I've Had the First Treatment with Sculptra and my Laugh Lines Have Actually Deepened. What to Do?

10 days ago I had my first Sculptra treatment...I was advised that I was an excellent candidate and since I wanted the subtle slow improvement I would love this. 5 days after my laugh lines have actually become more pronounced...make me look older now for sure. I'm just sick...my doctor said he had never had this happen...I need suggestions. Help please.... R Kelly Birmingham,Al

Doctor Answers 9


You most likely are experiencing swelling at this point as it is too early for the effects of Sculptra to be apparent.  Give it a few weeks for the swelling to taper and follow-up with your physician.

Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Effects of Sculptra gradual over weeks

It's unlikely that 10 days after a treatment the Sculptra has caused a significant change in volume.  The transient swelling from the injection may be the reason your smile lines looks more pronounced right now.  Give it a few weeks to settle down and then reassess it with your physician at that point.    

Donald B. Yoo, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 57 reviews

Sculptra and Laugh Lines

Sculptra fills volume, but only where it's put. It could be that the new volume you have (in the relatively short time you've had Sculptra), has made the laugh lines more obvious. You could absolutely fill these with a substance like Juvederm or Restylane, but I'd recommend waiting until you see the full effects of the Sculptra first. 

Cameron Rokhsar, MD, FAAD
New York Dermatologic Surgeon
4.5 out of 5 stars 35 reviews

Sculptra Helps Build Volume, Doesn't Fill Lines

Be patient.  Sculptra stimulates your body to rebuild collagen, which takes months.  One treatment is definitely not enough though to correct laugh lines.  2-3 vials is almost always needed to see improvement. The best thing to do is to wait at least 3-6 months to see the full effect of the one treatment you've had. If you don't want to wait that long, you could use a more rapidly effective filler in the area like Juvederm, Restylane or Radiesse. Sculptra is not a line filler.  

Missy Clifton, MD
Bentonville Dermatologist
3.7 out of 5 stars 3 reviews

Slow and Steady

Sculptra is an excellent option for facial volumizing.  It is important to be patient and allow for natural subtle results which can take up to 4-6 weeks.  Final results are typically seen over a series of treatments over several months.   Swelling is typical and will go down in time.  If you continue to be concerned, seek 2nd opinion for reassurance.

Richard W. Maack, MD
Saint Louis Facial Plastic Surgeon
5.0 out of 5 stars 46 reviews

Sculptra takes 6 weeks to show results

The doubled edged sword of Sculptra is that it takes 6 weeks to show full result. This gradual improvement is attractive to some patients, but it requires patience. Right after injection, the swelling associated with injecting multiple vials of fluid into the skin can be mistaken for the volumizing effect of Sculptra. Since the swelling largely resolves within one week as the fluid is absorbed, many patients mistakenly think they look worse once the swelling is gone. Careful review of before photos, however, can be very important in reminding both the patient and the physician of baseline wrinkles/volume status. Sculptra is a great product that yield reliable results, and it is my hope that your current disappointment will be gone in a month.

Ramona Behshad, MD
Saint Louis Dermatologic Surgeon
5.0 out of 5 stars 6 reviews

Sculptra usually takes up to 6 weeks for improvement


  If the treatment area was the nasolabial fold (laugh lines) and not to the surrounding lower cheek area, you may just need to give it more time.  Sculptra usually takes up to 6 weeks for improvement.  Give your body time to react and build collagen. You may also consider the use of another type of filler, such as Perlane or Juvederm Ultra, to correct the nasolabial fold.  With the hyaluronic acid fillers, the correction is "immediate" and most patients are very pleased with the results. 



Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 117 reviews

Laugh lines more prominent at ten days after Sculptra treatment

It is not uncommon to experience moderate swelling for a period of two to three weeks in the regions injected with Sculptra.  This swelling accounts for the more pronounced smile lines that you are noticing.  Relax and allow enough time for the swelling to dissipate. Good luck.  

Joseph N. Togba, MD
Oakland Plastic Surgeon
4.6 out of 5 stars 17 reviews

Sculptra results

In order to get good results with Sculptra, several treatment sessions normally need to be done.  Typically, after just one treatment, I would not expect there to be a significant change.  In your case, you feel that your laugh lines have gotten worse after the procedure.  Since it is only 10 days after the injection, I would do nothing but wait.  It is possible that the area looks worse just from the swelling involved with the injection.  I would also say that no matter what it looks like now, it definitely will still change, following the normal course of the treatment.  I would wait at least 4-6 weeks from the time you had the first treatment to evaluate the true results.   

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 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.