Sculptra is quite unique in the wide array of fillers. It consists of tiny parcels of a corn derived sugar in sterile water, with a small amount of local anesthesia added. This same sugar product has been used literally for decades to make common dissolving sutures. Once injected, the sugar dissolves and the body forms native collagen in response. That is why Sculptra results take time. Over the last ten years, my observation is approximately 50% of the volume is realized by three months. Only subtle improvement is seen at six weeks. Final peak volume can take nine months. Most other immediate acting fillers do also induce some collagen formation, albeit to a much lesser extent. Hence the gradual buildup often observed with repeat HA injections such as Restylane.Sculptra results are not immediate, and cost more initially. But it has significant volume, cost and durability advantages. Whereas most other injectables are dispensed in 1cc syringes (picture a small sugar cube). But each vial tends to produce approximately 4-5cc of collagen (picture a teaspoon). And our patients consistently retain volume well beyond the promised two-year mark. So on a "per-day" and "per cc" basis, Sculptra actually provides a greater value than most other injectables. Sculptra results are extremely injector dependent. It is often used alone, but also in conjunction with other fillers and surgery. Some of the best candidates are young, fit and lean but missing their youthful facial volume. Also eligible are older patients where 1-2 cc of HA is simply not enough to make much difference.