these wear off, Sculptra will have made a significant impact in re-volumizing your face. It is the thin, athletic and sun-aged patients who really enjoy the results from Sculptra. Since it has little volumizing effect, you don't appear fatter. Because of its stimulatory effects on the fibroblasts forming collagen, elastin and other dermal structural molecules, the appears to shrink and firm. It seems to have a stimulatory effect on the epidermis too with cell turnover and improved skin texture and evening of color. For those who are too thin or hollow, volumizing fillers provide long lasting satisfaction too. The truly cool aspect of Sculptra is that since it is your own tissue that is being stimulated. There is a beautiful natural glow and refreshed aspect about your face and skin quality. People will comment that you look really great but they will not be able to figure out why. It is best to "stimulate the stimulator". I recommend retinoids, dermal peels and dermal lasers to provide non-surgical regenerate the skins ability to rejuvenate every 3 months. I hope this has been helpful! All the best!