Do I need Sculptra, filler or microneedling? Have quite a bit of dimpling around the mouth area. (photos)

I gave up using Sculptra quite a few years ago once more robust HA fillers came on the scene. Years ago the advantage of Sculptra had been that it lasted longer than the ordinary Restylane or plain Juvederm that were available at the time. The disadvantage was that Sculptra was expensive, required about three treatment sessions to see a response, and it has had the very serious disadvantage that if there were any adverse reactions, there was no enzyme to dissolve it. Once longer-lasting, more robust HA fillers were approved, which did have the advantage of being relatively easily dissolvable, I could no longer justify the use of Sculptra. In experienced hands, the use of robust HA fillers can restore facial volume, improve under-eye hollows and tear troughs, diminish smile lines and marionette lines and straighten and define jowly jawlines. And all of this can be accomplished in about 30 minutes and typically engenders little to no significant downtime. Microneedling is best reserved for very treating very superficial, surface color and texture irregularities. It is not for facial contouring. You would be wise to consult with an experienced, board certified cosmetic dermatologist. Hope this helps and best of luck.

Your lower face doesn't have enough of support, hence you are bothered by the dimpling and lines. Your mid face/cheek area also needs support to make the under eye area better.Your treatment plan will include Sculptra and RF Microneedling in the same session . You need 4 vials of sculptra 2 in cheeks and 2 around mouth /chin area. RF microneedling will improve the malar rounds on your cheeks and tighten the skin as well. Depending on your provider comfort level, they can be done together or separate. In our practice we often combine both treatments at the same time. Sculptra sessions are usually 1 month apart and please include neck in RF microneedling as well to look balanced .
Have a beautiful day!

You don’t need fillers. I would consider Fat grafting. An expert such as myself performs fat grafting, the results should be natural and practically permanent. The procedure of fat grafting makes her the individual look at least 15 to 20 years younger and exactly like themselves when they were that much younger. I hope good luck from New York City plastic surgery.