Posted February 02, 2010 in Blog, Sculptra, Uncategorized
Sculptra Aesthetic (Dermik Lab., Sanofi-Aventis) is an exciting, new facial injectable treatment. Sculptra is injectable Poly-L-lactic acid (PLLA). PLLA is what absorbable suture material is made of. Sculptra has been used cosmetically outside the U.S. since 1999 and is a very popular procedure in Europe and Canada.
Dr. Persky has been following the use and development of Sculptra since its introduction to Europe in 1999. As with all new products and treatments related to facial plastic and reconstructive surgery, Dr. Persky is extremely conservative and believes that it is important that the treatment be proven not only effective, but more importantly safe. The Hippocratic Oath admonishes, “Physician, first do no harm!”
Early Sculptra treatments were very effective at replacing lost facial volume, so much so that in 2004 Sculptra was FDA approved for use in volume restoration from fat loss (facial lipoatrophy) for HIV patients. Some plastic surgeons and dermatologists began using Sculptra off-label to treat non-HIV lipoatrophy patients for cosmetic volume replacement. There were troublesome nodules and granulomas (lumps and bumps) during the early years of treatment with the product before techniques were improved.
In the past few years, physicians have learned how to minimize the occurrence of nodules with Sculptra. It is now injected in a much more dilute fashion. Patients massage the injected areas for 5 minutes, 5 times a day for 5 days. Injection techniques now avoid injecting through muscles that previously caused nodules. Superficial injections are now avoided. With a much greater safety profile, Dr. Persky now feels very comfortable treating his patients with Sculptra.
At The South Beach Symposium in February 2009, Dr. Persky met with the world leaders in Sculptra use, including Danny Vlleggar, MD. Impressive and natural before and after photos of patients treated with Sculptra, along with the much improved safety profile piqued Dr. Persky’s interest in the product. What ultimately convinced Dr. Persky that Sculptra was going to be the filler of the future was seeing and speaking with 3 relatively young, beautiful, intelligent, well known female U.S. dermatologists who have had Sculptra injected into themselves as their facial volume filler of choice. If it is good enough for those experts to use on their world famous faces, then that was good enough for Dr. Persky to begin using Sculptra.
In July of 2009, the FDA approved Sculptra for the cosmetic indications of volume deficiency and facial wrinkles. Once it was FDA approved, Dr. Persky began using Sculptra to contour and sculpt faces.
The beauty of Sculptra is that is works by stimulating natural collagen production. John Joseph, MD of Beverly Hills says, “It is like putting a grain of sand into an oyster to form a pearl”. I like to think of Sculptra as wonderful “seeds” that are spread where facial structure needs volume to restore youth.
Sculptra Aesthetic is different from all other filler products. Sculptra is injected as a very dilute cloudy solution that is mostly water and local anesthetic. Once injected, the patient can see a “preview” of what they will ultimately look like after their complete correction. Within hours to days, the fluid is reabsorbed by the body, and the treated patient’s appearance returns what it looked like before the injections, with possibly a new bruise or two. Over the next 6 to 8 weeks as collagen production occurs, the patient’s face subtly and gradually establishes a foundation for the correction. Re-evaluation and a second injection session are then carried out. Most patients are treated over 3 sessions with varying amounts of Sculptra depending on their individual need and individual response. At full correction, the result is natural and has been shown to last 25 months and longer. As aging continues, touch-up treatments restore lost volume.
Sculptra gives physicians the ability to treat faces after analyzing the skin, muscle, fat, and bone; determining what needs to be replaced, and then using aesthetic injection skills to achieve facial rejuvenation. Patients with early signs of aging from volume loss in their 30’s and 40’s are great candidates for Sculptra to correct early “jowling” and loss of volume in the cheeks. In older patients, Sculptra can be used beautifully to restore volume in hollow temples, jaw lines, chins, and to shorten elongated upper lips, restoring the proportions of youth to the face. By restoring volume at the base of the nose, the nasal tip is elevated, mimicking rhinoplasty in some patients. Other than in the nasolabial folds, all of these cosmetic uses are “off-label.”
Patient satisfaction studies have shown 84.9% satisfaction at 13 months and 80.0% satisfaction at 2 years. Sculptra should not be used in patients with a history of keloid formation or hypertrophic scarring, or in those patients allergic to absorbable stitches.
Dr. Persky is very excited about having Sculptra as a new powerful facial filling and contouring agent to go along with traditional fillers and fat. As with any treatment or product, it behooves the patient to do their homework and choose their injecting physician most carefully. It takes a combination of proper Sculptra technique with an aesthetic sense of beauty and proportion to help patients gradually look natural without feeling different or like someone else.
To view before and after patients who have been treated with Sculptra go to http://www.sculptra.co.uk/content.asp?section=3&subsection=3&picID=44.
Be well.
Dr Persky is located in Encino, California but services all of Los Angeles and the San Fernando Valley. Including, Beverly Hills, Hollywood, Santa Monica, Malibu, Sherman Oaks, Studio City, Calabasas, Woodland Hills, Tarzana and Agoura Hills and more.
