Why Does Sculptra Have a Low Rating in Realself?

Question

I'd like to have a bit more volume in my mid-face and buccal areas. While I'm considering fat grafting I think it's risky given the possible asymmetries/ variation in technique so I'm thinking of Sculptra. 1) Why does sculptra have only a 64% rating in real self? 2) What are the risks of sculptra? 3) Is it predictable compared to fat grafting? How can collagen formation be predictable? 4) How much does it cost per vial? Thanks.

Raffy Karamanoukian, MD, FACS · Answer

We have found that Sculptra can add useful definition and volume to the face and is a good complement to other types of cosmetic treatments such as Fraxel, laser resurfacing, chemical peels, and Ematrix skin tightening. Best, Dr. Karamanoukian Los Angeles

Nelson Lee Novick, MD · Answer

When Sculptra first came out I was among the first to use it. However, I stopped several years ago for the following reasons. First, Sculptra is NOT a filler, and thus does not yield immediate results. In other words, there's no "Wow!" response right after treatment, which is so often the case following treatment with dedicated volumizing fillers. Sculptra functions exclusively as a biostimulatory agent, in other words it works by stimulating new, native collagen synthesis (neocollagenesis). Treatment with Sculptra is relatively expensive and optimal treatment usual consists of a series of treatment sessions (typically about three) spaced at several week intervals. Results, once finally achieved, typically last about two years.By contrast, volumizing agents, such as Radiesse and Voluma XC (which I would use in my Upper East Side Manhattan practice), give rise to immediate improvement, often after one treatment session and results tend to last up to two years. (In my Israel satellite facility where a far greater number of regulatory agency approved fillers and volumizers are available, I would opt for Emervel Volume, Stylage XXL, and Teosyal Deep for nonsurgical cheek and temple augmentation). Moreover, it has also been discovered that volumizing fillers, such as Radiesse are indeed biostimulatory fillers that can promote neocollagenesis. As an aside, I also stopped autologous fat grafting quite a number of years ago, as well, once better and longer lasting off-the-shelf injectables, particularly the hyaluronic acid products that have little chance of allergenicity, became available. Fat grafting is relatively expensive, requires a separate procedure to harvest the fat, and despite the contention and the promise that the results were permanent, fat graft survival often didn't realize the promise. In addition, grafted fat retains the properties of the sites from which is taken (e.g.abdomen, buttocks), and thus, whatever fat does survive retains the tendency to put on weight with time, which may ultimately result in a less than optimal result with the passage of time.Whatever you decide, make sure you consult with a experienced and expert aesthetic physician injector.

Jason Emer, MD · Answer

Sculptra is fantastic in the right hands and in combination with other treatments.  It has a low rating because the expectations are typically not discussed prior and most physicians are uneducated on how to use it.  In the right persons hands, this collagen stimuator can give amazing results.  Best, Dr. Emer.

Michele S. Green, MD · Answer

Sculptra is a fabulous product but the reviews of procedures are linked to many factors.  It can be that they were the wrong candidate for the procedure and were not treated by an experienced physician.  My patients have loved Sculptra but it requires patience.  Monthly injections need to be performed over a 4 month period to see the desired results.  The trade-off is that it will last up to two years.  Please consult an experienced board certified dermatologist about Sculptra to have the best cosmetic results.

Martie Gidon, MD, FRCPC, FAAD · Answer

Sculptra stimulates the production of one's own collagen and is one of the best treatments for the buccal area. Patients need to realize that it is not a filler.  It is important to massage the areas treated with Sculptra for at least a week after treatment to avoid bumps.  Three treatments may be necessary to achieve the desired fullness and the result can last 1 to 2 years.

Adrian M. Guevara, MD · Answer

Modern injectors of Sculptra really love the ease of injection, smoothness of the result, overall utility of the product, and long-lasting results up to two years in studies. I would not hesitate to highly recommend Sculptra, as it gives great results.

Stephen Weber MD, FACS · Answer

To really answer your question, you would have to review the patient experiences with the product. I do think that Sculptra works. I also think that it's safe when injected by an experienced injector with a solid sense of facial aesthetics. I have also revised many patients who were harmed by an inexperienced Sculptra injector. In my experience, people can be discouraged about Sculptra due to:The number of injections required per session and the resulting bruisingThe fact that they require 2-3 treatment sessions for the full correctionSculptra can take 3-4 months between initial treatment and final resultsCost which can range from $2500-4000Possibility of nodule formation if the product is used incorrectlyWith these caveats, I think that there are better options available. I am performing far fewer Sculptra treatments and more volumizing treatments with Voluma and Radiesse as well as other hyaluronic acid fillers. I do think that Sculptra works but there are trade-offs that need to be addressed prior to treatment. Sculptra is not for everybody but can be incredibly helpful for people with full face volume loss who are willing to tolerate the downtime, multiple treatments and expense of Sculptra treatment. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Edward Szachowicz, MD, PhD · Answer

I have been using Sculptra for almost 10 years and I have
taught many physicians about the use of Sculptra as their instructor. Sculptra is
unique among dermal fillers as it is the only biostimulator of new collagen.
The new collagen which forms, grows naturally, and doesn't have an 'implant look.'
Once the facial volume is corrected, Sculptra can maintain the face's youthful
volume with only 1-2 treatments per year.
Injecting Sculptra does require that the practitioner creates a balanced, aesthetic
look, which does take experience. However, Sculptra restores volume in a more
complete (pan-facial) facial correction, than what you can achieve with more
site-specific gel dermal fillers.

Richard Ort, MD · Answer

Sculptra has been around now for a number of years and it continues to have a unique niche in dermatology.  It is a nice option for someone who needs to restore volume throughout the face as opposed to focusing on one or two problem areas.  It can give a nice, subtle volume restoration to the cheeks and temples with long-lasting results (up to two years).  It is a thinner product when diluted appropriately so it can be easier to inject and spread around larger areas than thicker fillers.Scupltra has never attained a large market share in the filler market, for several reasons.  For one thing, it was a relatively expensive product in the past, but the cost is now more reasonable,  It also usually requires multiple treatment sessions for best results.  Also, results are not immediate but appear more gradually as the body builds up its own collagen in response to the filler.  You don't get the immediate gratification that you get with other fillers.  There were also some problems early on with reactions to the product but those problems can generally be avoided with proper dilution of the product and correct injection technique.  Sculptra needs to be diluted ahead of time (at least 24 hours) which requires more planning on the part of the injector.Sculptra often gets overlooked by people since there are so many other competing fillers out there but it still has a definite, unique role for the right candidate who needs facial volume restoration.

Why Does Sculptra Have a Low Rating in Realself?

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