Sculptra Panic Attack?

Hi, I am two days post sculptra treatment. I went to a very experienced, highly recommended doctor and he recommended sculptra. However, I am utterly HORRIFIED having read so many stories of lumps and nodules forming, I will not be going to my follow up appointment due to the risk! Are there less risks of lumps forming if you only have one treatment? How long does one have to wait before having a hyaluonic acid filler put in the same area as the sculptra as I would rather go this route instead!

Doctor Answers 9


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Sculptra is poly-L-lactic acid, and works very well to rejuvenate hollows and fill volume loss by stimulating collagen production.  It was first approved to treat fat loss seen in patients with HIV.  The risks of lumps and nodules are very low when the correct dilution is used, as well as when the Sculptra is placed properly- injections should be deep.  It's important to go to an experienced injector who is board-certified in dermatology or plastic surgery.

Aventura Dermatologist


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We always recommend massaging the treated areas 5 times a day for 5 minutes each time for the next 5 days.  It's good that you saw a physician who is experienced with Sculptra treatments.  

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Dilution is key

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I think the risk of nodules forming is lowered by using a more dilute formula, injecting into the deep planes, and massage. At the earlier dilutions (5cc s per vial), nodules were much more common. Now we are reconstituting each vial with 19 cc water and 1 cc lidocaine. Nodule formation has reduced significantly.

Marilyn Pelias, MD
New Orleans General Surgeon

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Minimizing the risk of nodule formation after treatment with Sculptra

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By choosing an experienced doctor, your chance of forming nodules and lumps is minimized.  Massaging the area in a circular motion for 5 minutes, 5 times a day x 5 days is also recommended to reduce the risk of nodules.  It would be advisable to wait a minimum of 6-8 weeks to allow the Sculptra's effects to become manifest before undergoing treatment with a hyaluronic acid.   

Donald B. Yoo, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 64 reviews

Nodules after Sculptra injection

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It was wise of you to go to a physician experienced in Sculptra injections, as this will decrease your risk of nodule formation. Most experienced injectors dilute Sculptra in order to decrease the risk of nodules forming. I also have my patients massage their face regularly after injections. Finally, I feel that my technique helps to decrease the risk of nodule formation as well. I have not had any issues with nodules by adhering to these principles. If you do not want to continue with Sculptra treatment, then you can certainly switch over to treatment with a hyaluronic acid filler; however, you should wait until the clinical effects of the Sculptra have been fully realized. Just follow up with your physician, and they will be able to help guide you.

Ryan Greene, MD, PhD
Fort Lauderdale Facial Plastic Surgeon
5.0 out of 5 stars 85 reviews

Risks of lumps from Sculptra

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A significant reduction of the frequency of nodules from Sculptra injections has been achieved with higher reconstitution volume, a longer time between reconstitution and injection (36-48 hours rather than 2-12 hours), injections into the deeper tissue, and post injection massage. In a recent study, 8.5% of patients injected with Sculptra experienced formation of nodules. All nodules could be felt but were not visible. The onset of nodule formation from the time of injection can vary. Early nodules appear one to three months after treatment and most spontaneously disappear. Nodules can form for a variety of reasons which include injecting too superficially, insufficient time for reconstitution, inadequate dilution, over correction, increased concentration of Sculptra caused by muscle movement, or allergic or inflammatory host responses.

Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
4.7 out of 5 stars 12 reviews

Sculptra Lumps Unlikely

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Relax!  If you went to an expert injector you should not get any lumps especially after 1 treatment.  Sculptra stimulates your own collagen so nothing else works quite like it.  If you were to get a lump it will go away with time.  Sculptra continues to improve over 3-6 months, I would wait to see the full result before adding filler.  Botox can be done at any time after the injection.  

Janet M. Neigel, MD
Florham Park Oculoplastic Surgeon
4.6 out of 5 stars 21 reviews

Sculptra is a fantastic product in experienced hands

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I applaud you for going to an experienced injector. That is a very important factor in preventing nodule formation with Sculptra, which can be caused by improper Sculptra preparation, inappropriate treatment area (i.e. around the eyes), and/or depth of injection (too shallow). Most commonly, nodules are felt (but rarely seen) within months of injection and usually resolve, although it can take a year or two. Massaging immediately after injection helps evenly distribute the product, as does massaging injection sites for five minutes five times daily for five days after treatment. I feel this is very important in preventing small nodules. Nodules can also develop months to years after injection, and these nodules are unpredictable and are caused by the patient's immune system causing inflammation in the injection area. This also usually resolves with time, although it can be hastened by steroid injections. I would not rely on the internet for information over your injector. While the internet can be a great source of information, it can also lead to anxiety regarding side effects that are relatively uncommon and usually self-resolving.


If you have had Sculptra, it is not uncommon to have a hyaluronic acid filler injected into the same area.  Fillers such as Juvederm and Radiesse can be used in different places and layers to further enhance areas. I wait at least a month after the Sculptra series is complete to allow the Sculptra fully take effect.

Ramona Behshad, MD
Saint Louis Dermatologic Surgeon

Sculptra lumps and nodules

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First of all, I would tell you that in the hands of an experienced Sculptra injector, the risks of developing a lump or nodule is very slim.  If you had the Sculptra injected into your cheek area, the risk would be extremely small.  While it is possible to get lumps or nodules after Sculptra, if they do occur it tends to happen in areas of very thin skin.  This is why it is not recommended to use Sculptra around the eyes.  In the small chance that a lump or nodule does form, they normally will fade away with time and there are treatments that can sometimes be done to eliminate them.  I would recommend continuing with the Sculptra treatments, but if you don't wish to do that and want to have a hyaluronic acid filler instead, I would wait one to two months from when you had the Sculptra before using the hylauronic acid to the same area.  

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 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.