A new wrinkle treatment has entered the market and is a good option for filling out cheekbones. Sculptra (also known as New- Fill outside the U.S.) was approved by the FDA on July 29, 2009 to treat facial wrinkles.
Our research team at the University of Miami was involved in the clinical trial that began in 2003 and led to the FDA approval of Sculptra. In this trial, 117 people received injections to improve wrinkles between the nose and mouth (called the nasolabial folds). Sculptra was found to last 25 months in patients in the trial. (Restylane has been shown to last 18 months while Juvederm lasts one year.)
Sculpra vs. other wrinkle fillers
In contrast to hyaluronic acid (HA) "dermal fillers" on the market--such as Restylane, Perlane, and Juvederm--Sculptra is a "dermal stimulator." Restylane and Juvederm are sugars that are injected into the skin to plump up and fill lines and wrinkles, while Sculptra is injected to stimulate the skin cells into making collagen. This process takes time: In the study, patients required an average of 3 treatments at 3 week intervals to achieve the desired effect. With Juvederm and Restylane, results are immediate. However, Sculptra lasts longer--sometimes twice as long. To get the best of both worlds, many doctors perform injections of Restylane or Juvederm immediately after injecting Sculptra--instant gratification with longer lasting results.
The downside to wrinkle fillers
The one common side effect that wrinkle fillers have in common are soft bumps under the skin. Juvederm's and Restylane's small soft bumps can be easily removed with hyaluronidase injections by your doctor (these injections dissolve the HA sugars). Sculptra injections, however, can lead to small and medium sized bumps (called papules and nodules) that are rock hard and cannot be dissolved with hyaluronidase.
It is unknown what causes the Sculptra bumps, but they seem to occur in areas with more movement--such as around the eyes and in the corner of the mouth. These bumps can last for months to years. In the FDA Sculptra study mentioned above, at 13 months 8.6 % of patients had small bumps that they could feel under their skin. At 25 months, approximately 3% of patients had bumps under the skin that they could feel; however, most of them were not visible.
Find an experienced doctor
It is crucial if you plan to get Sculptra treatments that you find a doctor who is well trained. The incidence of bumps is lessened with experienced physicians while untrained doctors are much more likely to cause disfiguring bumps under the skin. (Search for trained doctors near you.) Take note: I have found web sites on the internet that will sell Sculptra to any doctor. This is unfortunate because the company that distributes Sculptra sells only to dermatologists, plastic surgeons and facial plastic surgeons who have received special training.
I have personally treated hundreds of patients with Sculptra since 2004. (It was approved for use in HIV associated lipoatrophy in 2004). In my opinion, it is best used in the cheek area to treat gaunt/ thin faces. It should not be used in areas that move a lot--around the eyes, the frown lines or the lower corner of the mouth--because these areas are more likely to develop bumps. Keep in mind that in my experience, most people require 4-5 treatments sessions for the best result. The cost is $400 to $1500 a session depending on how much volume is needed. (Juvederm and Restylane cost around $500 a syringe).
Although in the short term Sculptra is more expensive than Restylane and Juvederm, over a 3-year period it may be more cost-effective because fewer treatment sessions are required. Many patients who have been treated with Sculptra still have good results 3 years later. For large areas such as the cheekbones or for extremely wrinkled skin, this newest dermal filler is a good option.
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