How Does Sculptra Work?

Is it true that Sculptra was originally on the market for people with HIV?  Could it help someone look younger, even if they don't have HIV?  What is fat wasting?

Doctor Answers 18

Sculptra rejuvenates skin

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Sculptra is used much more for cosmetic reasons than for HIV and will likely soon gain FDA approval for cosmetic use.

Sculptra has been used with such great success that it is often called the "Liquid Face Lift". This non-invasive treatment corrects the deepest of creases and wrinkles with long-term results using a biodegradable material called "poly-L-lactic acid". Studies have shown that Sculptra's potency can even correct lipoatrophy, a condition that causes facial fat loss. Using numbing medication to minimize discomfort, Sculptra is injected using a fine needle. It works by stimulating collagen production in the skin and fills in what has been lost with age. Results are gradual and, depending on the level of improvement desired and the severity of the problem, anywhere between 3-5 monthly treatments may be needed. Once the desired look is achieved, this semi-permanent treatment appears to last greater than two years.

The best areas for Sculptra treatment are cheeks and jowls.

The worst areas for Sculptra treatment are the eyelids and tear trough areas.

Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Scupltra isn't just for HIV

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Sculptra® is approved by the FDA for restoration and/or correction of the signs of facial fat loss (lipoatrophy) in people with human immunodeficiency virus. It is used "off label" in non-HIV patients. It is my preferred filler for patients like, as you describe, have lost fat in their face and either don't have any fat for transfer or would rather not undergo that procedure.

Fat wasting is mere loss of fat in the face or anywhere else for that matter this can occurs with aging. Sculptra® is a safe product that relies on your body's reaction to it to "fill". It also causes thickening of the skin. It is important to realize that it usually takes a couple of treatments to get to the desired result (which may take 3-6 months). Once the endpoint is reached, it may last up to 2 years.

Jeffrey Kenkel, MD
Dallas Plastic Surgeon

Sculptra to help you look younger

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It is important to understand the difference between "stimulatory" fillers and "wrinkle" fillers. When treating problems due to volume loss (fat wasting) such as cheek hollows and sagging skin beside the mouth, I will almost always use stimulatory fillers such as Sculptra and/or Radiesse. They are injected more deeply, beneath the skin, and will generate more volume to create a much better lifting effect for sagging skin. They work by stimulating your skin to produce more collagen, which is why they are so effective, and give longer-lasting results too. I often combine Radiesse and Sculptra treatments for different areas of the face as I feel they each have certain advantages, when properly used, to fix specific problems due to volume loss.

It is a very safe treatment but please remember, your results depend upon the skill and experience of your physician injector. 

Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
4.4 out of 5 stars 13 reviews

Sculptra for facial rebalance and volume for a number of reasons

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Sculptra was initially FDA approved for HIV patients here in the US but had been used for a number of years in Europe and the UK for cosmetic use. It was used off label here since that time - and even before for the investigator trials. In 2009 the FDA approved it here for cosmetic purposes. The HIV patients were essentially having the treatment for cosmetic purposes but the approval initially did not include a broad scope cosmetic use for those simply seeking aesthetic improvement.

Facial fat wasting is an unwanted loss of the fat that keeps the face plump. Excess fat loss in the face leads to a gaunt appearance which can be aging. Your doctor is correct in stating it can make you look more youthful.

I will often use Sculptra as a re balancing agent. Most of us have some level of asymmetry in our facial features - one cheek may be wider, one jowl area lower or heavier, one or both temples depressed or pinched. Sculptra can be used to bring the face into a more harmonious balance so you just "look better".

Primary reputation at this point is that Sculptra is used to restore lost volume, but it can be used just as well to create volume that was never there in the first place.

I have many younger patients who particularly enjoy the effects of re balancing as it evens out features and makes them look and feel prettier.

Rebecca Fitzgerald, MD
Los Angeles Dermatologic Surgeon
4.1 out of 5 stars 22 reviews


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Sculptra is an injectable filler able to restore volume and correct the signs of facial fat loss. Sculptra is made of poly-L-lactic acid (PLLA), a synthetic material that is biocompatible and biodegradable. Sculptra is injected beneath the skin's surface, resulting in a gradual and significant increase in skin thickness, and may be used to treat sunken cheeks, hollow eyes, indentations, folds and other sunken areas.

Good candidates for Sculptra injections include individuals who are physically healthy, realistic in their expectations and looking to improve the appearance of facial fat loss. Sculptra is not appropriate for those who are allergic to any of the ingredients in Sculptra or have an active skin infection or inflammation in the treatment area. Sculptra can provide results lasting up to two years.

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 124 reviews

How does Sculptra work?

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Sculptra works by stimulating the body to produce its own collagen in response to the product after it is injected into the facial soft tissues. Sculptra is made of poly-L-lactic acid.

The product was originally approved for HIV patients with wasting in the facial soft tissues, but is now used commonly for restoring volume and reversing the signs of aging in non-HIV positive patients. 

All the best,

Matthew Richardson, MD
Frisco Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

How Sculptra Works

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Sculptra is an injectable filler able to correct the signs of facial fat loss. Sculptra is injected beneath the skin's surface gradually increasing the skin's thickness. It is used to treat sunken cheeks, hollow eyes, indentations and other sunken areas.

Hardik Soni, MD (not currently practicing)
Summit Emergency Medicine Physician

How does Sculptra work?

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Sculptra is an injectable form of poly-L-lactic acid, a biodegradable, biocompatible synthetic polymer that has been widely used for many years in dissolvable stitches. Sculptra is a powder form of the absorbable suture material that has been safety used for many years. Sculptra is mixed with water and injected below the surface of the skin to stimulate the production of collagen. This helps restore the facial volume you have lost and will even improve the appearance of your skin resulting in brighter younger healthier looking skin.

Sculptra is the safest filler to use for restoring volume in your temples. Sculptra is used to restore volume over cheekbones, the lateral cheek area, the jaw line, the chin and sometimes the nasolabial folds.

After your Sculptra treatment it may appear that it worked immediately because of swelling from the water used to dilute Scupltra. In a few days the swelling goes down as the water is absorbed by your body.

 You will start seeing results in a few weeks with peak results occurring around 6 months later. The results will last another 2 yrs before starting to diminish.  Patients need an average of one vial for every decade of life. So a 50 yr old would on average need 5 vials. I would inject 2-3 vials of Sculptra at their first visit and reevaluate their needs in 6-8 weeks.

Sculptra is considered the most cost effective filler for restoring facial volume.


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Sculptra was originally used for patients with facial atrophy due to HIV. It was used off label by many doctors for this purpose. Several years ago, Sculptra received FDA approval for cosmetic use. Sculptra is a pulverized poly-lactic-acid filler. Your body recognizes these particles and begins to build collagen around them. This process causes a gradual expansion of volume under the skin over a period of 12 weeks. YES, Sculptra is safe. 

Laura E. Skellchock, MD (in memoriam)
Boca Raton Dermatologic Surgeon

Sculptra is safe

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Sculptra Aesthetic started out as a product to help HIV patients build lost collagen, but has since become an option for anti-aging as well. It is made out of the same material as dissolvable sutures. When it is injected, your body has a response to build collagen around the foreign material. After your body builds collagen around the injection, it dissolves and you are left with your own natural collagen. Because of the gradual nature of this product, we recommend that patients come in 3 times 4 weeks apart to get the desired result.

Jeffrey W. Hall, MD
Austin Plastic Surgeon
4.4 out of 5 stars 19 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.