Thank you for your question. You’re asking about the difference between Juvederm Voluma and Sculptra. I suspect you’re asking because you’re looking at some overlap in results, so you’re wondering what are these two products and what really makes one different from the other.
I can share with you how I educate my patients who ask a similar question in my practice. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years. Injectable fillers are a big part of what I do, and I’m quite familiar with both fillers so I can help you understand the difference, and how I approach the use of these fillers in my practice. This is specifically my approach, so it doesn’t mean the way other people work is wrong, but this is how I do it.
There are basic medical or chemical structural differences between the two without getting unnecessarily technical. Juvederm Voluma falls in the category of hyaluronic acid fillers. Hyaluronic acid is a natural substance that’s found in our body, and hyaluronic acid fillers come in a wide range of different thicknesses and compositions. Major companies such as Galderma, Allergan and Merz have hyaluronic acid products. Now Juvederm specifically has FDA approval for mid-facial volume correction. FDA approval doesn’t mean that’s the only place doctors could use it, but that’s the only place the company Allergan, can promote its specific indications. The FDA regulates drugs and devices, and companies can do promotional activities specific to those indications. Physicians practice medicine and can do what is referred to as off label use, so they can use any material in a way they feel is best for the patient, so Juvederm Voluma can be used in different places by physicians.
What Juvederm Voluma and other hyaluronic acid fillers can do is restore volume with immediacy. When you place it, you see the correction immediately, and you pretty much know how much correction you’re getting.
Sculptra comes as a powder, which is mixed with saline. The chemical name for Sculptra is poly-l-lactic acid. What makes Sculptra very different from a hyaluronic acid filler is when it’s injected, it depends on your body’s response to generate a certain amount of volume correction. The way I look at it, Sculptra is more for diffuse areas of filling, typically in the hollows of the cheeks. When someone is very hollow, I consider using Sculptra.
Sculptra was initially used to help people with HIV lipodystrophy. This is the result of people who are HIV positive and taking antiviral drugs to help manage their disease or condition, and unfortunately it resulted in incredible amounts of fat loss in the face. Sculptra was incredibly effective in helping people look better by restoring some volume. When it came to the market, it was a bit of a challenge because people had an unfortunate tendency to develop some nodules and other things with the body’s response, but that was more on the technical elements of placement.
At present, when I make the decision on which filler to use, I look at from what is most predictable for me. When I want to specifically treat areas such as the cheekbones, jawline, chin, and jaw angle in a technique we call structural volumizing, I find Juvederm Voluma very useful. Juvederm Voluma and Ultra Plus are very effective, and work very well. I find these materials have a certain thickness, and I can see the correction, and the patient can see results immediately. I would not use Sculptra for those areas because of a variety of reasons, one being I can’t predict how much volume there will be when the material initiates a collagen response. It actually takes a few weeks to see the full response, so in a Sculptra patient, we see them after a month to see how much correction they had, then decide if they need more vials to get more correction. With someone who I place Juvederm, Juvederm Ultra Plus, or Juvederm Voluma, I place it and I usually see them after 2 weeks, and I see if any enhancement would be of benefit.
Just speaking from my practice, I generally use Juvederm Voluma considerably more often than I use Sculptra. I think for my kind of practice where I deal with a lot of facial aging issues, and volume loss related to bone structure, relative bone deficit in people who are a bit younger, or volume loss with people who are 40 and older, we end up using a lot more Voluma and hyaluronic acid fillers in our practice.
Understanding there are two different methods of correction, and two different areas, in my opinion, are best suited for these materials. There can be some degree of overlap particularly in the soft tissue area. You can put Sculptra in the soft tissue of the cheek, then allow it to increase to get a nice correction, and it can last a significant amount of time. However, I think in the modern world and in my practice, the immediacy of the result and the longevity of benefit, I end up using a lot more Juvederm Voluma. I hope that was helpful, I wish you the best of luck, and thank you for your question.