Acne scars - Sculptra or Restylane for the temples? (Photos)

Question

Weighing the options for a procedure for acne scars on the temples. The recommendation is subcision to break up the scars, and a deep placement of a filler to act as a temporary "scaffolding" to help prevent re-tethering as the temples heal. The recommendation is to use Sculptra, but why would Sculptra be better than using a safer HA filler like Restylane to achieve the same results? I know Sculptra can help replace volume long term, but that’s not really the goal here. The goal is to create the scaffolding to prevent re-tethering, so why wouldn’t you approach that with the safest filler you can if it’s just a temporary need during healing?

Michael A. Zadeh, MD, FACS · Answer

Acne scars respond best to a combination of treatments including lasers, subcision, fillers and Sculptra. There is no overnight fix and commitment to treatments is needed for optimal results. The goal is improvement and not total elimination. Both Sculptra and Fillers have a role in this. Fillers with subcision will give you some immediate improvement, whereas Sculptra is good for longer term results. Make sure you see an experienced physician for an in-person consultation and examination to formulate a treatment plan appropriate for you.

Michael A. Persky, MD · Answer

Hello A,
I would use a combination of subcision, Sculptra, and Fractionated CO2 laser treatments.  I would also use a combination of exosomes and prp during your laser treatment.  Given the depth of your scars, you will likely need a series of treatments but should see nice improvement after each session.  I would estimate 3 to 4 sessions separated by about 3 months.  Feel free to contact me with any further questions or concerns.  Good luck and be well.
Michael A. Persky, MD
Encino, CA

Anna Chacon, MD, FAAD · Answer

Hi! I completely understand your reasoning, and you’re asking the right questions about the goal versus the tool. Here’s a breakdown:

Purpose of the filler here – You’re correct that the primary goal isn’t long-term volume replacement. The main aim is to act as a temporary “scaffold” after subcision, to prevent the scar tissue from re-tethering while the area heals.

Why Sculptra is often recommended – Sculptra (poly-L-lactic acid) stimulates collagen formation over several weeks. Even though it is slower-acting than HA fillers like Restylane, this collagen stimulation can create a more lasting structural improvement, helping the scar stay elevated and smoother over time. In other words, it’s not just a space-filler—it actually supports tissue remodeling.

Using Restylane (HA fillers) – HA fillers are indeed “safer” in terms of reversibility and immediate correction. They can absolutely be used to create the scaffolding temporarily, and they will provide instant support. The downside is that once the HA is absorbed (usually a few months), there’s no added collagen support, so the scar may partially re-tether unless subcision alone has done enough to release it.

Choosing the approach – If you want temporary scaffolding with full reversibility, HA fillers like Restylane are fine. If you’re willing to allow for a slower, longer-term collagen-building effect, Sculptra may give a more durable improvement in the texture of the temple scars. Both approaches can work; it’s about whether you prioritize instant, reversible support or gradual, longer-lasting tissue remodeling.

Acne scars - Sculptra or Restylane for the temples? (Photos)

Answers (3)

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