Sculptra®: Beyond the Label

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Collagen is the main structural materials that creates volume and also young texture of the skin. As we age, we will have less collagen and our skin will lose its elasticity which in return causes wrinkles and lines. There are ways to restore this with cosmetic products such as anti-aging creams containing collagen, but most of these products work only in the superficial level. One of the best solutions is Scuptra®️   which is able to stimulate body to produce new collagen in deeper layers. The collagen restoration will happen gradually and steadily. This will usually happen after multiple sessions of Sculptra®️  treatments. The results of this treatment generally remain for about 2 years. This minimally invasive treatment is famous for its natural-looking and long-lasting results. In this virtual course we aim to introduce Sculptra®️  to our members and also share some tips to have a successful treatment of patients with Scupltra®️ .

Highlights

We know you are very excited to have a very interesting topic from a very well-known plastic surgeon from Beverly Hills. At first, we will go through the basics of PLLA or the Sculptra because some of you may not be familiar with it.

PLLA (Poly- l-lactic acid) is a biocompatible and biodegradable synthetic polymer which can cause minor subclinical inflammation if injected. Sculptra is a commercial name of PLLA that is distributed by Galderma Company in Canada. The vial of Sculptra usually comes in dry powder which is consists of PLLA, Mannitol, and some other stuff but the major active part is PLLA. Sculptra is health Canada approved. It is suitable for increasing the volume of depressed areas, particularly to correct skin depressions, such as in skin creases, wrinkles, folds, scars, and for skin aging and large volume correction of the signs of facial fat loss (lipoatrophy).

After being injected, PLLA induces a subclinical inflammatory response through phagocytosis by tissue macrophages, followed by encapsulation of the particles and subsequent fibroblast proliferation and collagen formation. A temporary soft tissue augmentation will be noticed after injection that will be resolved in a few days. Approximately half of the product will be digested within 6 months. You will need to do multiple treatments so it is a series of treatments and you will see the effects gradually after 6-9 months with multiple injections. The duration of action is 12-24 months.

The best candidate for PLLA are people who are looking for a subtle, natural, and gradual improvement. If the patient is looking for an immediate effect, PLLA is not a good choice for them because it takes time to see the result. People who are looking for a longer result are also good candidates for PLLA, according to a study almost 80% of patients treated with PLLA still saw full correction at 25 months. So patient selection is very important as the treatment plan, the number of vials, and treatment interval varies on different patients with different anatomy and aging signs.

Sculptra can be injected both supraperiostal or subcutaneously. In the Temple, Maxilla, Zygoma, and along the mandible area the injection will be supraperiostal, a deep injection on the bone, but in some areas such as preauricular regions, around the midface and small lines, you might do a subcutaneous injection. Superficial injections and overcorrection can increase the risk of nodule formation. Sculptra vials are for a single patient and single-session use only so do not reuse or resterilize the vial and discard it immediately after use.

Massage is performed after every few injections and at the end of treatment because the distribution of the product is very important, if you inject a huge amount of product in one area there is always a chance that you are going to have an overproduction of collagen or you may have a kind of granulation tissue or nodule. So patient should massage the area over the next few days, using the “rule of fives” (5 minutes/ 5 times a day/ 5 days). Sun exposure and using the laser, chemical peels or EBD increase the risk of inflammation.

The areas that we don’t want to inject are the preorbital and preoral areas. The main complication of Sculptra is noduling that we can treat it by breaking it with a needle into little pieces. You can resolve almost every nodule with this technique.

In comparison with the other treatment options, Sculptra gives a more natural look with a gradual improvement that will last longer. It is less invasive, more predictable, and has little to no downtime and fewer complications.