1 Day Post (the next day) - Also had Radiesse Removal from the Lips

Treatments are repeated approximately every 6 weeks for 3 to 4 treatments.  You should begin to notice your first results at about 6 weeks.  If you are going to form nodules, they commonly form within 3 to 6 weeks and should be reported to your doctor.  Nodules that can be felt, but not seen may occur.  Read my Sculptra Journal.

I had my second treatment 3 months later.  The collagen had formed in the areas where it was injected but where it was not, you could see little indentations.  Hence the second treatment.  Read my Second Sculptra Journal with a photo of the slightly perceptible nodule under the eye and end results. 

Risks & Complications Of Sculptra
The most common complication of Sculptra is palpable nodules.  I had a slightly visible nodule for about 7 to 9 months.  It was more easily felt than seen.  Other complications or risks include, blanching of the skin if injected too superficially (white areas seen under the skin).  I had blanching at the nodule only.   I did have thickening of the dermis which caused the darkness under my eyes and the vascularity to be less visible.  Again, Sculptra is not recommended for under the eyes anymore. 

Rare complications include hematoma, seroma, infection, necrosis, hyperpigmentation from bruising, and , prolonged abnormal inflammation.

The Average Prices Of Sculptra
The average cost of Sculptra is  approximately $300 to $500 per cc, and averages $1,500 per treatment which may include about 4cc.   The costs varies significantly so be sure to ask around.  Although don't base your doctor of choice on price alone.  Sculptra must be injected by someone with experience as complications are difficult to correct.

Frequently Asked Questions About Sculptra (Interview with Dr. Gail Humble)

Q. How long do the results from Sculptra last?
A. Your results last up to 24 months.

Q. How many rounds has the average patient without HIV needed for standard cheek augmentation? 
A. Between 2-3 treatments.

Q. What is the % of incidence of serious lumping requiring treatment?
A. 1 to 10% depending on what study.  54% spontaneously resolve the others respond to the below treatments.  Honestly with the new more dilute injection, even before, I have only seen 2 in four years in my patients.

Q. If there are lumps, what types of treatments are available?
A. Most of the time they resolve on their own, but if not you can do steroid injections, physically break it up (if they are new) with a needle or 5FU injections.

Q. How many cc of product is contained in one vial of Sculptra once reconstituted?  
A. 5cc

Q. Is it true it must be reconstituted several hours (how many) beforehand and is only good for 72 hours? 
A. Sculptra should be mixed AT LEAST 30 min prior to procedure.  Once mixed it is good for 72 hours. 

Q. About how many ppm (or whatever %) of Sculptra to saline is commonly used.
A. We mix it with 4cc sterile H2O and 1cc of Lidocaine

Q. How much do you charge per round of Sculptra?  
A. There is a $500 administration fee and $100/cc of Sculptra per visit.  The cost for the product is the same that we have to pay.  There is no up-charge.

Source: Gail Humble, M.D.

Dr. Jonathan Hoenig Answers a Few Questions About Sculptra

Q. Does Dr. Hoenig use Sculptra in the nasolabial folds?

A. Dr Hoenig likes to inject Juvederm in the lips and the nasolabial folds.

He uses Sculptra as an alternative to fat transfer - when someone needs a lot of volume in the cheeks but doesn't want surgery, recovery time, or doesn't have fat to harvest.

Dr. Hoenig only uses Restylane under the eyes.  In his experience, Juvederm seems to attract too much fluid and gets too puffy.  He doesn't use Sculptra under the eyes because you can't control how much collagen will build up around the Sculptra and work around the eyes needs to be very precise.  Also, with Radiesse and Sculptra you can get bumps which can't be dissolved like they can with hyaluronic acid fillers.

Sculptra, in his opinion, is not good for detailed work (like around the eyes) and definitely not in the lips.  It's good as a large volume filler when 5-25 or more cc's volume are needed.  He has devised his own dilution method to avoid lumps and bumps.

As an aside, he did Sculptra on me for the cheeks and jaw a few years ago.

One drawback is that you have to wait 4-6 weeks before you start to notice any results.

Danya Hoenig, P.A.

My Personal Opinion: Comparing Sculptra, Fat Grafting, Juvederm and Radiesse
I have had Sculptra, Fat Grafting (Twice), Juvederm, Restylane and Radiesse to my cheek area and I must say that overall, I prefer the convenience and immediate satisfaction that I got from Radiesse, as well as the longevity.

• Sculptra:  In retrospect, I DO like how it thickened the dermis, filled out lines and decreased the visibility of the under eye vascularity.  It actually made the skin thicker so that the veins did not show through as well.  Unfortunately, Sculptra may not be the best for the under eye area.  I feel that the benefits versus the risk of palpable nodules in the under eye area is not worth it considering the other products and procedures which are out there now.  I feel that it is nice for cheeks and the buccal area (lower, sunken in area of the face) however, but I am very impatient and 6 weeks per treatment with gradual augmentation just isn't what I want out of a product.  This is just my personal experience. 

• Fat Grafting: I feel that fat grafting, although nice, smooth and natural (and I LOVED the slight, post-operative swelling I had even after 6 weeks, it just doesn't last as long.  Plus fat transfer requires a donor site and also I felt that I did have scar tissue from the placement of the fat.  I do realize that today, with the use of your own stem cells, the fat graft can have a better chance of survival so this is promising for future endeavors.

• Juvederm:  I like Juvederm in the cheeks and nasolabials.   I have had Restylane in these areas as well, and feel that hyaluronic acid fillers are great in that they are soft and reversible.  However, their temporary nature is the one true drawback.  But this is also its benefit if you think about it.  You can't have it both ways.  I feel that Juvederm lasts longer in the cheeks and nasolabials than Restylane but is not best for under the eyes like Restylane is.  Although the Tyndall effect (bluish cast under the eyes, Tyndall scattering) after injection is sometimes a problem.

• Radiesse: I do prefer Radiesse for the cheek area (not NOT for the under eye or lips).  Reason being it is immediate and affordable and lasts just the right amount of time.  Your face can change as you age and I feel that although 4 months for Juvederm is too short, 2 years for Radiesse is just right.  A lot can change in 2 years, and the dissipation is quite gradual.  Nodules are possible, as I have found out, but injector skill is paramount in the overall end result.

Product and Procedure Comparison Based Upon My Own Experience

References 
Interview with Gail Humble, M.D.
Interview with Dr. Jonathan Hoenig
Personal Treatment Experiences

How Patients Rate This Procedure