Sculptra Treatment Caused Puffiness on Upper Cheek Under Eyes, Now What?

Fluid in this area can be caused by several factors such as sinus and allergy. What you're describing appears to be "malar edema" or "malar festoons". Assuming the Sculptra is no longer creating significant inflammation, it may be beneficial to check if sinus or allergy problems are contributing to the swelling in your upper cheek area below eyes. In our practice we have had success with treatment of some cases of malar swelling with nonsurgical treatment such as Pelleve' Skin tighening for the eyes and face and Fractional CO2 laser skin resurfacing for the eye area and face. It may also be best to just wait for a few weeks more and seeing the progress.

Typically this will resolve with time. Massage is critical. I would suggest you follow up with your surgeon for evaluation and options.

Usually the edema from Scultra treatment lasts about 3-7 days but can potentially last longer.  Sculptra can be injected into the top of the cheeks but does not do well when injected around the eyes. 

Dermal volumizers like Sculptra and Radiesse should not be injected into muscle, particularly circular muscles like the ones around the eyes (orbicularis oculi) and mouth (orbicularis oris).  The circular muscles act like a pump and when irritated by the particles of filler injected into them, try to discharge those particles out of the muscle.  That results in nodule formation.

Since what you describe sounds more like swelling (edema) rather than nodules, it is possible that the swelling will yet resolve.  Try icing the area for 5 minutes every 2 hours while awake.  Take care not to freeze the area as the eyelid tissue is very delicate.  I also recommend that you consult a board-certified dermatologist or plastic surgeon with training and experience in Sculptra injections for a second opinion.  Also, if you have before and after photos from each treatment, those would be helpful in the evaluation.