I think your advice sounds appropriate overall. Sculptra is a natural volumizer which gradually rebuilds collagen and can improve overlying skin as well. It can't be used in the eyelids at all. Fat transfer may also be an option for the lower face and periorbital areas as part of an overall plan for panfacial rejuvenation and revolumizing. Please discuss all options in consultation so you are well informed!
Sculptra cannot be used in the direct undereye or tear trough area. However, with an overall thinner face with hollowing, Sculptra will give you the most natural, well rounded and balanced results in the hands of an experienced injector. Voluma performs better to enhance a specific feature, such as cheeks, or even the chin, while I prefer Sculptra for overall volumnization. Restylane under the eyes is my preferred filler, but less is typically “more” in this area.
Both sculptra and voluma are excellent fillers for volume augmentation. Sculptra tends to be "more natural" in a sense that it stimulates your own collagen growth over time and it's rare to overfill/ cause lumpiness in my experience. It's great for hollow areas in the face with a relatively large surface area (cheeks, lower face, temples, forehead etc). So yes, it works very well on the lower face. Voluma/ hyaluronic acid when injected correctly and conservatively, can also improve the volume deficit in your lower face instantaneously. However, when it's overdone, it can create heaviness in your lower face which is undesired. Best to consult with a board certified plastic surgeon/ dermatologist in person.
Sounds about right. The under eye area would best be treated with either Restylane, Belotero, or, in certain cases, Juvederm. The lower face hollowing needs to be evaluated in person. In general, Sculptra is great for pan-filling. The product is injected all over the face (excluding eye, mouth) and forms a scaffold deep in the skin, on top of which new collagen will grow. This causes filling and tightening. If you have a very specific local hollow, and desire filling instantly, then Sculptra is NOT the way to go. Sculptra fills over 3 months and again is a gradual tightening. In that case, you would choose a hyaluronic acid filler (Juvederm, Lyft etc).
In my experience Sculptra for lower facial augmentation is preferable compared to Voluma because Sculptra (which is diluted with salt water) is more malleable. Therefore, I can achieve a smoother contour of the lower cheeks compared to more viscous hyaluronic acid gels like Voluma or Lyft. When treating the upper cheeks, over the malar bones then I prefer Voluma or Lyft. Belotero or Restylane are fine for the lower eyelids
Sculptra is great for what you are trying to achieve. Reminder, Sculptra is a "volumizer" so do not expect instant gratification. Multiple treatments are typically needed 4-6 weeks apart. The long term affects are amazing if done with an experienced injector.
Hope this helps.
Dr. Grant Stevens Marina Plastic
Surgery Associates Marina del Rey, CA The Institute
I agree with the consultation that you have described. Sculptra is excellent for the lower face. I would consider Belotero or Restylane for the delicate under eye area. Please make sure you consult an expert for the best cosmetic results. Best, Dr. Green
Thank you for your question. For the under eye area, Restylane or Belotero are good fillers to treat this area. If you have a thin face, Sculptra would be the best option as it helps increase the skin’s collagen, a key skin ingredient which gives the face volume and strength.
To give a more accurate answer, it would be vital for the injector to see the exact locations of the hollowing in the lower face. Generally, Sculptra excels at providing a lift with revolumization, particularly in larger and deeply hollowed areas like the lower lateral cheeks and temples. It can provide a nice jawline lift as well. I find the denser hyaluronic acids like Voluma work well above bone in focal areas like the upper cheeks, but may appear too heavy in other larger areas with less underlying support. Restylane or Restylane Lyft would be my recommendation under the eyes as well.
Belotero® and Restylane® are indeed best for under hallowing. Sculptra®/ Perlane®/Juvederm® UPXC are best for volumizing the lower face, although Sculptra® can take up to 1-3 months longer to manifest its results.