I'm a 38-year-old healthy male. Approximately 3 years ago I started noticing fat loss in the periorbital area, making me look tired and drawn. About 2 years ago I decided to do something about it, and started with hyluronic-acid products: Restylane, then Juvaderm.
My experience with both was unsatisfactory: they were applied so superficially that I'm yet to have had a single hyaluronic-acid treatment that yielded smooth, feathered results and, worse, the stuff lasted barely 4 months before starting to degrade -- a far cry from the "1 year" claimed by some literature.
Then about a month ago I stumbled on a mention of Sculptra, and was intrigued by its method of action: here was an agent that purported to increase collagen production, so that the collagen layer plumped up and made up for the fat layer above that had deflated. (I think I have that right.) Reading up on it my concern was the anecdotal and review evidence that seemed to contraindindicate Sculptra for a cosmetic procedure in thin-skinned areas such as the area around the eyes.
Luckily I found a doctor who was versed in using Sculptra, and with whom I felt confident. I had my first treatment approximately 1 month ago, and I am very happy with the results thus far. (I will have another treatment shortly since I was recommended 2.)
The procedure itself was straightforward: my face was numbed, then the cheek and periorbital areas treated with several dozen small injections on each side. Since Sculptra is administered as a dissolved solution the immediate after-effect was to immediately plump up areas treated, and very smoothly, respecting the face's own contours. I didn't have the "bee stung" look I often had after Restylane, etc was administered.
The thing wih Sculptra seems to be that you have to massage the injection site very frequently to inhibit clump formation. I did that near-religiously as directed, and attribute that to now being clump- and granule-free. At least as far as I can tell or feel.
I think the as-big or bigger reason for my results is because the doctor was that good. It doesn't matter what filler you have put in -- I believe results are determined 90% by the practitioner.
In summary: for me Sculptra as a cosmetic treatment for sinking around the eyes and cheek has worked very well in this first month post-procedure. I look forward to results getting better and better, and shall post an update in the future.
Update & Addenda about the Sculptra-injection procedure:
Since I'm skittish around needles in my face I opted to have it numbed with Lidocaine before the Sculptra injections themselves. For my second treatment I also dosed on Hydrocodone before the procedure, so the Lidocaine injections were uncomfortable rather than painful, and the Sculptra injections mostly un-felt.
The downside to pre-Sculptra Lidocaine injections, I'm told, is "extra volume" in a just-finished face. Fine by me, I'll pick my battles. (I'm told an alternative is to mix Lidocaine with Sculptra, so a little Lidocaine is delivered with each Sculptra injection. I opted for the former method because I didn't want to feel even the Sculptra pricks themselves. And I STILL had a vagal response during the procedure!)
Even so, as I noted before, the additional "volume" immediately post-procedure was not discernible under casual inspection, and since Sculptra is delivered much deeper than Restylate, etc, I didn't have any superficial pinching or welting on the skin -- it was mostly the same face shape, slightly bigger.
I was told that this liquid-induced facial volume would dissipate in 4 days, with the liquid being resorbed, but my experience has been different: overnight, excess volume went down to near-normal, and that continued for the next nearly 10 days. Sure, my face looked normal well before 4 days, but I did notice further gradual sinking even 3 weeks since, with the periorbital areas the last to go down -- from normal-looking to just below normal. I have to assume my varying liquid intake (I do badly at keeping hydrated) played a part.
My pre-procedure Hydrocodone dosing helped also in the immediate post-procedure massage. I got to enjoy the massage without associated discomfort or pain.
2 things I stress, one by experience and one by hearsay: pick a doctor who really knows this stuff (I gather there are just 5 or 6 top ones in the U.S.; I'm lucky to have access to one of them), and be religious in the post-procedure massage regimen -- I'm told this massage really needs to be kept up for up for a good 6 months post-procedure, which is Sculptra's half-life (?), to ensure granule-free results. For the kind of from-deep-within volumizing I seem to be seeing thus far it's a regimen you'll be glad to maintain!