Probability of Sculptra Lumps?

Thank you for your question. The newer mixing formulas, and mixing 48 hours before injection seem to have all but eliminated the lumps. We see virtually zero lumps, and we mix each bottle with 10cc of saline and lidocaine. We educate about massage, and proper care. The Sculptra has a high satisfaction rate, but in the early days 4-5 years ago, the lumps were more of an issue. Mixing too close to the injection and with too little dilutent seemed to be the cause of the early problems. Now, we feel it is completely safe. I hope this helps.

I would recommend that you see an experienced provider.  It is important for Sculptra to be injected properly.  It is also very important to massage the treated areas to minimize the risk of developing lumps.  

In general, the side effects of Sculptra may include the following:

1) Lumps, or "nodules."
2) Redness or swelling at the injection site
3) Bruising
4) Itching

With use of proper technique and an experienced injector, the likelihood of lumps appearing is small. It is best to do your homework before having Sculptra, and choose a board certified physician to perform your treatment, ideally a plastic surgeon or dermatologist. I hope this helps, and good luck to you.

With good technique and proper massage after treatment,  the chance of lumps is minimal.  Make sure you find an expert injector when choosing a doctor for facial filler.

The risk of nodules has decreased with Sculptra because many practioners were diluting the product with greater than the 5cc’s that the manufacturer recommends.  Many of the reports on nodules were reported at the lower dilutions. I do a great deal of Sculptra in my practice and have not had a patient experience a nodule thus far.

I think the more important question is what are the chances you will develop a visible nodule after treatment with Scultpra.  In experienced hands, with an appropriate dilution method, the chances of developing a visible lump is virtually nill.

That being said, there is still a chance of developing a palpable nodule, meaning one that you can feel but may not be able to see.  Again, with the appropriate dilution and injection technique, this chance is very low, but not trivial.  Fortunately, even when this does occur the vast majority will resolve on their own.  

The simple answer is that several factors (especially over the last 3 years) have significantly decreased the incidence of lumps with Sculptra.  Like some of the other posters on the issue, I was hesitant to perform Sculptra because of negative feedback I had heard from my colleagues roughly 5 years ago.  However, virtually all problems with Sculptra in the past stem from several factors: 1) Length of reconstitution time prior to injection.  If you are treated with Sculptra that was mixed 1-2 days prior, you are somewhat likely to have a problem.  Therefore, in my practice, Sculptra is mixed with sterile water 7 days before injection. 2) Depth of injection.  Sculptra is meant to be injected in a deep plane with avoidance of intradermal or immediate subdermal placement. 3) Appropriate massage.  Patients are instructed in 5,5,5, which translates into aggressive massage of injected areas for 5 minutes, 5 times per day, for 5 days.  Utilizing these principles, I have not encountered a single lump in 3 years, coupled with a very high satisfaction rate.

Hi M,

Practicing in Encino, CA and seeing patients daily from Beverly Hills, Hollywood, and LA, I was reluctant to use Sculptra when it first came to the market in 2000 as I cannot afford to have lumps and bumps in my patients, many of whom are in front of film, TV, and still modeling cameras.  

Fortunately, by 2008, the reasons for the formation of these lumps and bumps were understood, and preparation of the product as well as injection techniques and patient choice have resulted in a much lower incidence of lumps.  I agree with what my colleagues have said here, particularily Dr. Weiner.  

I began using Sculptra in late 2008 after attending a meeting where the world's experts were demonstrating their techniques for injecting Sculptra.  I leaned over the to physician next to me, a young, beautiful, brilliant cosmetic dermatologist and whispered, "What do you think about this Sculptra?", and she replied, "I've had it myself!"  That was the "straw that broke the camel's back for me, if this well educated, high profile dermatologist trusted the material in her own face, that was enough for me.  

I have not seen any visible nodules or lumps in the hundreds of patients that I have treated with Sculptra since 2008.  We have seen a handful of patients with a smaller than pea sized palpable bump, all of which disappeared spontaneously on their own.  I am a clinical instructor for physicians wishing to learn how to use Sculptra.

When used properly, Sculptra is a very safe volume replacement treatment.  Good luck and be well.

Dr. P

Sculptra is a useful filler for broad facial surface areas - like the cheeks and temple areas. The volume of reconstitution, depth of injection and post-injection massage are all improvements over the past few years that have resulted in less nodularity and happier patients.

It took me a long time to come on board with the Sculptra because of this very issue.  After observing the very low frequency of issues with the newer dilution, I started using it (early 2012).  Other measures which have helped are: not injecting around the eye or mouth, avoiding people with autoimmune disease, mixing the Sculptra days in advance, and massaging the areas injected.  At this point, the most likely reason to get lumps would be technique (injecting too much Sculptra in a single location).  I am now a Sculptra Instructor too.  Please see my blog which addresses this very issue.  Steve Weiner, MD, Destin, Florida.