Sculptra is an injectable filler agent that contains microparticles of poly-L-lactic acid (PLLA), which is a biodegradable product from the alpha-hydroxy acid family. Biodegradable means that it breaks down gradually into natural substances – mainly lactic acid which is non-toxic and a product the body is used to dealing with daily.

So, Sculptra is a product made from natural sources that breaks down slowly via natural, biologic processes into natural ingredients common in the body. PLLA has been used for many years in sutures and bone screws designed to break down or degrade naturally and safely over time. Sculptra PLLA has been used cosmetically as a dermal filler since 2004 when it was FDA approved to treat lipoatrophy (facial wasting) caused by drugs to treat HIV.

Sculptra is referred to as a biostimulatory filler. What this means is a filler that stimulates your skin to produce collagen and renew the extracellular matix – the support structure and home for collagen in the skin. All fillers have some biostimulatory effect but with Sculptra, this stimulation of collagen is its primary effect and goal. 

I have used Sculptra since its approval in 2004 and have loved it as a versatile filler. I commonly use it for full face volume restoration in individuals who have thin faces or thin skin where a bulkier filler might show – Sculptra can give a slow, subtle, gradual volume enhancement that is very natural. I use it as a solo agent or with other fillers. For example, I might use a bulkier filler to create lift by injecting in the upper lateral cheeks and even hairline, and then use Sculptra in the lower cheek just lateral to the mouth where the skin does not lie over bone so you need to use a flexible, fluid filler that won’t be visible under the skin. Also, in this area – just lateral to the corners of the mouth – there is often crepey skin or fine vertical lines that look more prominent with smiling. Using a biostimulatory filler is ideal in this area for both some volume as well as skin and wrinkle improvement. 

Today, fillers are commonly being used off the face to improve wrinkles on the chest, arms, neck and knees, and Sculptra is commonly used for this purpose as well as Radiesse. The biostimulatory effect of these fillers renews the skin thus improving fine lines and wrinkles. These fillers can also be used with laser and energy (radiofrequency) treatments to get even better results. 

Modern use of fillers in not just about filling lines, it is a complex coordination of multiple goals – volume replacement, skin hydration, collagen stimulation, lifting and enhanced skin resistance to movement that creates wrinkles and lines. These fillers last – and I frequently say “they continue to work for you long after I have injected them”. Sculptra taught us this years ago and it remains a favorite cosmetic tool.