Lump on forehead after Sculptra 12 months ago. Any suggestions? (photos)

Question

I did sculpture 12 months ago on my forehead and this visable lump is still there. Sometimes is a big massive lump like on the picture and sometimes is 2 smaller nodules. I have been massaging it everyday. Does massage helps and is there certain cream I can use when I am massaging to make it go away faster? Does HIFU (high-intensity focused ultrasound) on the lump will make it better or worse? Or it will eventually go away in 2-3 years later even I do nothing? Tks in advance.

Dean P. Kane, MD, FACS · Answer

Dear baby_bunny:Sculptra use is injector AND patient dependent. Sculptra is a bio-stimulant of collagen production in thinning tissues. It is particularly useful to firm the skin and resist creasing by causing a slow and gradual stimulus of those cells forming collagen and other structural proteins. It had in the past developed a reputation of forming collagen lumps or nodules. This has largely resolved with newer techniques of dilution and injection. There are areas where the Sculptra molecule if not properly massaged may coalesce and stimulate a growing mass of collagen. In my personal experience, the forehead,
particularly around the fusion line of the temporalis muscle and the upper
outer orbital ridge are areas of nodule formation. This may be due to
inadequate dilution, distribution or massage. If found early on, injection of
local anesthetic to dilute the area and desensitize the area for deeper scar
massage has been very helpful. Other alternatives include the use of dilute Kenalog
and massage or collagenase and massage.The consideration for using creams or HIFU (high intensity focused ultrasound) or other lasers to resolve the lump is not known to me but theoretically, any further injury may make the situation worse by further stimulating an inflammatory response to produce scar (collagen) rather than remove that response. Please seek the expertise of a Board Certified Plastic Surgeon, ENT Facial Surgeon or Dermatologist well experienced in the use and care of Sculptra therapy. I hope this has been helpful. All the best!

Sheryl D. Clark, MD, FAAD · Answer

This lump will resolve eventually even if you do not massage it at all, although it can take another year or possibly even more.  In the meantime, numbing the area and breaking it up with a needle, or injecting with 5-FU, may be helpful.  I am not aware that HIFU has been used for this but I can imagine it might be helpful.  Another approach is to correct some of the volume deficits you have in the forehead with an HA filler such as Beletero, which will not cause lumps and will actually disguise the bump you have now.Injection techniques for Sculptra have changed and this would be unlikely to happen to someone receiving Sculptra now.  I do hope this is helpful to you!Dr. Clark

Deborah Ekstrom, MD · Answer

You have uneven growth of the foerhead area.  The best treatment is to not try to get rid of it (probably futile and expensive for no result).In my opinion you best bet is to fill in around it with hyaluronic filler such as Voluma or Juvederm.

Steven F. Weiner, MD · Answer

The forehead has too much movement to inject with Sculptra.  It will clump, as it has done.  Ulthera might not be a bad way to remove.  Surgical removal can be done but will leave a scar. I use only HA's in the forehead.

Henry Gasiorowski, MD · Answer

In all likelihood, this probably is the result of Sculptra but after one year one must make sure that this is not a rapidly expanding tumor of some sort and you should consult the doctor that did the injection for possible further consultation.Once established that this is a result of Sculptra, one can inject an anesthetic and then go in and break up the nodule in various ways that you can discuss with your doctor. This can be combined with two other injections (an anti-inflammatory mixed with 5 FU) that your doctor will be familiar with.H C Gasiorowski MD

Lump on forehead after Sculptra 12 months ago. Any suggestions? (photos)

Answers (5)

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