Facelift in a Bottle
Informational Article on Sculptra®
Over the last five years in the lowcountry, I have come to learn what most facial rejuvenation patients want. They come in for consults wanting only to look younger and natural, and they prefer to achieve this with no downtime. Additionally, they add the confusing goal of looking significantly better and having it last, but in a way that their friends don’t all notice (?).
Unfortunately, I spent 10 years studying medicine and plastic surgery, not magic. So, I don’t know exactly how to address these conflicting goals in all patients. In general, patients in their minds, are trying to balance their own aesthetic goals with fear about the persisting stigma of “having something done” and not wanting to be scrutinized by their friends. Unfortunately, it is hard to reconcile the goals of having a meaningful improvement in one’s face without it being noticeable.
Fortunately, a new product has been approved by the FDA which goes a long way toward that goal. Sculptra is a newly approved injectable product that restores volume and fullness to the aging face. Sculptra has several attractive characteristics that make it different from other injectable fillers and a good fit for many patients:
- It gives a long-lasting result (approximately 2years)
- It is arguably the most natural of all fillers
- it gives a gradual change over 3 months
Sculptra is injected into the face in a series of 3 injections spaced at least a month apart. Each injection deposits small dissolvable crystals into the soft tissue of the face in the fatty layer. These crystals essentially irritate the body into producing its own collagen as a reaction to the irritation. After this occurs, the crystals disappear, dissolving into water and carbon dioxide which the patient breaths off, leaving only the resulting collagen in its place. In this way, the final “filler” left by the Sculptra injections is actually the patient’s own collagen tissue, this making Sculptra the most natural of all off-the-shelf injectable fillers.
The fact that the Sculptra is not all injected at one time gives the unique benefit that the improvement in appearance is gradual. Not only are the injections themselves spread out by a month each, but after each injection the accumulation of the patient’s own collagen in the face is gradual as well, taking several weeks. The plastic surgeon can therefore see the resulting change after one month before deciding how much and where to inject at the next session. During the 3 month injection process, Sculptra causes the slow accumulation of the patient’s own collagen. This causes a change that is noticeable after 3 months when compared to the before photos, but not necessarily obvious to the patient’s friends or co-workers.
Once the Sculptra injections are completed, the filling effect created by the collagen that the body creates tends to last approximately 2 years. Because everyone continues to age during that time, touch-up reinjections after 2 years will be required to maintain the result or to improve upon it.
Sculptra therefore provides an exciting tool to gradually improve patients’ appearance with a long-lasting, natural result. Ideally it can be combined with other rejuvenating modalities such as laser resurfacing to give the maximal improvement with minimal downtime and without the cost and risk of a trip to the operating room. Either way, Sculptra should be injected by a plastic surgeon with significant experience with the product.