Why Does my Face Keep Getting Flatter? Considering Sculptra.

I had buccal fat removed 10 years ago. Within the last 3mos my face keeps losing an inordinate amount of vol. I got Radiesse a month ago, it helped a little. Considering more, but improvement seems to be wearing off. I'm considering getting Sculptra at the same time as Radiesse but... 1. if the fat in my cheeks keeps "burning" off, will Sculptra really help? Can I maintain results? and 2. can you get as much as you want and establish as much volume as you want or will this too "burn" off?

Doctor Answers 5

Sculptra and longevity

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As long as you can build collagen, you can continue to build on your Sculptra outcomes.  I would normally be reassessing you after each visit.  Sculptra is one of my favorite injectables since it lasts longer than others, and can produce more volume for the same investment compared to our other injectables.  However, it does require an experienced injector to get great results and know where it is safe to inject and where one must have caution.

Sculptra for a thinning face

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We love Sculptra here in my clinic because it does inspire the building of one's own collagen and it does have a lasting effect of many years (as opposed to most any other type of filler).  Even patients suffering from fat atrophy due to medication causes such as HIV afflicted patients see lasting improvement.  Plus, it is very well tolerated by people's tissues and we have yet to see any nodule formation or allergic reactions to this product.  It is a wonderful choice to get some lasting facial volume. 

Before choosing a filler, it would be better to determine why you are looseing so much volumn

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Typically if you are suddenly loosing volumn:in your face:

  • You have been loosing weight
  • You have increased your excercise level
  • You have added a hormone such as thyroid
  • You have changed a basic medication that you might have been taking
  • You have developed an illness such as rheumatoid arthritis or sprue etc.

Sculptra is the best product to restore your volumn, but if something else is going on, you need diagnosis and treatment.

Dr. Mayl

Fort Lauderdale


Nathan Mayl, MD (retired)
Fort Lauderdale Plastic Surgeon

Scultpra for facial wasting

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Sculptra is best for treating overall facial wasting that occurs with age due to loss of fat and other supporting tissue. It's an interesting product because unlike other fillers such as Juvederm, Sculptura itself fills, and its presence also motivates the body to produce collagen encasing substance, similar to seeding a pearl.

The body slowly digests the stimulus and only the new collagen remains. And the nice thing is there's really no down time to this quick fix treatment, except for some possible bruising and initial swelling. Two to four applications spaced over four to six-week intervals are normally needed to get poly-L-lactic acid's full effect. The fresh fibers are subject to the same breakdown process as other body collagen and, therefore, last about two years.

Using Sculptra for facial volume replacement

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Since Sculptra works by stimulating collagen production it will work even if you continue to "burn off" fat. Between Sculptra and Radiesse injections you should be able to regain the volume you lost and then keep up as necessary. You can get as much as you want. As long as it is effective for you, cost is the only limiting factor. Sculptra is a sugar molecule and is produced through corn dextrose fermentation. Sculptra is gradually degraded into water and carbon dioxide over approximately 9 to 24 months. Newly formed collagen remains and the cosmetic augmentation has been noted to last up to at least 24 months.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.