Would Sculptra work for me or will it make my face rounder? (Photos)

Question

35 F - I just got HA fillers on my cheeks and chin as well as a nefirtiti lift and forehead/massater botox done 2 weeks ago. I told my injector that I liked the results but I felt like my smile lines are still really noticable. So I asked about Sculptra and she said it would help and it would help with my deep acne scars as well. I've done some research and I've seen some horror stories of people's face ending up looking rounder and I don't want that to happen to me, but I don't know if my face is too round to get sculptra. I've attached 2 photos, the first is Aug 2024 before any procedures vs Jan 2026 a week after my fillers/botox. the second photo is me a week ago, in less flattering light, to show my smile lines I have a naturally wide jaw, so I don't think my massaters can shrink anymore because my bone will still be there. any insight would be helpful. If sculptra is not a good fit for my face shape, what alternatives do i have for my smile/marionette lines?

Anna Chacon, MD, FAAD · Answer

Would Sculptra work for me or will it make my face rounder? (Photos)
Answer by Anna Chacon

This is a really thoughtful question, and I’m glad you’re pausing to evaluate before moving forward. When someone has already had HA filler, Botox, and a Nefertiti lift recently, it’s smart to look at how everything is settling before layering in another biostimulatory treatment like Sculptra.

Let me break this down in a practical, honest way.

What Sculptra actually does (and doesn’t do):
Sculptra is not a traditional filler. It doesn’t just “fill a line.” Instead, it stimulates your own collagen production gradually over months. Because it works by building collagen volume in treated areas, it can improve:

General facial hollowing

Skin quality and thickness

Some acne scarring (especially rolling scars)

Broad volume loss that contributes to deeper folds

But it is not a precision line-filler for smile lines or marionette lines in the same way hyaluronic acid fillers are.

Can Sculptra make a face look rounder?
It can — if:

Too much is placed

It’s injected in the wrong zones

The face already has good volume and width

The injector uses a blanket approach instead of structural placement

Patients who report looking “rounder” are often those who were treated diffusely in the cheeks or lower face when they didn’t actually have volume loss there to begin with.

From what you’ve described — naturally wide jaw, recent cheek and chin filler, and concern about facial width — adding a collagen stimulator broadly through the midface right now could potentially create more fullness than you want.

Timing matters here too.
You’re only about two weeks out from HA fillers and Botox. Smile lines can still look more noticeable early on because:

Filler hasn’t fully integrated yet

Mild swelling in adjacent areas can temporarily change contrast

Movement patterns are still adjusting after neuromodulator treatment

I usually consider the result more “truthful” at about 4–6 weeks.

About smile lines and marionette lines specifically:
These folds are usually best addressed with more targeted approaches such as:

Strategic HA filler placement (often not directly in the line, but around it for support)

Small amounts of structural support in the lateral cheek or prejowl area

Occasionally micro-droplet techniques

Energy-based skin tightening in select cases

For acne scars:
Sculptra can help certain types of atrophic acne scars, but it’s not the first-line choice for all scar patterns. Many patients see more predictable improvement from:

Subcision

RF microneedling

Fractional laser

TCA CROSS (for narrow deep scars)

Bottom line:
Sculptra is a powerful tool when someone has true collagen and volume loss — but it’s not automatically the best tool for smile lines, and in a face that already has width and recent filler, careful restraint is important. The goal is contour and support, not generalized expansion.

Would Sculptra work for me or will it make my face rounder? (Photos)

Answers (1)

More Sculptra Questions

Would Sculptra help with thin cheeks? Or would facial fat transfer be better for me?

If a cannula is used to release tethered acne scars in areas where there are facial ligaments, will the ligaments be harmed?

How often can I get Sculptra?

Is it safe to get Sculptra with Rhumatoud Arthritis?

25 pound weight loss, crepey forearms - how can I fix significant wrinkling and skin laxity? (Photo)

Is Sculpra safe for ehlers danlos skin?

WE SEND PRETTY
EMAILS