I am 29, female, 5’5, 140lbs. Is sculptura good for extreme volume loss and sagging? (Photos)

Thank you for sharing your concerns and photo. At 29, it’s not uncommon to start noticing changes in facial volume and early soft tissue laxity — especially in the cheeks and nasolabial folds — as collagen production begins to gradually decline in our late 20s.

Sculptra can be a very good option in cases like yours. Unlike traditional fillers that give immediate plumping, Sculptra works by stimulating your body’s own collagen production over time, leading to gradual and natural-looking improvement in facial volume, skin thickness, and contour. Many patients appreciate that the results develop subtly and last longer — often up to two years or more after the initial series of treatments.

That said, expectations are important: Sculptra won’t produce an “instant lift,” but it can restore youthful fullness and improve skin quality in a way that looks soft and natural. For more immediate correction, hyaluronic acid fillers (such as those for the midface or nasolabial folds) can sometimes be combined with Sculptra for the best outcome.

In younger patients like you, I often find that Sculptra is an excellent preventive and restorative choice because it helps rebuild collagen before changes become more advanced. The key is a personalized plan tailored to your anatomy and goals — sometimes a layered approach using both collagen stimulators and fillers achieves the most natural and balanced look.

I gave up using Sculptra many years ago. Its main advantage at the time was that the results lasted around two years, far longer than the HA fillers that were around at the time. However, since then, many HA fillers have come to market that can last 1.5 to 2 years. Sculptra is expensive, typiically requires a treatment series of about three monthly treatments in order to achieve visible results, and should there be any adverse or unwanted reactions, there is no dissolving enzyme to get rid of it.
By contrast, robust HA volumizing fillers typically yield immediate results, engender little to no significant downtime, and can be dissolved with an enzyme should the need arise.
You would be wise to consult an experienced, board certified cosmetic dermatologist filler injection expert and best of luck.

Even though Sculptra can be used in the cheek area, your lower eyelids appear to be also very deflated and unfortunately Sculptra is not supposed to come anywhere close to the lower eyelid. In your case, I would recommend doing facial fat grafting. With the use of proper fat, the result should be extremely natural and practically permanent. I hope this helps and good luck from Leonard Grossman M. D., organic Plastic Surgery, New York City