Does 3 Vials Of Sculptra All At Once Increase My Risk Of Granuloma Development?

I see that it is typical to get 1-2 vials per session. I had 3 Vials of Sculptra on First Visit, 3 Days Ago. My Dr. gave me 3 on the first visit (and said she could give me 4). I will go back in 5 weeks to get more. I think I am only willing to get one more vial. Most likely the Dr. will say I need two more. I am a 56 year old athlete with a thin face.

Doctor Answers 8


Thank you for your question. The standard is 5-6 vials for your age over several months.  You will have to monitor your results to see and determine if this is going to achieve your goals. I hope this helps!

Bay Area Dermatologist
3.9 out of 5 stars 12 reviews

Decreasing the risk of granuloma formation

The reconstitution method and injection technique play a much larger role in reducing granuloma formation than the amount of product injected.  Be diligent with your post-injection massage of the treated areas, and follow your doctor's recommendations.  

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

Three vials of Sculptra is not unusual.

Sculptra stimulates collagen growth.  Recommendations of the amount used is based upon the individual assessment of the client.  One of the highest risk attributed to the use of Sculptra is granuloma.  Reducing the amount of the product used doesn't reduce the risk of granulomas.  Dilution and distribution of the product and post-procedure massage are essential to decreasing this risk.  Therefore, three vials may be warranted, and with the correct dilution and distribution of the product followed with massage, one would have a low incidence of granuloma formation. 

Nana N. Mizuguchi, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 50 reviews


The amount of Sculptra used per patient is tailored to how much volume is needed for that patient for optimal results.  I do not feel that the chance of granulomas increases with the amount of Sculptra used, but it is more likely due how the patient responds to the product or product placement.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Sculptra Nodules.

The number of vials of Sculptra that you receive at a session does not influence nodule formation.  3 vials at a sitting is perfectly acceptable, and the number administered generally is governed by how fast you want a result and budget of the individual. 

Sculptra is a volumizer, not a spot filler like most of the fillers you may have experienced or heard about.  Too little treatment will lead to an incomplete result.  Thin faces often need more stimulation from Sculptra than do fuller faces, but every patient responds a little differently. Sculptra can't be beat for the natural look that can be achieved and the youthful healthy look that results.  I hope you get great results!

Deborah Ekstrom, MD
Worcester Plastic Surgeon
4.7 out of 5 stars 39 reviews

SCULPTRA - "Enough" may be one vial or six vials

I have been a trainer for Sculptra since it was first released for HIV patients and continue to train now for both Cosmetic and HIV patients. I emphasize that the treating physician must use enough to get an adequate result.  It seems you physician is doing the right things for you.  I do not believe the chance of granulomas increases with the amount used, but is due either to patient response or injection in the wrong area.  Dr. Mayl Fort Lauderdale  

Nathan Mayl, MD (retired)
Fort Lauderdale Plastic Surgeon
4.3 out of 5 stars 7 reviews

Does treatment with 3 vials of Sculptra increase chance of granuloma?

When treating patients with Sculptra, the treatments are individualized for each person.  Some people may only need one vial per treatment and others may need more.  Treatment with three vials of Sculptra in a session would not necessarily be considered excessive, but it would depend on the patient's starting point and the areas being treated.  Each physician may have a different opinion of how much to use for an individual patient.  Using three vials in a treatment would not necessarily increase the risk of developing a granuloma or other side effect.  If an excessive amount was placed in one particular area, then it might lead to a higher chance of a complication.  I would also say that in my experience, athletes with thin faces sometimes do not respond as well to Sculptra as other people.  I still think that it is worth trying but would caution you as to your potential final result.  

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

Sculptra: An injectable nightmare

 Here is a story about Sculptra, please stay away from iy.

I don’t really need to see Dr. Klein but I want to relay a thank you to him for his stance on Sculptra in Realself. I was just released from the hospital 3 weeks ago and nearly lost my life. I have used Sculptra over the last 6 years and I loved it, until now. I had a deep neck infection or abcess that was linked back to sculptra. I had a touch up 3 weeks prior to getting sick. I had a surgery to put a drain in my neck and was given antibiotics, 24 hours later my airway was closing again and the infection was spreading. The doctors couldn’t understand why it was still spreading. I had a 2nd surgery to place more neck drains, intubated and put in ICU. My daughter was looking into all the case studies for sculptra and found out that the staph and strep biofilm infections are methicillin resistant and talked to my doctors. I was put on vancomycin and I it began killing the infection. It wasn’t MRSA because I was tested for that, it was directly related to the sculptra, my body was rejecting. I had a 3rd surgery to place more drains, a total of six. I spent a total of 16 days in the hospital, 8 in the ICU and came home on 4 IV antibiotics and all the drains in place. It has been a few weeks with all the drains removed and off all meds. I am grateful to be alive and I respect what you are telling people because it is true. I don’t want to see anyone have to go through what I just endured and what my husband and daughters went through. I feel that the makers of sculptra are hiding facts and it has everything to do with money. Again, I just wanted to express my thanks to you for being honest and taking a stand.

Arnold W. Klein, MD (in memoriam)
Beverly Hills Dermatologic Surgeon
4.8 out of 5 stars 5 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.