Sculptra is a novel therapy that restores volume to sagging or wrinkled areas of the face. It represents a totally new concept in facial rejuvenation. Rather than plumping up individual lines and wrinkles, it is used to build up larger areas of the face. The structure of facial bones changes with age. As we get older, we lose facial fat and our skin becomes thinner due to the loss of collagen. All the above changes lead to droopy appearance (jowls) and wrinkling.

Pictured are several images of patients before and after Sculptra treatments.

Sculptra is poly-L-lactic acid. This substance has been used for decades as a component of dissolvable sutures. Sculptra comes in vials which have to be diluted with sterile water at least 2 hours prior to treatment. I usually dilute Sculptra on a day preceding the injection session and let it hydrate overnight. It is injected into the deep layers of the skin, which results in the immediate correction of skin laxity. These changes however, are transient. In about one or two days skin returns to the pre-treatment appearance. After injection, Sculptra stimulates the skin to produce its own collagen. Within the next 2 to 6 weeks this stimulation results in a gradual and natural increase of skin thickness. This results in the great reduction of sagging and wrinkling. Many physicians refer to Sculptra as the “liquid facelift”.
Conceptually, Sculptra is not a filler, but rather a catalyst or stimulator of your own collagen production. The changes are gradual. Every patient produces collagen at his/her own rate. Therefore, treatment is individualized for each patient.
Someone may need only one session of Sculptra injections, while another will achieve full correction after 3 to 5 sessions. The results are long-lasting. While the literature reports 1 to 2 years duration of effect, many studies were short-duration, so it is possible that the correction can be even longer lasting.

Sculptra is FDA-approved in the United States for the treatment of lipodystrophy in HIV patients. These patients often lose a lot of facial volume due to side effects of their medications. Since Sculptra is FDA approved, it can be used off-label to treat any patient cosmetically. The most common side effects are bumps in the skin which are not typically visible. Visible lumps and bumps have also been reported, yet they are quite rare.

Alexander Doctoroff, D.O., F.A.O.C.D.
Assistant Chief of Dermatology
Veterans Administration Medical Center, East Orange, New Jersey
Clinical Assistant Professor of Medicine
University of Medicine and Dentistry of New Jersey