Will Sculptra scarring cause complications to future facelift results?

Question

I am 45 and anticipate getting a face lift in the next 10 years. Currently I receive filler injections to achieve a "liquid face lift" effect. My injector has recommended I try Sculptra in lieu of the HA filler I currently use. Can Sculptra cause scarring that may ultimately complicate face lift results in the future?

Jacob Tower, MD · Answer

Hello, hope you are well. The short answer is 'yes', Sculptra injections can add a layer of complexity to future facelift surgery. The degree of that complexity will depend on many factors like the location and depth of the injections, and your body's own inflammatory response to the PLLA material. Because of dermal fillers, volume loss as the proximal cause of facing aging has been massively overhyped to the public. In reality, the most significant factor that makes one appear older is the descent of the facial soft tissue envelope (loss of skin elasticity).

Best,
Dr. Tower

Best,
Dr. Tower

Anil R. Shah, MD · Answer

This is a controversial question, sculptra can make it more difficult to raise up your tissue planes. However, a skilled surgeon should be able to get in the appropriate planes. Sometimes you can have a little more swelling post procedure, because your lymphatics can be  altered as well. Go in there with cautious optimism, and make sure you go to a super experienced surgeon for your facelift.

Ryan Rebowe, MD · Answer

Sculpta and other biomodulators are a hot topic amongst surgeons who perform facial cosmetic surgery. Many surgeons feel as it they do lead to granulomas and scarring in the dissection planes. I myself have seen a similar effect from previous "thread" lifts. It can complicate the dissection and lead to concerns of nerve injury or an inability to get as much or as "aggressive" of a lift. While it does not preclude you from having the procedure, this does certainly complicate things in getting the absolute best result.

Lucian Ion, FRCS · Answer

Thank you for your question. Sculptra is indeed a treatment for volumizing the face that is less affected by weight fluctuations and has similarities with fat transfer more than hyaluronic acid filler injections. However, it can lead to more significant scar tissue formation in the deeper layers. When used in the midface, it may create some difficulties with deep plane facelift interventions in the future.

It might be preferable to have the facelift procedure earlier and then decide how much additional volume you wish to achieve. Sculptra can increase the longevity of your facelift intervention through its mechanisms of volumization and increased collagen production in the tissues.

Stephen Prendiville, MD · Answer

Sculptra is an amazing product for generating facial volume incrementally.  The only problem that I have with this plan is that 1 vial of Sculptra may not produce much or a result.  You should have no problem with a future facelift.  Threadlifts, and Energy devices like Ultherapy and RF microneedling devices can cause issues with a future facelift.

Jeffrey M. Darrow, MD · Answer

Just the action of passing a needle through your skin and then underneath your skin to place fillers in, whether they are Sculptra or Hyaluronic acid fillers, gives slight injury to the skin and the underlying tissues and your body will heal that with a fine scar.  At all of the plastic surgery meetings that I have attended over the last several years, there is always comments by the surgeons who are lecturing on facelifts, that their patients who request facial rejuvenation after years of fillers or prior treatment with noninvasive energy base systems that the surgeries are always slightly more difficult because of these prior treatments.  This does not mean that you can’t get an excellent result after prior treatments with filling agents, but it is something that your surgeon should be aware of. I am not aware of any literature that says that Sculptra is worse than the Hyaluronidase acid fillers. Best wishes.

Mats Hagstrom, MD (license on probation) · Answer

Sculptra does cause an inflammatory response and will add some potential issue. 
I’ve not heard this to be a major issue for future facelift surgery. 
Prolonged use over many years could potentially cause some changes. I think it is of fairly low relevance in comparison to variables that have significant impact like provider selection for facelift surgery. 
Best,
Mats Hagström MD