If Sculptra is accidentally injected into a vein or artery, can this mistake be detected immediately by the cosmetic surgeon?

Question

Also, if this happens, can prompt and effective action be taken by the cosmetic surgeon in the office to prevent any long-term complications in the patient, such as blindness or stroke? Can too much Sculptra be injected at once, possibly leading to tissue necrosis because of occlusion, etc.? is it true that only physicians trained by the manufacturer are permitted to purchase Sculptra for use on patients?

Nelson Castillo, MD · Answer

Thank you for sharing your excellent question.  Intraarterial injection of Sculptra can cause vascular occlusion with possible damage to a patient's skin surface.  It is typically immediately recognized and treated with heat, aspirin, massage, nitropaste and perhaps hyaluronidase.  Because of the distensibility of the skin it would be nearly impossible to inject too much Sculptra to cause tissue necrosis.  Only individuals who have completed an on-line teaching course are candidates for Sculptra purchase and use.  Hope this helps.

Steven F. Weiner, MD · Answer

Sculptra can cause vascular occlusion as any other filler can. Only arterial injection poses a risk, not venous. If there is vascular occlusion, it can almost always be recognized immediately as blanching. Delayed occlusion is much rarer and will present within 24 hours. Unfortunately, there is not any enzyme to dissolve Sculptra as there is with HA fillers. However, the protocol is similar is there is a recognized occlusion - hyaluronidase, heat, massage, nitropaste, aspirin, viagra. The company now only requires an online training session for credentialing providers. After completing the training, any provider is able to purchase the product. Delayed occlusion should not happen with Sculptra because this is theorized to be due to swelling of the filler which doesn't happen with Sculptra. I'm one of the few who inject Sculptra with cannulas which further minimizes the risk of vascular occlusion.

Faiyaaz Kalimullah, MD, FAAD · Answer

This is a great question!  As with any other filler, there is a small but serious risk of complications if Sculptra is accidentally injected into a blood vessel.  These risks can include necrosis of the skin, and in some rare cases, even blindness.  That said, reconstituted Sculptra is a very thin, watery suspension, which seems to make it less likely to cause a blockage of blood supply even if it is accidentally injected into a vessel, especially when compared to thicker hyaluronic acid gels (Restylane/Juvederm) or mineral-based products (Radiesse).  As a result, there are exceptionally few reports of vascular occlusion with Sculptra in the medical literature.  Unfortunately, unlike hyaluronic acid fillers, there is no way to reverse or dissolve Sculptra once it has been injected.No cosmetic procedure is without risks.  I would recommend seeing an expert, who understands the anatomy of the face, and has extensive experience with Sculptra injections.  It would be best to schedule a consultation with a cosmetic dermatologist or plastic surgeon to discuss your concerns and determine the best treatment plan to help you achieve your goals.  Best of luck!

If Sculptra is accidentally injected into a vein or artery, can this mistake be detected immediately by the cosmetic surgeon?

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If Sculptra is accidentally injected into a vein or artery, can this mistake be detected immediately by the cosmetic surgeon?

Answers (3)

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Everything you need to know about Sculptra

Our mission is to create a world where every investment in modern beauty is Worth It.