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Dear Dr. Togba,

Q.   Dr. Togba, I know this is not an unusual complaint but I look older with a few more lines and less “umph” to my face as certain areas have sagged ever so slightly.  I’m only in my mid-fifties and I don’t feel I’m ready for a facelift.  My friends have mentioned several facial fillers that restore facial volume, particularly Sculptra. Could you tell me about it and why it might be better than other options?

 A.   FDA approved Sculptra is one of the newer additions to our armamentarium of products aimed at restoring facial volume associated with the aging process.  Sculptra is a crystalline form of poly-L-lactic acid, a product that has been used for more than twenty-five years as a dissolvable stitching material under the skin by most surgical specialties. 

Sculptra is mixed with sterile water and a local anesthetic before injecting it under the skin.  The initial mild swelling of the injected site caused by the water component disappears within a few days to a week.  As the residual crystalline product is metabolized by the body, it stimulates the production of collagen, which gradually causes expansion of the injected site over a period of several weeks to months.  The net result of fullness is apparent after two to three months and lasts for about two years.

Most patients with mild to moderate facial “deflation” require two to three treatments separated by a period of four to six weeks which allows for adequate clinical evaluation of the response to the previous treatment. 

Unlike other products used to restore facial volume, Sculptra brings about a gradual, predictable long-term increase in facial volume.  Results are comparable to that of fat grafting without the prolonged swelling and donor site discomfort.

The combination of Sculptra with eyelid surgery, brow lift or neck lift can result in total facial rejuvenation without a facelift for many patients in their 40’s and early 50’s.  For those requiring facelifts, the addition of Sculptra results in an even more youthful appearance.