Should I Wait Until I Lose All of the Volume in my Cheeks Before Using Sculptra?

I had buccal fat pads removed 10 years ago. Ever since then I can literally feel when I'm burning through the fat. My cheeks feel hot and I have this throbbing feeling. I've labeled these "healing" episodes. My face has less volume each time after this happens. Now I've lost too much volume and I'm considering Sculptra, but I can't tell how much more fat I have to burn through before I stop "healing". Or if the "healing" episodes will ever stop. Can I start Sculptra now?

Doctor Answers 3

When to begin volume restoration is when you are bothered by the volume loss

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I will make the assumption that your primary physician has ruled out any underlying condition that would cause you to lose body fat and also that you are only experiencing this fat loss in your cheeks and not other areas. Lifestyle, including exercise intensity and frequency, could play some part - but you did not mention what precipitates the "healing" episodes as you refer to them. In any instance, it would be best if you know for certain there is no health issue at play before addressing the cosmetic correction.

Sculptra is a collagen stimulator for the skin and as such will boost the volume of your cheeks with your own collagen. If you have ongoing fat dissipation this long, it could be it will continue, so waiting may not be a viable option. Volume replacement with Sculptra, or with a fat transfer using your own fat from another body location, should make a discernible difference.

Los Angeles Dermatologic Surgeon
4.1 out of 5 stars 22 reviews

Timing of Facial Volume Restoration

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Aging is associated with facial volume loss. As seductive as facial (Bichat's) fat pad may initially seem it is usually a long-term miscalculation and in some cases,as you can readily attest to, a disaster. When it comes to reconstructing such faces and the aging face the answer is volume restoration in several sessions. The primary filler is fat. Fat is not only readily available and looks and feels natural, it also has a huge number  of stem cells which rejuvenate the overlying skin making it younger. 

There is no reason to wait and lose more fat. It is best to start facial filling as soon as possible. If fat is not available a second choice may be Sculpta. 

Peter A. Aldea, MD
Memphis Plastic Surgeon

At what point should cheek volume loss be treated?

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A natural consequence of aging is the loss of volume in the cheeks and other regions of the face. This becomes noticeable in the 40's, but may be already very evident in someone in their 30's. Ideally, keeping up with facial volume changes as it is happening will allow for a gradual appearance of maturation (i.e., aging!), rather than waiting until that moment we look in the mirror and look aged.

So what are the best ways to improve the appearance of volume loss? We currently have 2 options:

  • Sculptra, which stimulates you to make your own collagen 
  • Fillers, with Juvéderm Voluma the most recent and exciting addition to our filler options
I've been a patient of Sculptra (as well as treating my patients) for over 8 years, and I don't think anything can do what Sculptra can do for creating a natural and balanced facial shape.

Juvéderm Voluma, the newest filler option in the US, is a phenomenal filler for cheek volume. It offers the best lift and support for depleted and sagging cheeks. I'm very impressed with what I'm seeing.

Kimberly Finder, MD
San Antonio Dermatologic Surgeon
4.6 out of 5 stars 64 reviews

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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.