During my recent national ASPS meeting @ home 2020 (love!), the first presenter in the noninvasive treatment panel discussed use of Sculptra for contour deformities of the body.
I already know Sculptra well. It absolutely works for most people to fill volume loss. It is a synthetic polymer lactic acid derived from the AHA family. It causes your body to react to form collagen- essentially scar- to give volume. It tends to last 1-2 years. Of note, in my practice I stopped using Sculptra as much in my office if you are a candidate at all for fat grafting, because I believe FAT GRAFTING IS BETTER. In fat grafting, I can add volume, there is essentially “no scar” as I use an 18 gauge needle for access (the size of an IV needle), and fat can last for years or longer (think of it as planting shrubs. When they get a new water supply, they thrive in their new position.). And fat has stem cells, which improves the quality of the overlying skin.
But the presenter rightfully states some people are not candidates for fat grafting. It could be because they do not have fat to harvest (and crazy enough, here in the Bay Area I see some patients with truly no fat). It could be that they want to avoid a surgical procedure.
His technique:
- He used a more diffuse Sculptra reconstitution average 11cc/vial (not the usual 7cc dilution we use in the face). 8-12 cc of bacteriostatic water, mixed with 2-3 lido with epi.
- He used 5 vials/abdomen/cycle
- He did 4 treatments.
My thoughts?
His photos were great.
As he repeated often, “my patients did not want a surgical procedure.” “They did not want fat grafting.” If the cost were less (each of these rounds of treatments likely ran the patient $4-5,000) or if the results were permanent (Sculptra lasts about 2 years), I could understand it better. But it worked. I find things like this help us be better plastic surgeons. The more tools we have in our tool box to fix things, the better. As I repeatedly state, I think fat is better. But for those who fat or surgery is not an option, this is an answer for them.