How Can We Be Sure That 1 Vial of Sculptra is Being Injected?

Sculptra (like Botox) is a product that is used by physicians with various amounts of diluting anesthetic and/or saline, but the amount delivered is ultimately the same. The vial has a fixed amount in it, and no matter if that amount is delivered in 5 cc or 10 cc total, you're still getting the full vial. In fact, more liquid is often better, so don't worry about higher dilutions.

Ultimately, you can't know by the amount injected how much of the vial you've received unless you monitor the dilution, but I don't recommend that at all. It is a matter of trust. I believe it's fine to confirm with your provider how much of the vial (or how many vials) you've will be receiving, but it's concerning if you haven't established this level of trust with your provider prior to injection.

Before you let anyone inject any amount of any product in your face, I believe it's important to establish a relationship based on trust.

Sculptra comes as a powder in a vial. You might probably be billed based on the number of vials used. It is usually one or two. The powder must be mixed with both sterile water and a local anesthetic. There has been a trend to increase the amount of fluids used to mix the powder to decrease the concentration of the Sculptra to avoid nodule (bump) formation. A physician could get 5 or 10 ccs of this solution from one vial.  Ask your physician how many vials were used. Sometimes there might be more on one cheek than the other to create symmetry if there was an unbalanced volume noted preoperatively.

it would be easy to fool a pt with a placebo or diluted product. So you have to have faith in your doctor. if the price is too good, then that might be a red flag. ultimately, the leap is yours to take.

You need to find a doctor with a solid reputation in the community so that you can trust what he/she says.  If you are thinking that your doctor is cheating you , you need to find a new doctor.  The integrity of your doctor is of the utmost importance.

I would recommend asking your Dr. how he dilutes the Sculptra.  Package insert recommends 5 cc of water.  However, I use more than 5 cc of water to minimize the risk of papule and/or nodule formation (i.e. small bumps in the deeper skin that you can feel, but usually not see).  I usually use 8 cc's of water at least 24 hours before and add 2 cc of lidocaine (a numbing agent) the am of the procedure.  Most injectors that I know use more than the recommended 5 cc water dilution.  I usually fill 4 (four) 3 cc syringes with about 2.5 ml of diluted Sculptra.  This added volume is what often gives an immediate, albeit short term aesthetic volumized improvement.  Several treatments are usually recommended to stimulate new collagen and achieve longer-term satisfaction.  Also, extra volume is probably more expensive, albeit minimally.  It requires more water, anesthetic solution, syringes and needles and probably more time to inject.  Sounds like he is doing OK for you.

Because keeping someone attractive and younger-looking entails an ongoing relationship between the doctor and the patient, trust is the most important part of your treatment. The effectiveness of your Sculptra treatment depends on your physician’s ability to visualize the desired changes and to select and skillfully administer the best treatments alone or in combination. Your trust in your doctor is essential. If you do not feel comfortable in trusting your doctor, you need to find another doctor with whom you feel more comfortable. Sculptra is supplied in glass vials and should be reconstituted with sterile water at least overnight and preferably one to two days prior to use so you would really have no way of knowing if you were being cheated by your doctor. Find a doctor you trust.

It is absolutely reasonable and appropriate to dilute Sculptra with water and with local anesthetic to decrease the frequency of lumps.  I generally do this at least 24 hours in advance of the time of the patient’s appointment.  I have never been asked but I doubt that I would allow a patient to watch me do this.  If there is so little trust on the patient’s part, I agree with an earlier responder that it would be better for the patient to go elsewhere for this filler.

It is difficult but can be done. Come in and watch the doctor unseal the fresh vial and mix it with sterile water and lidocaine, you then lock it in a portable gunsafe which you leave at the doctor's office. Come back when it is ready, take the bottle out and watch them load the syringes. Use the same syringes for injection. It is simpler to go to someone you trust.

If you are concerned about your physicians honesty, you should go elsewhere.

However, with all injectables, you can request that the original bottle be shown to you and the syringes filled from that container.

however, Sculptra is best mixed well before hand so that it is smoother. (we use 24 hours as a minimum.).

consequently you cannot request it be mixed on the spot.

if you are ever foolish enough to have an injection by an unlicensed injector (we have many in Florida) you are likely to be substituted as well as watered down.

Dr. Mayl

Fort Lauderdale

You are right, that it is impossible to know if your docotr is really injecting the product, or amount that you paid for.  This is why you chose a board certified plastic surgeon and ASPS member. They are obligated to adhere to the standards and ethics set forthby the society.  Some unscruptulous doctors may over dilute botox or sculptra or inject less volume than they say they are. There has to be some level of trust in your doctor. Also, if the price seems too low compared to market value, then there is a good chance that the product is over diluted or you are not getting the adequate dose. When I see Botox advertised for $150 per area, I am always a little suspicious.