Sculptra vs Juverderm (photo)

I have pock mark scars between my eyebrows & on my cheeks, I had TCA peel (35%) but this caused more scarring. My skin hasn't been the same since, my cheeks have sagged & my naso labial folds are more pronounced. I'd like fillers but I want something that lasts because I burn up Juvederm & Restylane, but no one will give me Sculptra, why is this? I also want laser for the scarring & to tighten the skin, but what type of laser will achieve this? I have also been on Roaccutane back in 2009/10,.

Doctor Answers 5

Sagging skin and scars

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There is more than one approach to your issues. Your fae is fairly full already, so perhaps physicians have been reluctant to add more fullness with Sculptra. If you are goin to have this filler, it might be best to stay peripheral with it, putting some even under the hairline to drape your skin higher on your fCe. But before doing that, you might want to try a few radiofrequency sessions with Pelleve to tighten the skin.  

The scarring can be approached with CoolTouch laser and/or microneedling, with topical retinoids.

Sculptra Aesthetic for Sagging

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Sculptra Aesthetic is a great option for sagging skin and nasolabial folds. It helps your body produce more collagen, which in turn can contribute to a "lifted" appearance. It's important to remember, however, that the final results of Sculptra Aesthetic can take around 16 weeks to develop, and they can last for more than 2 years. Sculptra Aesthetic is excellent for stimulating your cells to produce more collagen whereas the other fillers immediately replace the volume loss with the hyaluronic acid. Sculptra has a different learning curve and this is why some practices simply don’t offer it.

For scarring, I've seen excellent results with non-ablative lasers, such as the ResurFX and CO2 systems I offer at my practice. Finally there is no contraindication to have taken Accutane like medications in the past and doing laser treatments. We usually wait at least 6-12 months after completing your medication course though.

Sagging Skin and Acne Scars

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Sculptra would be a great treatment for you to give your skin a lift and help look natural.  Your scars would best be treated with Fraxel Laser.  The 1550 setting of the Fraxel will provide great results after a few treatments and little down time.  Thermage could be utilized as well to give your skin tightening and help build up your body's own natural collagen.  Please find a board certified dermatologist in your area to give you the best cosmetic results.

Treatment of sagging cheeks and acne scarring

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Deeper stimulatory fillers such as Sculptra or Radiesse, when strategically injected high along the cheekbones and lateral face, will create a much better lifting effect for sagging skin. For treatment of your acne scars, medical micro-needling, when properly done and combined with effective skin care products such as human growth-factor serums, has been shown to give as good or better results than laser or Fraxel treatments. And at a fraction of the cost! In my office, we combine motorized micro-needling using the RejuvaStamp
micro-needling machine combined with RejuvaCells growth factor serum and we have been getting excellent results for treatment of acne scars.
You can follow the video link above to learn more about micro-needling and human growth factor serums.

Fillers and Dermapen

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Sculptra or Voluma are great options for the mid face volume loss that likely has led to your issues. I'd find a Derm or plastics that offers both then get their opinion.
Have you considered skin needling ( micropen) vs fractional laser? We are seeing great results for acne scars - better than with lasers.

John DeSpain, MD
Columbia Dermatologist

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.