While your question is specifically about Sculptra, it really demands a broader answer. Everyone is familiar with the term the "Practice of Medicine" but few pause to actually think about what it means. When an accountant learns how to perform a particular calculation, the result of that calculation performed over and over again forever into the future will be the same if the data in the calculation are the same. However, for a physician, people are never the same and even if we were, the same intervention in the same person may produce different results. A physician should be always learning and gaining experience throughout their career. But, just like with anyone else, physicians have different skill levels and learn at different rates. So, the "first time" a particular physician does a procedure, it might be better than someone else who has done it a hundred times. Just like professional athletes, just because someone is "older" does not necessarily mean that they are "better". And, some physicians, as they age or reach the end of their career, are less aware of new developments or perhaps are not as sharp as they once were. Other physicans are at their "best" as they are ready to retire. So, because medicine IS practice, one must choose someone who is competent and capable, regardless of their experience with a very specific procedure and not necessarily based on age. With respect to injectables, some physicians are very, very experienced because they have injected many patients. If a new product comes out, the skills learned from injecting other products may be applied to the new product and the physician might "instantly" be able to achieve an excellent result. For example, would you rather have a physician who is a radiologist (a physician who reads x-rays) that never has any patient contact that goes to a course and starts injecting Sculptra into patients inject you after they have "tried it out" on two dozen other patients OR would you rather have a seasoned cosmetic surgeon that has injected thousands of patients (with other products) have you as their first Sculptra patient? I know (not trying to speak badly about radiology as a subspecialty, of course) that I'd be the first patient done by the cosmetic surgeon! So, the bottom line is that I would personally inform a patient if they were my first Sculptra patient, but that doesn't mean they will have an inferior result nor does it mean that that's what every physician should or would do. And, while a person should have informed consent about any procedure they agree to, I do not believe that if someone is doing a procedure for the first time the patient needs to be informed "in writing."