Sculptra Aesthetics is different than others injectables. It is not a filler, such as the hyaluronic acid fillers, for isolated wrinkles. Many of these fillers are used primarily for the smile lines, called the nasolabial creases, or the marionette lines below the corners of the mouth.
Sculptra changes the shape of the face back to the fullness seen in younger people. I’m sure most everyone has noticed that in the twenties a friend or acquaintance loses their “baby fat.” Unfortunately, they will continue to lose it through out life. This loss of volume is from loss of fat, thinner skin, and even loss of bone, especially around the mouth region and usually from less than the best dental hygiene. The name Sculptra is prophetic, because one can literally re-sculpt the face back into a more youthful shape and volume, for example, cheeks and chins can be made larger.
The use of Sculptra requires a trainer to demonstrate to either a plastic surgeon or cosmetic dermatologist “hands on” instructions to assure proper assessment of the face regarding the lost volume and how to restore the volume with the most natural appearance.
The patient must be assessed in the sitting position to see the effects of gravity, which is imperative, because people appear quite different in the supine or reclined position. Surprisingly, most people including some plastic surgeons are not alert to the small nuances of differences in a young face and an older one. This is part of the instructional training session. Then the actual technique of injecting is demonstrated. The product must be injected in exactly the proper quantity to prevent complications such as small nodules. These are very rare, but can occur if too much is injected into one area or if it is injected into certain muscles, such as around the lower eyelids. If the Sculptra is injected in the right plane, just below the dermis, it will build collagen and thus volume, but if injected too deep the product is wasted because very little buildup of collagen will occur.
Now that there are more trainers, the product is being used much more, and we are seeing many more happy patients.
The problem with the aging face is loss of volume in addition to the well known loss of elasticity. Replacing volume deficiencies can sometimes correct deficiencies better than an actual face lift. If non-surgical rejuvenation is desired, the loss of elasticity can be treated with the Fraxel lasers or a deep peel, such as a Croton oil peel. It is also often needed in someone who has had a face lift but needs additional volume. This is usually apparent after the swelling has subsided. The difference in a youthful and older face must be appreciated in these cases as well to achieve a natural look.
I applaud Sanofi-Aventis, the parent company of Sculptra Aesthetics, for limiting the product to those who have had training and those with a cosmetic surgery background.