Sculptra for the Body
Sculptra is a bio-stimulant containing poly-L-lactic acid (PLLA), a biocompatible synthetic substance that can be used on the face and body to create a more youthful appearance.
This holy grail produces collagen and replaces lost volume helping with structure, elasticity, and texture of the skin. Botox and fillers can be used to replace volume and treat fine lines, but nothing compares to the long lasting fibroblast stimulation you get from sculptra that also improves your skin quality. Whether it is treating creepy skin on the décolletage, neck, arms, legs, or abdomen sculptra can be used in multiple ways on appropriate candidates. Since Sculptra is a bio- stimulant a healthy immune response is needed for best results, chronic anti-inflammatory use is not recommended and use of anti-inflammatories two weeks before and after treatment may decrease results. For full correction, most areas will take 2-3 treatments at 6 week intervals, each visit usually requires 1-2 vials (butt augmentation typically requires minimum of 4). Talk to your provider about sculptra and if it is right for you. It takes a skilled provider with specific training on treating these areas and proper preparation of the Sculptra, make sure to inquire about your providers experience and training when getting this procedure done.
Sculptra vs Microneedling
Microneedling and Sculptra are both very effective procedures that boost collagen. Microneedling provides subtle collagen production over time, and is great for textural changes like fine lines, pore size, and acne or traumatic scars. Sculptra works differently as an injectable biostimulator used to induce deep collagen production for treatment of more significant volume loss in the face over time.
If you are looking for more preventative or more textural rejuvenation, microneedling is less expensive and effective. If you are noticing loss of volume, or gravitational changes on your face like drooping, Sculptra can be natural and extremely effective with minimal to no downtime for most patients. The exciting news for collagen stimulation is actually seen with the combination.
Off-Label Uses of Sculptra
More and more expert injectors are using Sculptra in other parts of the body that patients need or desire volume such as the bottom, some sort of defect, and the chest/de’colletage. There is exciting clinical experiences that show intense collagen stimulation with the use of microneedling with SkinPen or ProCell with topical Sculptra.
Sculptra is made from poly-L-lactic acid (PLLA) and FDA-approved to stimulate the body’s own natural production of collagen over a period of time. Sculptra is most frequently used to treat mild to severe facial wrinkling by addressing the underlying cause of aging. This can be a loss of good volume in key locations that enhance the aesthetic units found in youth.
On average, one vial per decade of life over three injection sessions spanned across a few months are necessary to achieve desired fullness. Very thin-skinned, lean body massed patients will sometimes require a bit more. The injections are administered by a board certified medical provider, such as Drs. Carlotti, who will determine the number of treatment sessions needed based on the patient’s pre-treatment volume deficiencies, severity of elastosis, and the individual’s personal genetic response and goals for the desired endpoint. At that point, we typically go into a maintenance mode and re-evaluate our Sculptra patients once a year with most opting for 2-3 vials once a year there after.
After receiving Sculptra injections, initially you will see a volumized face, due to the fluid infiltration, along with a very minimal amount of swelling. After the initial three days, much of what you could visualize night of or day after will appear to have gone down. At this point your fibroblasts are at work responding to the seeded poly-L-lactic acid granules placed.
You can expect a gradual increase in volume as your body responds to the PLLA granules to promote your body’s own new collagen. The increase typically starts to be noticeable sometimes as early as week 3-4 and natural appearing volume in approximately three months after the first session. Results reaches its peak four to six months post-treatment. Results are no immediate nor linear with Sculptra.
Fat cells carry stem cells that stimulate our own collagen and elastin similar to Sculptra and provide an immediate result to volume deficit. Other treatments that provide immediate results are injectables including Radiesse, the Juvéderm product line, or Restylane line of products. However, duration of affect varies depending on the filler type that is used and the area it is placed.
The biostimulatory effect of hyluranic acid filler is also not comparable to Sculptra and fat cells. A combination treatment of Sculptra, to stimulate collagen production, followed by a hyaluronic acid filler is also a fantastic combination to provide immediate results with the longer term benefits of having a biostimulator.
With Sculptra, multiple sessions are needed. Not every patient is a suitable candidate for Sculptra as it is a more delayed gratification instead of immediate event such as Radiesse. We have seen that very thin, lean patients with speedy natural metabolisms are the happiest Sculptra patients after disappointment of length of duration of hyaluronic acid (HA) products.
Radiesse is FDA approved for some collagen build up over time and is best injected in deeper areas and slowly to stimulate the subcutaneous tissue to build collagen. The effects can last 18-24 months. It is best to avoid injecting Radiesse near the eyelids. Great care should be taken when injecting in the nasolabial creases and in the lips as Radiesse has unacceptably hardened in some patients. Sculptra can form granulomas that can usually be treated with saline dilution with or without intra-lesional steroids.
Sculptra is a minimally invasive procedure that allows most individuals to return to work the following day. Having injections done on a Friday is common, patients recover over the weekend and return to work on Monday. It is important to do a five-minute massage over the injected areas five times a day for five days. The massages help develop a stronger initial collagen response by stimulating blood flow to the injected areas and provide an even result. They also help to reduce the formation of granulomas. The initial volume seen right after treatment will disappear in about three days as the water and lidocaine of the Sculptra injections are absorbed by the body.
In about six weeks patients can usually start to see some effects of the first treatment, expect to see optimal results in about six months. Additional treatment is done at the six-twelve week follow-up appointments as needed.
There can be side effects such as bruising, asymmetry, over-correction, under-correction, intra-vasculature injection and infection. Nodule or granuloma most likely occurs when the injection is too superficial, a higher than recommended concentration is used, or inadequate massaging occurred. Gentle five minute massages five times a day for 5 days usually prevents this and/or can help resolve this problem along with intra-lesional injections. Allergic reactions are rare but have been seen.
The best approach would be doing Sculptra first and allowing sufficient time for the dilutant to resorb before injecting PRP to stimulate the fibroblasts. By injecting micro-particles of poly-lactic acid followed by PRP to stimulate fibroblasts there can be an even greater production of collagen. Multiple peer review studies have shown PRP can be extremely effective, due to its growth factors and cytokines, in reducing fine lines and wrinkles on the face. A combination approach is very effective in thin patients.