Sculptra for Hollowed Cheeks and Under Eye Hollows?

Sculptra was suggested to me by a surgeon at a recent consultation. Is this safe to use for loss of volume on the cheeks and hollowed out look under the eyes? I am in my late 40's.

Doctor Answers 5

Your roadmap for volume replacement

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You are an ideal candidate for volume replacement given your age and the concerns about your appearance that you note above. Of course, these recommendations need to be personalized with a face to face consultation. That being said...

There are different tradeoffs and considerations for different products and areas of your face. I favor Sculptra for pan-facial volume rejuvenation. It is a biostimulator (causing your body to build its own collagen) with long lasting results (24 months or more). It has minimal downtime, but takes a while to work because it requires 1-3 treatment sessions. Final results can usually be judged after 3-4 months on average. Another option for larger volume restoration is fat transfer, which may last even longer that Sculptra, but has substantial swelling and downtime when performed correctly (up to 3-4 weeks of swelling).

Other hyaluronic acid (HA) fillers like Juvederm and Perlane can be used for facial volume restoration as well. They have minimal downtime like Sculptra, but they don't last as long (~8-18 months depending on your age, metabolism and which area of the face is treated). I've found that it is more expensive to rejuvenate the whole face with an HA filler than it is with Sculptra. However, HA fillers do give immediate results, which may be important if you have an event in the near future.

Which product/technique do you use in which area? When you paint a room, you would use a large brush or roller to paint large walls, but you would choose a smaller, finer brush for detailed areas like around doors and crown molding. On your face, Sculptra and fat transfer are nice for large volume restoration (cheeks, temples, etc), but fine detailed areas (i.e. around your eyes) are best touched up with Restylane. While Restylane may not last quite as long as Sculptra, it gives me the fine control I need to ensure a beautiful result. Restylane will usually last 12-18 months in the tear trough. This is a sensitive area, and you will want to make sure you have a skilled injector to ensure good results.

So, in summary, for most patients in your age range, I would probably recommend Sculptra for the majority of your volume loss with a touch up of Restylane around the eyes. These recommendations reflect my personal techniques and abilities. I would recommend you seek consultation with a qualified local injector(s) and get a feeling for what will be best for your appearance. Best Wishes!

Roanoke Facial Plastic Surgeon

Sculptra is the Ideal Product for Hollowed Cheeks

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Sculpta is the idea product for the loss of volume in the cheeks that stars occurring in your late 30's and early 40's.  One of the first signs of aging is when we lose that "apple" in your cheek which signifies youth.  Sculptra is the idea product for volumizing this area and achieving a natural look.  I do not use Sculptra under the eyes.  I much prefer Belotero for the thin skin under the eyes since this is such delicate skin. It is much easier to place small drops and get an elegant effect with Beloero for the hollows under the eyes. Please find a board certified dermatologist with many years of experience in cosmetic injections for your procedure.

Sculptra in cheeks, yes; lower lids, NO

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Sculptra is great to use to fill out about the cheek bones, but it takes at least six weeks to see an effect. For patients in a hurry we typically will prefer Radiesse which will give an immediate effect. Both are good. For maximum effect in patients with loss of a lot of fat, we typically prefer to do two treatments so the tissues can settle in and the look is natural.

We NEVER use Sculptra or Radiesse in the lower lids, since both have a high incidence of showthrough. (As a referral practice we have seen showthrough of virtually all materials except for Restylane). The lower lids rightfully have a reputation for taking the most expertise. Fortunately, Restylane will last longer in the lower lids than elsewhere, and therefore has high effectiveness and safety.

Nathan Mayl, MD (retired)
Fort Lauderdale Plastic Surgeon

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Sculptra is OK for the cheeks but NOT for under the eyes.

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Hi!  I don't use Sculptra.  I think Juvederm gives great, long lasting results in the cheeks, and it is only one treatment, unlike Sculptra.

For under the eyes, Restylane is best because it is the most forgiving. This area is quite tricky.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Sculptura sculpts and fills hollowed cheeks and eyes

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Sculptra is best for treating overall facial wasting that occurs with age due to loss of fat and other supporting tissue. It's an interesting product because unlike other fillers such as Juvederm, Sculptura itself fills, and its presence also motivates the body to produce collagen encasing substance, similar to seeding a pearl.

The body slowly digests the stimulus and only the new collagen remains. And the nice thing is there's really no down time to this quick fix treatment, except for some possible bruising and initial swelling. Two to four applications spaced over four to six-week intervals are normally needed to get poly-L-lactic acid's full effect. The fresh fibers are subject to the same breakdown process as other body collagen and, therefore, last about two years.

Michelle Copeland, MD, DMD
New York Plastic Surgeon
4.6 out of 5 stars 10 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.