Restylane SubQ vs. Sculptra

A year ago I had restalene sub q injected into my cheeks. On occasion after this the cheeks would swell and become tender for a few days and then go away. Apart from that the results were good. All the restalene is gone now and I am thinking of having Sculptra instead but I am afraid that I may get a worse reaction to it which would cause Granulomas. The swelling was like an infection with the sub q and I do not want it to be worse and last longer with Sculptra. I am prone to getting infections.

Doctor Answers 12

Restylane SubQ vs. Sculptra

Both previous expert posters have given you excellent reasons not to use Sculptra vs Restylane SubQ. I agree. But to simplify, Sculptra is not a "filler" it is a stimulator of collagen product by the poly lactic acid. It takes many series of injections over 3 to 6 months to attain a volumezing effect. Which lasts from 6 months to a year. While Restylane is a HA filler giving immediate volume by the amount injected. It lasts a few months but you need only 1 or 2 sessions. Best to you 

Lumps and granulomas after restylane vs. Sculptra

All fillers can cause lumps, but the lumps that are created by Sculptra can be delayed secondarily being caused by granulomata.  The lumps of Restylane or Juvederm can be injected and considreed side effects can be monitored.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
5.0 out of 5 stars 38 reviews

Fillers and swelling

All fillers can cause swelling and granulomas, and firmness.  I prefer to use the hyaluronic acid products myself because they can always be dissolved if there is an undesired result.

Steven Wallach, MD
New York Plastic Surgeon
4.0 out of 5 stars 23 reviews

Restylane vs Sculptra

It is natural to have some swelling for 2-3 days following Restylane injections, because the Restylane absorbs water fron the surrounding tissues.  The tenderness may have just been  caused y the injection trauma. Restylane (Hyaluronic Acid) is very well tolerated.

With Restylane, the improvement lasts 6 months, occasionally longer.

Sculptra, unlike Restylane, is not  a filler. It is a stimulator of the body's own cells (Fibrocytes) which will start producing more collagen when stimulated.

The results may last 1-2 years with Sculptra

There is a much lesser incidence of nodules, now that  the dilution of the Sculptra has been increased.

Eugene Mandrea, MD
Chicago Dermatologist
4.5 out of 5 stars 4 reviews

Restylane vs Sculptra is Like Apples vs Oranges

Sculptra and Restylane are two completely different fillers and do completely different things. For long-lasting volume correction, Sculptra is by far the best product on the market. When properly injected, Sculptra has given physicians and patients a new dimension in facial contouring by revolumizing the aging face through a minimally invasive approach. Sculptra injections are well-tolerated by patients. They have a low incidence of side effects and results in high patient satisfaction. Seemingly small changes in shape, proportions, balance, and symmetry can have a surprisingly large effect on our perception of the aging face. When Sculptra is properly reconstituted and properly injected, nodules or granulomas are quite uncommon.

Restylane, on the other hand, is best for superficial wrinkle lines in the skin and should not be used for volume replacement. Restylane is the icing on the cake, but the cake first has to be shaped by using Sculptra.


Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
5.0 out of 5 stars 10 reviews

Reaction to Restylane for cheek augmentation

 Restylane is a fine product, IMHO but to thin for cheek augmentation.  For shaping cheeks, chin and jaw line, I prefer using Radiesse or Perlane.  Given your concerns about granulomas, all these fillers have about the same rate of their formation....I'd try PerlaneSculptra is another fine product but in my eyes is better at filling in defects or depressions than it is at creating raised curved shapes like the cheeks.  For that I believe a larger molecule, like Radiesse or Perlane shapes the tiissues to a greater extent.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 17 reviews

Restylane vs Sculptra risk of side effects

Restylane and Sculptra do different things.  Restylane is a hyaluronic acid filler that adds volume by filling the areas of the skin where it is injected.  Hyaluronic acid is a normal constituent of our skin.  The risk of infection with Restylane is very low.  The risk of granuloma formation is very small.  And Restylane can be dissolved with hyaluronidase if there is a problem with the injection.

Sculptra is a biostimulator, which means it stimulates your own new collagen formation in the skin.  Sculptra can provide excellent overall facial revolumization.  It is true that there can be nodule formation, but since the dissolving protocol and the massage protocol after injections have changed, the frequency of nodules after Sculptra injections is significantly less.

The risk of true granuloma formation from dermal fillers ranges from 1 in 100 people to 1 in 5000.  There is no way of predicting who will get granuloma formation and these can form several years after injections.

As far as infections after filler injections are concerned, the area of injection has to be very clean, all the numbing cream has to be thoroughly removed.  No injection should be performed through any infected area at all.  And if the patient is immunosuppressed and gets infections often or easily, filler injections may be contraindicated altogether. 

I am not certain that what you describe were infections.  Infections don't come and go.  They either resolve or continue to progress.  Is it possible that you had acne cysts or a similar process happening there?

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

Restylane vs sculptra

Restylane is a very safe product with results that are immediate and last 9-12 months, Sculptra takes several injections over a few months time. because it stimulates collegen the enhancement seen is more permanent.The lower cost of Restylane and it's immediate results favors it's use. However for more expense Sculptra will give a longer lasting result. Your problem was most likely due to injection technique and not the product.  Restylane and Sculptra are completely different compounds so, using should be ok with proper sterile technique.

David A. Bray, Sr., MD
Los Angeles Facial Plastic Surgeon
4.5 out of 5 stars 6 reviews

Restylane vs. Sculptra


If what you are looking for is more volume to your cheeks I would advise you consider an HA filler such as the Restylane instead of Sculptra. You could try a different filler if you had problems with the Restylane, I use Perlane (among other fillers) for volume enhancement and find that it gives my patients 12 to 18 months of correction with virtually no problems. I find that it is difficult to attain the same degree of improvement (and often at a much higher cost) with Sculptra. Good luck.

Dr. A. Gantous


Andres Gantous, MD
Toronto Facial Plastic Surgeon
5.0 out of 5 stars 16 reviews

Sculptra not an ideal cosmetic treatment.

Sculptra does provide lasting (but not permanent) volume.  By injecting this product within the cheek fat, granulomas are hidden in the deep cheek volume.  As the material is placed close to the skin, the risk of irregularities increase.  There are a couple of issues to be aware of with the Sculptra: 1) the product takes time to see the result of volumizing.  Some patients find the process frustrating.  2) There is no easy way to deal with lumps and bumps that do become visible.  Restylane sub q is a product that is unlikely to be approved for use in the United States due to the problem of lumps and bumps.  This is a product that behaves much more like an implant.  It is excellent for deep volumizing.  However if is placed close to the skin surface, lumps and bumps can be a problem.  Fortunately, like all hylauronic acid fillers, this service can be modified with an enzyme treatment.  This flexibility tips the balance to Sub Q as far as I am concerned.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
5.0 out of 5 stars 22 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.