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Sculptra should be considered as a volumising (or re-volumising) programme for the face,
and certainly not as a filler.
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The concept of Sculptra is quite exciting in that Sculptra encourages the body to build up its own collagen and tissue volume. Sculptra is the trademark for poly lactic acid – many molecules of lactic acid joined together. Lactic acid is normally formed by the action of the muscles in the body, making the product totally compatible with the body's own tissue. However the product is not made from animal or human sources, like most cosmetic and medical products it is made from bacterial fermentation.
Sculptra should be considered as a volumising (or re-volumising) programme for the face, and certainly not a filler. The product is injected into the areas of the face that require volume. Although there will be a "result" after the first treatment, this is due mostly to swelling and merely gives us an idea of the end result. The initial swelling disappears after one or two days, but gradually and often imperceptibly the volume builds up until the next treatment, six weeks later. Yet again the face appears to show a further result, but this is short-lived and disappears after a two days. The real results will now start to show as the tissues of the face respond to the injected poly lactic acid. One third and possibly final treatment will complete the programme. The results should now last for up to three years. You may of course top the treatment up from time to time but with one injection session rather than the full three again.
The manufacturers of Sculptra suggest an average of six vials per treatment programme, but many clients who have only a small volume loss or who have taken care of their volume with standard HA fillers may need less, maybe three vials. We know that Sculptra will work, it sometimes takes time to work. We prefer not to over-inject but to take our time and wait for the results to show before adding more product. This is why we tend to recommend one or two per treatment and to space the treatments out to every six weeks. We can always add more product, we can never take it away.
Sculptra is best placed deep in the tissues to replace the deep fatty stores and to obtain a natural, soft result in keeping with the contours of the face. The temples thin early and these should be treated first. The other areas of the upper face (cheeks, eye area, nose to mouth area) need to be addressed before the lower face is treated, since the lower face begins to lift as upper facial volume is re-established.
In the lower face, Sculptra is used more to stimulate collagen synthesis in the skin itself, thereby increasing the quality of the skin and preventing fracture lines.
Sculptra can be used to lift the forehead. Very often treatment with BTX is requested for this area, but BTX would only make the forehead droop further. The real cause of lines is volume loss, and Sculptra can be placed in the forehead area to re-expand and re-curve the forehead, literally lifting the eyebrows.
Sculptra can also be used for adding volume back to the hands and to the chest/décolleté area.
As we begin to lose volume at about the age of 35, we should start thinking about treatment with Sculptra from this age.
Combining Sculptra with HA fillers
Those of us who insist on instant results will be reassured to know that Sculptra and HA fillers are compatible and can be used together. Once you have decided on a volumising treatment, perform the HA filler first to give instant results in the areas where it is recommended. Then, at your leisure, embark upon the course of Sculptra.
Adverse reactions to HA fillers
Manufacturers cite an "adverse" reaction rate to HA fillers of 1:20,000. We have never witnessed an adverse reaction to an HA filler in the clinic but it can and probably will happen. We will do our level best to ensure that it does not happen in the first place (use well-established products, maintain hygiene, select clients in good health, etc), and then treat you accordingly should the unfortunate event arise. Although the reaction rate is small, it is not insignificant if you are that one. Please remember this when deciding on a treatment. In our experience the most likely cause of "reactions" are infections. This is why we prefer not to treat you when you are unwell or have an obvious source of infection (eg infected tooth, bronchitis).
The advantage of HA is that it will dissolve and disappear totally with time. It can also be dissolved actively with the enzyme hyaluronidase should you really not like the result or suffer an adverse reaction.
Adverse reactions to Sculptra.
There are many historical reports of Sculptra causing lumps. There are two reasons for lumps developing; injection of undissolved product and infection. A recent paper exposed these two causes and has allowed us to take precautions against these two factors. The manufacturers have issued new guidelines on preparation and injection of the product. We have always followed these and to date have experienced no problems with lumps. |
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56-year-old woman – 3 treatments |
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54-year-old woman – 4 treatments |
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57-year-old woman – 4 treatments |
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