If you have, or you’re starting to notice, sagging at the jowls, bagging under the eyes, or a general deflating of areas on your face Sculptra Aesthetic may be something to think about.
I’ve recently been interested in something longer term than a standard filler – at first glance Sculptra Aesthetic injectable seemed like a very real option.
So, I rolled up my sleeves and began the meticulous process of gathering the clinical data, reviewing the research and interviewing both doctors and patients who have had personal experience with Sculptra.
Here is what I found.
What is Sculptra?
Referred to as New-Fill in some countries, Sculptra Aesthetic is a Polylactic Acid-based (PLLA or poly-C-lactic) injectable filler that promotes the production of collagen in your face, neck, hands and decollete.
It has been used throughout Europe since 1999 and was approved for sale in the U.S. in 2004 for the facial wasting associated with HIV/AIDS. In 2009, Valeant got the okay to market Sculptra for beautification purposes, and here we are.
Sculptra vs Hyaluronic Dermal Fillers
Although Sculptra is grouped into the dermal fillers category, it’s not your standard filler.
Instead of using hyaluronic acid to temporarily fill in the parts of your face that have begun wrinkling and sagging with age, Sculptra actually gets to the heart of the matter for the long term.
Another difference, and possibly a reason that the name ‘Sculptra’ isn’t as well recognized as say, ‘Juvederm‘ or ‘Restylane‘, is that it’s not for the impatient. You may have to get 2 or 3 treatments over a 6 month period and the optimal result doesn’t show up for 8 months after the last treatment.
That being said, the results of Sculptra can last for 5 years or more.
NOTE: Plastic Surgeons used to think that aging was primarily about the skin. But in the past 5 years or so, they’ve discovered that we also lose bone and muscle mass. You don’t realize it but this effects the symmetry of your face.
Notice the temple, cheek and jaw area.
Sculptra can change the shape of your face, or just get it back to how it was before the morning you woke up and saw that other person staring at you. This is some serious stuff and nothing to consider casually, because once you do it, you’ll be living with it for a while.
Clinical research has shown that the results of Sculptra can last 2+ years, but the study ended in 25 months. What we know though is that the collagen molecules in our body last for 7 years or longer, so it stands to reason that you could possibly still see the results for many years more.
You’d have to know where you are in the collagen producing and depletion process to realistically predict how long you will see the effects of Sculptra. However, what you can unequivocally know, is that whatever you look like in a few years, that isn’t how you’d look had you not had that Sculptra treatment all those years ago.
Where Can You Use Sculptra?
You can use Sculptra in your temples, nasolabial folds, marionette lines, and the chin area where your jowls start to form. You can also use it in your hands, decollete, and your neck for cording and wrinkling.
NOTE: But you will never get chest lines if you use a decollette pad like I taught you girls (and that’s a promise)!
The Science Behind Sculptra
It all boils down to science, ladies. At least for me, and it should for you too! That way you can make an informed decision based on facts and not just hope. We’re talking about your FACE girl! HOPE alone is not where you want to live.
Sculptra promotes your body to make more collagen. Collagen is the building block of our skin, keeping it smooth, supple and tight. We start losing it in our 20’s and we never produce enough to take it’s place. And then, in our 40’s or 50’s, it just stops.
Our fibroblasts, which are responsible for producing our collagen, retire, and that is when your skin starts to sag, you start seeing wrinkles, and you get a little gaunt looking in the cheek and temple area. But that’s not the only thing that happens.
Since Sculptra has Polylactic Acid (aka PLLA or poly-C-acid), it’s considered to be a stimulatory filler, meaning it stimulates the production of collagen. When PLLA is introduced to the under layers of your skin it begins to degrade, and when it does, within 2 or 3 days, micro-particles are released into the skin.
Once released, they go to work, causing controlled damage in the fibroblast, forcing them to produce more collagen to close the breach.
The collagen production begins immediately, but it isn’t apparent for about 6 weeks, and depending where you are in the aging process, can be very subtle.
The optimal results can be seen at 8 months, however, most physicians say that they see a substantial result after the second treatment that takes place between 6 – 8 weeks after the first one.
How it Goes Down
Unfortunately, the Sculptra can’t just teleport itself deep into the dermis and there isn’t a laser (yet) that can beam it down, so it involves a long needle. Take a deep breath, relax and think about the end game as you watch the video below.
I don’t know about you, but I just vomited in my mouth a little. I told ya, this ain’t no standard filler!
Here’s how it goes down:
First, your physician will apply topical numbing cream. If you’re me, some facial blockers will be happening soon thereafter so that you feel absolutely nothing. Or, you can choose to just get some ice to numb the area and a vibrating tool to distract you, like in the video.
There’s actually lidocaine in the mix, so the good news is that after the first plunge you will be less likely to feel the manipulation that I talk about next.
Next, the Sculptra is injected once in each area of interest, then the needle or cannula is manipulated under the skin to the exact spots where you need subtle contouring. As it is diluted with water, it’s much easier to get it to spread more evenly than hyaluronic (HA) fillers.
