For filling marionette lines and cheeks what are alternatives to Sculptura injections?

Sculptra and Radiesse restore volume to the cheeks and mid face. This helps to pull hanging skin folds at the nose and mouth back up in a very satisfying way.
The other fillers are much better at treating the symptoms by filling in lines and wrinkles, but are not actually addressing the cause of the problem in the first place.
Don't get me wrong, I like most of the fillers out there and they all have their purpose, but when I get a patient who is willing to listen to my best advice, I fill the mid face first - and they typically end up much happier.

I recommend fillers to soften the nasolabial folds themselves and also lift around the mouth and cheeks to build underlying anatomical support. In our practice we combine Sculptra with other fillers "layered" on top and lasers, skin tightening treatments such as Thermage, Fractora, and Renuvion (J Plasma), thread lifting, and peels to get the most conservative, natural look. I suggest seeing a facial sculpting expert for a formal consultation. Best, Dr. Emer

For the marionette lines and the cheeks, there are numerous filler options. I tend to use Sculptra for restoring volume in broad areas like the cheeks or temples, but not commonly in the marionette lines.
Products like Restylane, Restylane Lyft, Voluma, Juvederm, and Radiesse can all work well in the marionette lines and the cheeks. Voluma is a great option as long as you are addressing primarily volume deficits and not superficial fine lines around the mouth.
All the best,

Hello, 

Thank you for your question. There are several options. You could use something like Juvederm, Restylane, or Perlane to correct the marionette lines. Then there is Voluma or Radiesse for your cheeks. It is best to visit a local physician for a complete consult on which treatments would be best for you. Good luck!

In the rapidly evolving world of fillers, there are more and more alternatives to Sculptra.  Patients should consider an injector with multiple alternatives to provide appropriate filler.  Some alternatives include:-Radiesse-Juvederm Voluma-Allofill-Fat transfer

Radiesse and HA fillers are frequently used to treat marionette lines, nasolabial folds and cheeks.  They have the advantage of immediate correction, but their effect does not last as long as Sculptra.

Sculptra is a stimulating agent for collagen and there is no other medication like it on the market.  However, in terms of results, there are several volumizers that can give a good result in the areas of the nasolabial folds and marionette lines, namely, Radiesse, Perlane and Voluma.These 3 agents are great lifting agents and work well to lift the cheek and midface tissues upwards to counter the downward drop of the cheek tissue causing the deepening of the marionette line and nasolabial fold.  Voluma is the closest in longevity by lasting 24 months but requires several syringes to get the same effect.  All of these are popular fillers, including Sculptra.  The most important thing is find someone that does all of them and discuss which ones may be right for you.

There are several options for the marionette region.  Juvederm, Perlane, Restylane and Radiesse are all reasonable options for filling in the marionette region.  I often combine Sculptra with one of the above fillers.  The fillers above are used to fill the area and soften the marionette shadows.  I add Sculptra to further soften the area and give the corrected result more longevity.

Sculptra injections are ideal for replacing lost facial volume when the goal is for natural, long lasting results, and when the patient is willing to wait 4 to 6 months for final results and undergo 3 treatments spaced 6 to 8 weeks apart.  There is no downtime.  With proper technique, and post treatment care, the complication rate is very low and comparable to other filler injections.Patients seeking alternative products are usually either looking for even longer lasting results, such as with fat injections, or want instant results, where products like Restylane, Juvederm, Juvederm Voluma and Radiesse would be used.Fat transfer is a surgical procedure and performed in the operating room under sedation.  There is 7 to 10 days of downtime.  Results are not always consistent from patient to patient and only one third to half the fat injected takes and remains for a long period of time.  This often necessitates a second boost treatment after 6 months.  One has to be careful not to gain much weight as the face will also gain weight, sometimes dramatically, where the fat has been injected.Other fillers are very appealing because the results are instant.  With Juvederm Voluma's recent FDA approval, we now have the option of injecting patients one time with a product that can last up to two years, in a single treatment safely and naturally.  The most important factor is not what product is used but more so where, how much, and the technique used to inject the products.  When done properly, all products will have a youthful volumization to the face.

Hyaluronic acid fillers (Juvederm, Restylane) and Radiesse are great for filling the marionette lines and cheeks.  However, if you are looking for a longer lasting solution, fat grafting and other surgical options may be a better option.