WHAT IS SCULPTRA AESTHETIC?
Sculptra is an injectable liquid used to add volume to areas of the face to create a soft, natural, more youthful re-contouring of the face. It builds your own collagen while it gradually disappears. When done well, it doesn’t have that “over stuffed” look that is all too common when too much Juvederm, Restylane or Radiesse are used in the cheeks. It is best for adding volume to:
- hollow cheeks
- softening bony cheekbones
- nasolabial and melolabial folds (nose to mouth/mouth to chin)
- hollow chin area
- defining the jawline
- hollow temples
- some body sites
“Well, the last time I had a picture taken I could hardly see my eyes because of the weight of heavy eyelid. Then I paid attention to how I was actually using my eyes and I really noticed when I was looking at anything especially the computer I was straining my forehead to see better. Since I have had it done I no longer have to lift the forehead and tilt my head to see. It is amazing! I love…” D. Rock 63 Yrs Old with Fat Droopy Eyes – Salt Lake City, UT
WHAT IS SCULPTRA MADE OF?
Sculptra (generic name is “poly-L-lactic acid” or PLLA) is a synthetic of lactic acid. Lactic acid is made in our muscles after exercise. Polylactic acid is lactic acid molecules stuck together in strings (a polymer). It is made in a laboratory and contains no animal products and no human DNA. It very gradually disappears by the action of your own cell enzymes.
IS SCULPTRA FDA APPROVED?
“I had a excellent eye lift done by Dr. Patel. He knows what he is doing and is very pleasant. Dr.Patel was easy to get an appointment and he works with you. The office staff was very pleasant and made you feel calm.” D. Gull Highly recommended for eye lift surgery – Salt Lake City, UT
HOW IS SCULPTRA DIFFERENT FROM JUVEDERM AND RESYLANE (HA FILLERS)?
Sculptra adds volume to the face and fills grooves and hollows. This can give some lift and help with wrinkles because many wrinkles are created by loss of volume (think of a deflating balloon). Juvederm and Restylane (HAs), in general, fill specific wrinkles and lines. In the past few years longer lasting HAs have been added like Juvederm Ultra Plus and Perlane. These can also be used for cheek contouring and a “lift” effect. The choice between the HA fillers and Sculptra often comes down to the amount of volume replacement desired, your age, and maintenance issues.
If a small amount of filling is all that’s needed, then I generally recommend an HA. If more than 2-3 syringes of HA are needed, then Sculptra may be more cost effective over time (2-3 years). Only one maintenance treatment a year is typical with Sculptra, while 2 maintenance treatments per year are needed with Juvederm/Restylane. There are longer lasting HAs available in Europe and other parts of the world but these are not FDA approved in the USA.
Radiesse is another excellent filler which works very well when definition of the cheek or chin is required. Again, depending upon your age, the desired outcome and the degree to which augmentation is desired, the appropriate filler will be recommended.
Patients get confused by the huge array of commercial names and direct advertising by companies promoting their particular HA product. Remember: have your surgeon use the product he/she is most comfortable with and with full knowledge of the effects and possible side-effects. To that end, Restylane and Juvederm have had the best safety record over time. Adverse reactions to them are extremely rare outside of bruising or slight tenderness at the injection sites for a few days. See the section below on adverse reactions.
Allergies to HAs are usually related to the protein load and other contaminants, so inferior products or companies who are less than compulsive in their formulation result in complications even though they are sometimes cheaper. For example, you can read about the recent problems with Evolence.
The best result may be with both Sculptra and HAs. Sculptra will re-volumize the cheek area, chin, and temples, and 1 syringe of Juvederm/Restylane 1-2/year will fill right around the lips where Sculptra is not suitable.
Sculptra lasts approximately 2 years once the series of treatments is completed. Generally one maintenance treatment a year is needed so you don’t completely return to your original volume. HAs last approximately 6 months on average depending on the person and product used. Sculptra stimulates your own cells to make more collagen which it why it lasts longer. Radiesse also stimulates more collagen. HAs are implanted gels (hyaluronic acid – a natural substance in skin) that gradually goes away.
ARE THERE ANY SITES WHERE SCULPTRA SHOULD NOT BE USED?
Sculptra should not be used in the frown lines, the forehead, around the eyes, around the mouth, or in the lips. There may be other areas that are prohibited in your particular situation. We will inform you.
IS SCULPTRA SAFE?
Sculptra has been used in Europe since 1999. Since 2002 when the product was reformulated, it has had an excellent safety profile when treatments are done correctly. Dr. Vleggar in Geneva has treated a series of over 8,000 patients and had less than 20 complications, all of them temporary (lasting 1 year or less). Be aware that small, invisible bumps can occur (which means you can feel them but you cannot see them) and will gradually go away. The same applies to Radiesse. There are very rare cases reported of longer lasting nodules. Most of these were prior to 2003 when the product was reformulated with a smaller, smoother particle size.
The company does not now recommend treating the eye area because it is more prone to temporary bumps. They are more likely to be visible there because the skin is so thin. Around the eyelids (tear trough, malar groove, upper eyelid sulcus, etc), restylane works beautifully.
