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Sculptra Q & A

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Have you ever wanted to naturally replace the volume we all lose as we age? Now you can. Sculptra allows for the gradual and long-lasting correction of volume defects and contour deficiencies. Dr. Mest is a pioneer in the use of Sculptra in the United States. He was the Principal Investigator of one of two US trials that led to the approval of Sculptra in 2004. He is a national trainer of other physicians in the correct use of Sculptra and also serves as a consultant to the manufacturer Galderma Aesthetics.

What is Sculptra?

Sculptra, also known as Poly-L-Lactic Acid, is a synthetic sugar made up of many individual lactic acid units. Lactic acid is a substance that occurs naturally in your body. When injected into the skin, Sculptra stimulates the body to lay down new collagen in reaction to the material. Since it is synthetic (non-animal origin) no skin test is required. So although synthetic, the end result is the gradual, natural production of your own collagen to replace that which is damaged and degraded with age. In addition, the material is designed to break down over time into individual lactic acid units. Since Lactic acid is naturally occurring in your body, there is already an existing pathway for your body to metabolize the lactic acid into Carbon Dioxide and water. 

What are the benefits of treatment with Sculptra?

By adding volume back to the face in specific areas, Dr. Mest is able to Sculpt the face into more youthful contours. As we age, we all lose not only our skin laxity but also the underlying soft tissue and bone is affected. This allows the skin to drape in various defects and hollows as well as wrinkles and folds. By strategically placing the material, Dr Mest is able to build up support for the overlying structures as well as increase the skin turgor and elasticity thereby softening facial wrinkles and folds. Therefore treatment with Sculptra is more than just treating the wrinkle or fold. It truly is possible for total facial restoration. In addition to the natural production of your own collagen and the natural pathway for the breakdown of the material, the other main benefit of treatment with Sculptra is the long-lasting correction that is obtained. In general the results last 2 years or even more in some patients. 

What areas can be treated with Sculptra?

The exact areas to be treated with Sculptra vary from patient to patient and Dr. Mest will take his time to address your individual needs in the initial consultation. In general, all areas of volume loss such as the temples, mid-face, nasolabial folds, and marionette lines can be treated with Sculptra. Also, the wrinkling that occurs when one smiles can usually be addressed with Sculptra. More superficial wrinkles cannot be treated with Sculptra. It is also not recommended for use in the lips. 

What is a Sculptra Treatment like?

Treatment with Sculptra is very well tolerated. Sculptra comes as a powder that is mixed with Sterile water for injection. We also add the local anesthetic lidocaine to the Sculptra mix before we use it and therefore the treatment is usually described as more pressure sensation than pain. In addition, Dr. Mest will perform some local anesthetic injections at various skin sites to minimize the pain of the needle entering the skin. These injections are similar to those at the dentist office and do involve a slight burning sensation.

Afterward, patients may have some mild discomfort that can be treated with Tylenol. The initial correction that one sees is due to the water that we use to mix the Sculptra into an injectable form. This water is relatively rapidly absorbed by the body over the next few days to a week. For the next week or so, you will not see any appreciable response. But don’t worry, the Scultpra particles are working, stimulating your own collagen to be produced. Over the next few weeks, there will be a gradual correction in the treated areas. Finally, like all injection therapies, bruising may occur. 

What else should I know about a Sculptra Treatment?

Since the mechanism of action of Sculptra is the production of your own collagen in response to the material, this by definition is a gradual process. Like fertilizer for your lawn, it is not possible to put all the Sculptra in at one time. Rather we need to retreat several weeks later. Most cosmetic patients need 2-3 treatment sessions depending on the volume loss present as well as your ability to form new collagen.

Rarely, some elderly patients may require additional treatment sessions. Rarely, in some patients, too much collagen will form too quickly in one area. This will cause a little lump of collagen, which is referred to as a nodule or papule depending on the size. Most of these are very deep if they do occur and therefore are only palpable but not visible, and therefore not bothersome to patients. It is also important to note that since Sculptra is designed to go away over time, 95% of these tiny lumps also disappear over time with no treatment.

If bothersome to patients, these lumps can be easily treated. We have learned a lot about how to minimize the potential for these “lumps” to occur. The mixture, time of mixture and skill/experience of the physician injector all help to determine the chance of their occurrence. Finally, post procedure massage has also been shown to decrease the occurrence rate. Therefore you will be instructed to massage the treated areas several times a day for several minutes for several weeks after each Sculptra treatment. 

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