Sculptra is the latest injectable filler to be approved for aesthetic facial treatment. While it enters a milieu of ten other injectable compositions that are commercially available, Sculptra has the unique distinction that it lasts the longest. Duration of action is usually the one injectable filler feature that is most desireable.
But before you run out to get your Sculptra injections, it is extremely important for you to realize that how it works is also different. Its mechanism of action means that is a facial volume restoration technique not just a direct wrinkle filler.
Sculptra uses a completely different approach to achieving soft tissue augmentation. Rather than merely being a filling material which breaks down and goes a way on a set time period, Sculptra does not fill, it stimulates. By injecting tiny particles of a resorbable polymer (poly L-lactide acid) which is mixed with water, much like implanting tiny seeds, the tissues are sewn with many collagen stimuli. The body reacts to them over time to lay down collagen around the polymer seeds, a perfectly normal response. The particles are not big enough or nor are there enough of them placed to result in a significant foreign-body reaction. (known as inflammation and swelling)
This approach leads to two fundamental concepts of how the biology of Sculptra works. First, water is used to carry the particles into place. This gives a very satisfying immediate effect but it will subside within days. It will look like nothing has been done a week after injection. Then the tissues will start to thicken up again due to the stimulation of new collagen in the tissues which have been implanted. Secondly, it requires more than one injection session to build up enough collagen to create the desired effect. Two or sometimes three injection sessions, spaced four weeks apart, are needed to create an effect that will last two years or longer.
By virtue of the need to build up the facial area over time, Sculptra is not best used as a simple wrinkle filler. Rather it is intended to be for volume restoration due to fat atrophy and aging. This requires much more of an artistic sense and truly represents a form of facial sculpting ¦as the name implies. In my Indianapolis plastic surgery practice, Sculptra can be very useful for after facelift touch-ups, reversing volume loss from early signs of facial aging, and, when combined with other facial treatments such as Botox and skin treatments, one can really have facial rejuvenation without a surgical recovery.
Dr. Barry Eppley
Indianapolis, Indiana