Results of Sculptra and Perlane Cheek Injections Gone After 4 Days

I just had a vial of Sculptra and a cc of Perlane injected in my cheeks to correct asymmetry from cheek implants. I loved how it looked on the day of the injection, but 4 days later, it looks as if I never had the fillers injected at all. What do you think has happened? I spent $2000 and don't see any benefit at all.

Doctor Answers 6

Sculptra combined with Perlane or other filler

Of course, an examination of the need for volume replacement would need to be assessed.  I have been using Sculptra for about 6-7 years.  There are several issues of concern:

1. In my opinion, one vial of sculptra is usually not nearly enough to fill the cheeks;

2. One syringe of Perlane is not nearly enough for the cheeks either.  The obvious strategy is to have the Perlane give the immediate fill effect and while this dissipates over the next 9 months (normal duration of Perlane), this gives enough time for the Sculptra to take effect;

3.  Sculptra MUST be used in at least 2 if not 3 sessions in fairly large volumes, certainly more than one vial for two cheeks on most occasions.  One must wait about SIX MONTHS (not weeks) after the LAST injection before one can expect any reasonable results.  Waiting four days just means that the sterile water and lidocaine have been reabsorbed and the one syringe (1.0 cc) of Perlane is just not enough to make enough difference.  Patience is required while the Sculptra takes effect.  It is a SLOW and controlled process;

4. Bottom line suggestion (again, need an exam to confirm) - need more Perlane (or Juvederm Ultra Plus), probably another syringe for the short term effect (first 6 months).  As this dissipates, the Sculptra should be beginning to have effect.  Sculptra should be given in session 2 six weeks after session one, usually with more volume, and session 3 six weeks after session 2 with a slight decrease in volume need again.  I would try to buy the Sculptra on a 1cc basis rather than a vial (7cc) basis.  Only get what you need--no more and no less.

I hope this was helpful.

Greenville Plastic Surgeon
5.0 out of 5 stars 64 reviews

Inadequate result from fillers

Sculptra naturally "disappears" after about a day, as the diluting fluid is absorbed by your body.Over about 4 weeks, your body will respond to the particles by creating inflammation and  new collagen, and this is how your face "fills in" after sculptra injection. That said, one bottle of sculptra will rarely give a dramatic change and you may need more. Perlane may not be the best choice for cheek augmentation because you want something that works best deeper under the skin or over the bone.

Roy A. David, MD
San Diego Facial Plastic Surgeon
4.5 out of 5 stars 23 reviews

Immediate Sculptra & Perlane results


Patients should keep in mind that Sculptra works a little differently than the other cheek injections. Sculptra is a chemical that once injected into the cheek will slowly accumulate and attract water. As this does so this chemical will swell and thus create fullness in your area of treatment. For this reason, the immediate results of Sculptra will not be your final results. Patience is necessary as the Sculptra continues to work. You will likely need to return to your doctor in approximately 6 to 9 months for a reevaluation and to inject additional Sculptra.

Pat Pazmino, MD, FACS
Miami Plastic Surgeon
4.7 out of 5 stars 101 reviews

Sculptra results take weeks

Sculptra works by inducing inflammation and collagen formation. It is completely normal to see the initial volume effect and swelling diminish after several day. Understand tat your result will evolve over the course of several weeks. Generally, you will need to massage the treated areas to minimize firmness and lumps.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.8 out of 5 stars 93 reviews

Be Patient

While I chose not to inject Sculptra, its effect is gradual and it is not supposed to do much at the time of its original injection. It is supposed to cause a reaction in which your own body lays down collagen. Your physician injected the Perlane, so that you would at least have some immediate response while the Sculptra takes effect. If it was only one syringe, it may not have been that much to make an apparent difference, butI am sure your physician is depending on the Sculptra kicking in and giving you the desired result.

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist
4.7 out of 5 stars 14 reviews

Sculptra takes time

Hi there!

Sculptra takes many weeks to fully produce its intended effect, and so I wouldn't worry at this point. Think of Sculptra injections like planting seeds that take time to grow. Give it about a month, and the original effect of the injection will likely return.

1 cc of Perlane is not a large volume to split between the two cheeks, and so its effect, while more immediate than Sculptra, may not be obvious.

In short, I think you will be happier with your treatment next month. Hope this is helpful!

Tanuj Nakra, MD, FACS
Austin Oculoplastic Surgeon
5.0 out of 5 stars 23 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.