It's true that Sculptra and PDO threads are similar (being the materials of dissolvable stitches), however they have different chemical structures and behave differently in the skin. I think the difference between them is worth trying PDO threads despite lack of response to Sculptra. I'm also wondering how long it has been since your 5 Sculptra treatments were placed? It typically takes at least 3 months to see any difference and at least 6 months to see the full effect. At that point, results last at least 2 years (according to clinical studies). Comparing high quality before and after photos is especially helpful to see the change in fine lines and hollows/folds being improved with Sculptra, since the changes take place so gradually as you look at yourself in the mirror daily. It's also worth noting that Sculptra revolumizes and improves skin quality drastically, but may not provide the lift that is ultimately your goal. However, it can properaly prepare your skin for a more effective PDO thread lift. It's common for people to truly need both modalities to reach their aesthetic treatment goal of lifted cheeks and jowls. Without Sculptra, PDO lifted thinner skin isn't as youthful appearing as when the skin has been rejuvenated with Sculptra first. Sculptra treatment also provides more texture within the skin (increased collagen fibers) for it to grip the PDO thread when it's placed. When the skin is thinner, it's more likely that the PDO thread may not hold as well, and you may be disspointed with your PDO thread results at that point or require more threads placed to reach your goal. As far as difference in chemical structure. PDO threads are made of polydioxanone, whereas Sculptra is made of PLLA. PLLA is Poly-L-lactic acid. They are similar with both being dissolvable stitches in the body. PDO typically dissolve faster than PLLA. PDO stimulates collagen growth for about 3 months while Sculptra does so for 6 months. Bottom line, give it a try, combining these two treatment modalities may be the key to reaching your goals!