Sculptura Vs. Juvederm For Facial Fat Loss?

Hello, I'm a thin woman in her 30s. I've noticed facial fat loss over time. It's not terrible but I'm definitely looking more "gaunt" these days. I use Botox for forehead lines and occasionally fill smile lines/lips w/ juvederm and love it. Is Juvederm or Sculptra better for filling out hollow areas? I've noticed it around the temples and lower face as well (the "sunken cheek" look). Thanks for any input!

Doctor Answers 14

Facial volume loss

You've asked a very important question. It's  being recognized more and more that loss of facial volume, or in some cases, just a natural lack of balance in facial volume, can be very aging. There are 3 ways to approach the problem:

  1. space-occupying fillers, e.g. Juvéderm, Perlane, etc. (and this includes fat transfer)
  2. a biostimulatory (causes you to make your own collagen) product, i.e. Sculptra
  3. a somewhat biostimulatory, mostly space-occupying product, i.e. Radiesse

The choice of approach needs to be tailored to your specific needs. I use all 3 of the methods, although I rarely use fat transfer at the moment. (That may change as the means to enhance the "take" and predictability of fat improves.)

In general, my approach will usually involve Sculptra because it can stimulate you to make your own collagen, and it can create a very natural, not "I-look-like-I've-had-filler" result. I often then use fillers as a finessing, or instant gratification method.

The temples, in many individuals can be particularly sunken and aging, and in those patients I will use a hyaluronic acid filler, because Sculptra alone may not be enough, or takes too long to get a result.

Most importantly, see a physician who does a lot of fillers, and uses all of them. There is both a science, that is, understanding the anatomy, and an art to facial volumizing. In particular Sculptra is highly dependent on the skill and knowledge of the injector and should never be injected by a novice.

San Antonio Dermatologic Surgeon
4.7 out of 5 stars 63 reviews

Which is more appropriate for facial volume loss? Sculptra or Juvederm?

It's not possible to give an entirely accurate answer without seeing photos or meeting you. However, there are some critical differences between Sculptra and Juvederm. Sculptra (and Radiesse) stimulate collagen formation which results in 2+ years of improvement. Sculptra does require multiple treatments and does not provide any immediate improvement in facial volume. However, Sculptra is a great option for full face revolumization or reshaping. Juvederm provides an immediate correction but lasts somewhere between 6-9 months. It is possible to achieve similar results with both products. Some patients will shy away from Sculptra due to the need for multiple treatments and what is perceived to be a more expensive course of treatment. However, to achieve similar results with Juvederm or another hyaluronic acid filler, most people require many syringes of Juvederm resulting in a similar up front cost but with the downside of a much shorter duration of improvement. I hope this is helpful.

Stephen Weber, MD, FACS
Denver Facial Plastic Surgeon
4.9 out of 5 stars 129 reviews

Sculptra vs Juvederm for volume loss

When comparing Sculptra to the hyaluronic acid fillers such as Juvederm, it is important to understand the difference between "stimulatory" fillers and "wrinkle" fillers. When treating problems due to volume loss such as cheek hollows and sagging skin beside the mouth, I will almost always use stimulatory fillers such as Sculptra or Radiesse. They are injected deeper, 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 for problems due to volume loss. Hyaluronic acid gels like Juvederm or Restylane are used as wrinkle fillers because they are injected more superficially, being injected into the skin rather than beneath it.

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

Sculptra vs Juvederm for Facial volume Loss

In order to really make a decision an in office consultation is needed. However ft sounds like with your description I would probably use Sculptra for you. As you know you should select a physician that is very experienced with this product.What is also nice about this product is that it lasts years for you.

Esta Kronberg, MD
Houston Dermatologic Surgeon
4.9 out of 5 stars 30 reviews

Sculptra vs Juvederm for facial volume loss

In order to make a decision as to which revolumizing agent is best for a particular person, an in-person examination is a must.  There are a number of factors to consider and there are no answers that apply to everyone.

Given that, from your description it sounds like you would benefit from a global facial revolumization.  Sculptra would be the ideal product for that, as it stimulates your own collagen production in the skin and can be placed anywhere from the temples down with the exception of periorbital areas and lips.

Juvederm is an excellent filler, however for a full facial revolumization, one might require a number of syringes, which can be significantly more expensive.

Sculptra offers a gradual improvement in collagen production and lasts approximately 2 years.

Approximately 80% of "aging" changes, such as volume loss, are related to sun damage.  It is essential that sun protection with a broad spectrum sunscreen and sun avoidance be practiced to prevent further volume loss.  Ultraviolet light both breaks down your collagen and impedes the ability of fibroblasts from making more of it.

One of the most important points in the decision making process is to make sure you consult with a board-certified dermatologist or plastic surgeon with training and experience in fillers for facial revolumization.

Emily Altman, MD
Short Hills Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Facial fat loss

Facial fat loss is better replaaced with fat transfer to the face. But fat transfer to the face require expertise and experience.

Samir Shureih, MD
Baltimore Plastic Surgeon
4.2 out of 5 stars 7 reviews

Juvederm or sculptra for facial volume ?

                                                                                                                             Both treatments are beneficial but Sculptra would give more long lasting results than Juvederm in areas that are appropriate for it. Be sure to have a proper consult, addressing risks, benefits before making your decision.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Stimulatory facial fillers including Radiesse

In my opinion, Radiesse provides excellent results and a high, reliable safety record that is unmatched in terms of stimulatory fillers.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 94 reviews

Sculptra for volume, Juvederm for lines

In general, Sculptra is the best product for replacing lost volume in the face. Based on your description of looking "gaunt," you are most likely going to need a fair amount of volume placed out over larger areas of the face.  Sculptra is the best product there.  As a collagen stimulator, you need to know that Sculptra's effects are not immediate, but they are long lasting (at least 2 years for most clients).


For a single wrinkle or focused problem area, Juvederm, Restylane or another HA filler is the best solution.


Your doctor should be able to explain the best choice for you based on your appearance and be able to tell you what to expect after treatment.  Good luck!

Michael Bowman, MD
Roanoke Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Facial Fat loss

Without a photo giving an opinion on what filler is better is not possible. For facial fat loss the best filler would be fat inections.

Walter D. Gracia, MD
Fort Worth Plastic Surgeon
4.7 out of 5 stars 3 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.