Some people get a hyaluronic dermal filler like Juvederm or Restylane at the same time for immediate gratification while the Sculptra takes time to work. If you do combine the two, make sure not to use a longer term filler like Voluma or Radiesse or you may end up looking like a blow-up doll as the two overlap!
Post treatment you will probably be a little swollen, red, maybe bruised and you may experience a bit of pain, but nothing extraordinary.
For the first 24 hours you will have to apply an ice pack to the area for a few minutes at a time. Never apply ice directly to your skin, make sure it is wrapped in a cloth. This should help with any swelling.
You also will be told to massage the treated area for 5 minutes, 5 times a day for 5 days to insure that the product spreads evenly and smooth.
You will see projection in the areas of treatment, and some doctors say it can be a good indication of the long term result, but don’t get too attached because in a couple of days the water will be absorbed into your body and you’ll look exactly like you did before. (this is for the long term gain remember?)
Before and After Sculptra
Check out these before and after pics so you’ll understand why, after doing all the research, I still decided to do an article on Sculptra. The differences are subtle but meaningful. Would you think that any of these women had filler?
And remember, the changes happen over a long period of time, so no one will notice anything except your beauty.
The Benefits of Sculptra
- Looks natural
- Lasts for 5 + years
- Can change the shape of your face
Sculptra stands out in my mind because I’ve yet to see a situation of an overfilled looking face who got that way from Sculptra. When it works correctly, the look is way more natural than any other fillers I’ve seen and that’s important to me.
Another couple benefits are how long it lasts (which can also be a detriment), and the ability to correct a harsh or disproportionate face shape.
You can literally change the shape of your face. Bone structure used to be, well, bone structure and you pretty much had to live with it. Thanks to Sculptra you can make subtle changes with the angles in your face and look closer to your ideal.
There is truly nothing better out there for filling in temples, defining a sagging jaw and creating cheek contours than Sculptra.
Sculptra is an art and your injector has to have vision and a strong knowledge of facial proportion as well as the proportion that you find beautiful. The ‘ideal’ may not be the look you’re after. Choose your doctor carefully because you will live with the outcome for a while.
The Risks of Sculptra
All dermal fillers come with risks but the risks associated with Sculptra are a bit more substantial as the consequences could be much longer term.
Nodules and Papules
Nodules and Papules (little hard lumps) aren’t said to be common but are always a risk with dermal fillers. However, out of 20 or more people that I personally interviewed, all but one spoke of these lumps with Sculptra.
As a matter of fact, I’ve spoken to several plastic surgeons who have stop using Sculptra for this exact reason. Some injectors I’ve spoken to have said they won’t touch Sculptra because they were dealing with lumps from Sculptra in their own faces.
Especially in areas of thin skin, like under the eyes, on the temples, and on the tops of your hands or chest – but I came across several who had lumps in the cheeks. Not pretty.
Treatment of Nodules or Papules
And, the treatments for these lumps are scant, do not usually work, and come with side effects that can be more noticeable than the lumps themselves. Hyaluronidase is one example.
Hyaluronidase, which dissolves collagen has no way to differentiate the new, over projected lumpy stuff from the old collagen that you had before. Not only do you risk having a large dip in your skin, you will most likely be left with less collagen than you started out with before the treatment.
Or you can try excision (cutting it out), which will leave you with a gnarly scar. Some doctors spoke of Steroid shots, but you still get a concave dip in the area which may or may not correct itself with time.
Several doctors have mentioned using a mix of steroids, lidocaine and 5-FU, which is a chemotherapy drug. I don’t know about you, but I’d like to abstain from cancer drugs unless I have cancer, thank you very much. And even then it would take a lot of hard consideration.
If the downside wasn’t so scary, it makes total fiscal sense.
Regular fillers such as Juvederm, Belotero, Restalyne, and Perlane (Radiesse & Voluma costs more) run from $350 to $550 per syringe (unless you live in NYC where everything’s more expensive). Plus, you have to touch it up every 6 months.
So, 5 years of fillers would cost you at the very least $3500. And that’s just if you use 1 syringe per treatment. Realistically, I’ve seen girls who went for the first time and had to use 2 or even 3. Also, as you age you can expect to need more than now as you will lose more collagen.
For Sculptra, a good rule of thumb is to plan on one syringe for every decade you’ve lived (rounding down). At $750 to $850 per syringe. So figure $3,000 to $3,400 if you’ve kept relatively good care of your skin.
Summing it Up
I personally will not be doing this procedure. I like the low maintenance and subtlety of it but I’m not willing to risk the lumps.
If you are considering using Sculptra, I would suggest starting with one syringe and wait it out. It’s better than risking a bad reaction. If after 6 months it looks good and there are no bad reactions, then you can decide how much more you want, if any.
But most importantly, go to a doctor that’s been doing it for a few years and has lots and lots of before and after images. And don’t be shy. Ask to speak to a couple of those patients to find out their experience.