Sculptra is more difficult to inject than Botox or fillers like Restylane and Juvederm, so be sure your surgeon is experienced. Also, be sure you follow all the recommendations regarding massage and any post-injection care.
WHEN IS SCULPTRA CONTRAINDICATED
Do not have Sculptra injections if you are allergic to lidocaine or are pregnant or nursing. Do not use Sculptra if you have lupus, Sjogren’s Syndrome, or rheumatoid arthritis. Ask us if you have other autoimmune diseases.
HOW IS SCULPTRA ADMINISTERED TO GET THE BEST RESULTS?
After the first injection, two more treatments may be necessary about 6 – 10 weeks apart: this gives the initial ideal response. The volume injected depends upon a number of factors, including your age, the degree of deflation, the desired result and how “aggressive” one wants to be. One size does not fit all: we will discuss options with you to allow you to choose the most cost-effective material and number of treatments. However, it is important to remember, that using small amounts will give minimal visual results. The cost of the various fillers must be balanced with the longevity of the fillers. Once the initial injections with Sculptra are completed, most patients will only need an injection once a year to maintain the correction.
WHAT DOES SCULPTRA TREATMENT FEEL LIKE AND HOW MUCH DISCOMFORT IS THERE?
There is little discomfort with the injections because Sculptra is mixed with lidocaine, which is a local anesthetic. We also apply a topical numbing cream about 45 minutes before the treatment and also use a Zimmer cooler: this makes your injections much more pleasant.
WHAT WILL I LOOK LIKE IMMEDIATELY AFTER SCULPTRA TREATMENT?
You can put on makeup immediately and go back to normal activities. It’s best not to exercise vigorously for one to two days. There is almost undetectable fullness (from the water in the product) for about two days after a treatment. A little bruising is normal, but it’s usually minimal. You may have mild to moderate swelling at the injection sites which could last up to a week.
To avoid bruising don’t take aspirin, ibuprofen or Aleve (naproxyn) or any other drug which increases bleeding for 1 week prior to your treatment unless required by your doctor.
IS SCULPTRA COMPATIBLE WITH OTHER PROCEDURES LIKE LASER, BOTOX, ETC?
Generally yes, but there are a couple of exceptions. There are anecdotal reports of Sculptra bumps after Thermage (radiofrequency treatment) and some Fraxel treatments. This is probably due to the deeper collagen stimulation of these technologies. The combination of Sculptra with these could produce too much collagen in the form of bumps. Have your radiofrequency treatment before your Sculptra treatments. Having other fillers or botox at the same time is perfectly fine.
CAN I HAVE ANYTHING DONE BESIDES SCULPTRA FOR VOLUME AUGMENTATION?
Other injectable materials like Radiesse, Voluma and Juvederm can be used. Each has advantages and different longevities. The other option is a surgical midface lift which is usually combined with other procedures like browlifts and blepharoplasty. Fat grafts are generally used in combination with surgery and, on occasion, cheek implants may be indicated. Permanent fillers like Silicone, Artefill or Artecoll are best avoided as any
undesireable outcomes will be permanent.
DOES SCULPTRA HAVE ANY SIDE EFFECTS?
Small, temporary bumps may develop: these are palpable but rarely visible and disappear within a week or so. Rarely, if a bump persists, the product needs to be broken down with an injection with Kenalog. If the product is not properly prepared, or injections are administered in areas where they are not recommended (around eyes and lips, for example), lumps can appear. Ensure your surgeon knows the product and is experienced.
After the treatment, some common injection-related reactions might occur, such as swelling, bruising, redness, tenderness, itching, and discoloration at the injection site. Occasionally, a treatment can trigger an acne flare. These side effects resolve naturally within 1 to 14 days after the treatment.
The use of anti-inflammatory drugs or aspirin might cause bleeding or increased bruising at the injection site. If you’ve previously had facial herpes simplex at the injection site, the injection might provoke an outbreak. Talk to your doctor about this before the treatment.
I AM A RUNNER WITH LOW BODY FAT. MY CHEEKS HAVE BECOME HOLLOW. WOULD SCULPTRA HELP WITH THIS?
Yes, it would be perfect for you to replace some of the volume in your face you’ve lost through your exercise program. And, if you’re under 45, it’s likely that 2-3 vials total over 6 months might be enough. The Sculptra would slowly build enough collagen in that area to give your face a more rounded contour.
I AM 65 YEARS OLD AND WOULD LIKE TO GET A FACELIFT BUT MY HEART PROBLEMS PRECLUDE ME FROM HAVING A FACELIFT. CAN I GET A SIMILAR EFFECT WITH SCULPTRA?
HOW LONG WILL SCULPTRA LAST?
It will last up to 2 years in most patients, but one treatment once a year is important for maintenance. It is not advisable to let the filler go from a nice full appearance to none at all. It takes 45-90 days after the treatment to see the full results. This is because you are building your own collagen.
HOW OFTEN DO I NEED MAINTENANCE TREATMENTS WITH SCULPTRA?
ARE THERE ANY SIDE EFFECTS?
The main side effects are mild, temporary swelling, redness, and an occasional bruise.
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