Q & A: Dr. Finger: How does Sculptra Work?

How does Sculptra work?
Sculptra is the latest of a multitude of injectable fillers to be approved for aesthetic facial anti-aging treatment. While it enters a milieu of other injectable products that are commercially available, Sculptra has the unique distinction in that it lasts the longest, about 2 years and often longer. Duration of action is usually the one injectable filler feature that is most desirable.

But before you run out to get your Sculptra injections, it is extremely important for you to realize that the mechanism of action s different than with other fillers. Strictly speaking, Sculptra is not a filler, but is more like a volumizer. The face will de-volumize or deflate with age. A analogy would be an inner tube that is filled with air. Hold the inner tube up with one hand and deflate it 10-20% and it will sag, but reflate it and the sagging is corrected. The same correction occurs when the face is “re-inflated,” although it is not as simple. So Sculptra is not an instant filler of wrinkles, but more like a volumizer. It changes the face back into a more youthful shape, which in itself reduces many of the wrinkles.
Sculptra uses a completely different approach to achieving soft tissue augmentation. Rather than merely being a filling material which breaks down and goes away in a set period of time, Sculptra does not fill, it stimulates your own tissues to produce collagen, which creates volume. The tiny Sculptra particles (poly L-lactic acid) are basically a powder, which is mixed (suspended) with water and then injected into the desired tissue. The body reacts to these particles over time by laying down collagen around the polymer seeds, a perfectly normal response. The particles are not big enough nor are there enough of them placed to result in a significant foreign-body reaction. (known as inflammation and swelling).
This approach leads to two fundamental concepts of how the biology of Sculptra works. First, water is used to carry the particles into place. This gives a very satisfying immediate effect and allows the patient to view the ultimate goal of the treatments, but it will subside within a few days to a week. The correction at this time will only be about 20%. Then the tissues will start to thicken up again due to the stimulation of new collagen in the tissues from the product, and the face will re-volumize, filling some of the depressions of the aging process. Secondly, it requires more than one injection session to build up enough collagen to create the optimal effect. Two or often three injection sessions, spaced four to six weeks apart, are needed to create an effect that will last two years or longer. Because of its mechanism of action, Sculptra can also be used to create the “cheek bone” or weak chin that have been deficient since birth
By virtue of the build up of the facial area over time, Sculptra is not best used as a simple wrinkle filler for an immediate result. Rather it is intended to be for volume restoration due to fat atrophy and aging. This requires much more of an artistic sense and truly represents a form of facial sculpting…as the name implies. In our Savannah, GA and Bluffton, S. C. plastic surgery practices, Sculptra can be very useful for after facelift touch-ups, reversing volume loss from early signs of facial aging, and, when combined with other facial treatments such as Botox, the Fraxel laser, New Youth Skin Treatment System, one can have dramatic facial rejuvenation without a surgery.

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