Sculptra (also known as Sculptra Aesthetic) is an FDA approved synthetic, biodegradable injectable dermal filler, used to treat signs of aging on facial skin. (1) The active ingredient in Sculptra is poly-L-lactic acid (PLLA), which is used for numerous medical applications besides dermal injections. Sculptra was initially intended for treating the hollow face appearance of people with HIV, but in 2009 it received approval for use in correcting volume loss and lines and wrinkles in any patient. (2)
Are you a good candidate?
Sculptra is only for use in people who are 18 years of age and up. Since Sculptra stimulates the immune system to create collagen, you must have a healthy immune system to be a candidate for injections. The safety of Sculptra has not been established for women who are pregnant, lactating, or breastfeeding. People who are susceptible to keloid formation or hypertrophic scarring should not be treated with Sculptra.
Sculptra is used for treating shallow to deep facial folds and wrinkles. The most commons areas for treatment are: (3)
- Nasolabial folds (the “smile lines” extending from the nose to the corners of the mouth)
- Marionette lines (extend vertically down the chin from the corners of the mouth)
- Hollows or skin depressions, such as sunken cheeks
- Chin wrinkles
Sculptra can also be used “off-label” (not FDA approved) for areas other than the face: (4)
- Butt augmentations and butt lifts
- Hip augmentation
- Treatment of cellulite
- Treatment of elbow, knee and chest wrinkles
Sculptra is also a popular choice for those looking to create the appearance of more muscle mass and definition on the:
It’s not recommended that Sculptra be used around the eyes or the lips.
As we age, the collagen and elastin that provide the support structure of our skin and which are responsible for the suppleness and elasticity of our skin lose their connections and become disorganized and dried out. This gives skin the baggy, wrinkled, and dry appearance that we associate with aging. Sculptra is a unique product because it is a “stimulatory” filler. (4) Stimulatory fillers do not fill the space under the skin with their own volume, but rather stimulate the body to produce a fibrous collagen support structure that builds up to support the lost volume and to tighten the loose skin, thereby softening lines and wrinkles. (4) Sculptra is usually administered over a series of treatment sessions. Results improve with each injection as more and more collagen builds up. Generally, at least three treatment sessions, 4-6 weeks apart, are required for optimal results. (4)
The treatment usually begins with cleansing the face of make-up and creams, and then taking “before” photos, usually from five angles. This will help the patient more easily see their before and after results at a later date. The treatment area is then sterilized, and a local anesthetic may be applied to minimize discomfort before the injection process begins, although treatment is not usually painful. Treatment takes about 30 to 60 minutes, and is performed in the doctor’s office. Using a thin needle, the doctor will inject Sculptra into the targeted facial areas using a special “cross-hatch” injection technique. Sculptra is placed in the deepest layers of the skin, where it can best stimulate collagen production. After the injections are done, the area is massaged by the injector to ensure even distribution of the product. This helps reduce the incidence of hard nodules. You are then required to do the same for five minutes, five times a day for the next five days.
How much Sculptra will I need?
In general, the rule of thumb is one vial per decade of life. So if you’re in your 30’s, you will most likely need 3 vials; however, there are exceptions to this rule depending upon the amount of volume loss. It also depends on the area being treated. For example, with Sculptra butt augmentations it is common to use up to 5 vials for each buttock. With 2-3 treatment sessions, this equates to approximately 20-30 vials. After the initial 2-3 treatment sessions, typically, patients will need one maintenance session a year to maintain Sculptra results.
Potential risks & side effects
Although Sculptra treatments have an excellent safety profile and present a non-invasive alternative to surgery, no procedure is without its risks. (2) The most common side effects of Sculptra include redness, swelling, tenderness or pain, bleeding, itching, and bruising around the injection site. These are usually mild, and subside within a few days of treatment. (2) The injected material may also cause bumps or lumps underneath the skin. This risk is small, and can be reduced by massaging the treated skin to evenly distribute the Sculptra. (2) Other side effects may occur, and your injection professional should review these with you prior to your procedure.
It is normal and expected to not notice much difference immediately after a Sculptra treatment. The water carrier in Sculptra may produce some filling effect, but this water is absorbed by the body within a few days and you may look just like you did before the treatment. Progressive, visible results usually become visible within a few weeks of each treatment session. Sculptra delivers its results gradually, usually after three treatments, as it stimulates the body to produce new collagen. (4) Because the results come on gradually, the most effective way to see the changes is by comparing with the photos taken before treatment.
There is no downtime after treatment; most patients return to work and other daily activities immediately. With your doctor’s agreement, it is safe to start wearing makeup a few hours after a treatment. There are three key aspects of taking care of the treatment area for optimum results:
- Apply a cold pack wrapped in a facecloth for a few minutes at a time for the first 24 hours to reduce any swelling
- 5/5/5 massage: massage the treatment area for 5 minutes a day, 5 times a day, for 5 days
- Avoid excessive sunlight or UV lamp exposure until any redness or swelling has resolved
How long does Sculptra last?
Once collagen build-up has occurred, the biodegradable PLLA is absorbed by the body, leaving just the natural collagen support structure. A study demonstrated that the effects with Sculptra can last for up to 25 months after treatment. Another study showed that 40% of people still see the results of their treatment after 3 years. (4)
Tips for choosing your provider
Sculptra treatments require special injection techniques, so the skill of the healthcare professional is very important to the outcome. To help you find a qualified provider:
- Consider choosing a board-certified plastic surgeon, facial plastic surgeon or dermatologist
- Ask to see before and after photos of their Sculptra patients
- Check out the providers online reviews
According to the American Society of Plastic Surgeons, the average cost per syringe of Sculptra was $878. (4) The average cost of a Sculptra treatment session is about $1,500. You may need 3-4 treatment sessions to achieve your goals. The cost of Sculptra is defrayed by the longevity of the results; you would require a number of re-treatments with most other fillers to provide the same duration of improvements. The overall cost of the procedure will depend on a number of factors:
- The number of syringes used
- The duration of the treatment session
- Your geographic area
- The skill level and fee schedule of the treating physician
- The number of treatment sessions required
As with most cosmetic procedures, the cost is not typically covered by health insurance, but many doctors offer payment plans to help make Sculptra injections affordable.