Why I don’t use Sculptra

First, let me say that I truly do not believe Sculptra is a bad product. In fact, I have many trusted colleagues who use it and use it well.  However, I have used it in the past but I do not anymore for several reasons.  The motivation behind this blog is not to denigrate a good product but to outline why (at least at this time) I choose not to use Sculptra (a question that I get all the time and I am tired of answering):

Why I Dont Use Sculptra Sculptra, Poly-L-Lactic Acid
  1. I believe that Sculptra is good for static areas like the temples and the cheeks.  It is not good for the area around the mouth or the eyes in which movement occurs since it is a bioactivator, meaning that it can create nodules in areas of high movement. I have personally seen it.  Therefore, if it is only good for a narrow sector of the face, then I am not interested in using it, especially since I think cheeks are one of the most overdone areas if not effectively blended with the rest of the face.
  2. There is too much variability in the results. I have seen good responders who get great results and poor responders who get close to nothing.  I need consistency delivered especially at the costs that are incurred.
  3. Sculptra is painful.  Despite numbing cream and blocks, I have found that by injecting Sculptra I simply cannot make it as pleasant as my other injectable filler products.
  4. You have to wait to see results.  Most people who do fillers want immediate results, and so do I.  However, you get teased with the swelling during the first week then it goes away then you have to wait weeks to months to see results that may or may not appear.
  5. It is a pain in the butt to have to massage it for 3 days to limit nodules.  Ok, this is not a big deal but still something I don’t like.
  6. This is one of the big ones for me:  you cannot sculpt or design a face with precision as I can with other products.  You sort of guess how much you put in the face and hope for results months later.  I like the absolute precision of what I put in is what I get with other products.

These are the top 6 reasons that I no longer use Sculptra.  I think that my colleagues who do it well should be commended.  I simply cannot see room in my practice at this time to use Sculptra.  The one thing that I have learned is never to say never.  Perhaps with advancements with this product or new ways to use this product that I will be able to eventually re-incorporate it back into my practice but not at least for the time being.

Sam M. Lam, MD, FACS is a board certified plastic surgeon in Dallas, Texas. Call 972.312.8188 to schedule a consultation or to ask Dr Lam a question please visit our plastic surgery forum.