I'm looking for clinical pearls here: like the dilution you use for this application and any other info you'd like to share for the treatment of acne scars especially in the cheeks.

Sculptra is not going to be your best choice for this in my opinion. As we all know, sculptra is a volumizer. Fillers ought to gain exceptional results.

I would consider Juvederm but only with some subcision, as the acne scars are typically too tense/non-elastic for the filler to truly fill anything visible. I prefer using high concentration TCA vs. CO2 laser ablation...those work much better in my opinion.

Sculptra is a good volumizer but I've been using it less and less as it requires tyipcally 3+ treatments, is expensive, and not immediate. Thus, you have to carefully choose your patients who are very patient.

I would go for a filler that will be more rigid and use in conjunction with subcision if you go that route. Be glad to provide details on high con TCA (wrote papers on it) and/or CO2, and hoping this does not sound too obnoxious.

Elaine, I have been using subcision with HA fillers for scars but Sculptra does seem to improve skin texture. I was speaking with a plastics the other day (but didn't get details from him) and he said that he used it in cheeks at a more dilute solution than the 9cc per vial that I use to volumize. Also I was looking for something that I could use in Fitz IV and darker but would love the reference to the TCA peels anyway. Knowledge is power.

Agree...almost every Sculptra patient notes an improvement of skin texture. The dilution for Sculptra has changed so much...I started using Sculptra when it first came out and we used 3-4 ccs...now it is up to 9 or whatever pretty much.

I still have sculptra and do use it...but see much better results (tightening for both wrinkles and acne scars, texture, etc.) with CO2 fractional resurfacing. It is probably cheaper and lasts much longer as well.

Consider subcision and fat transfer.

Anybody here who has also experienced lumps post injection of Sculptra? Any tips on how to prevent this?

I work with a group of physicians involved in the initial clinical trials. There are definitely complications with Sculptra, such as the nodules. To date, I am still hesitant to introduce Sculptra into my practice. That's why I'm sticking with HAs.

Tips i've learned to lessen nodule formation are 1)dilute, dilute, dilute, 2) mix ( i use a vibrator to get it in better suspension even in the syringe) and 3) pt massage to keep it in suspension in the tissue (i have them massage after i've done it during the injection every two hours until bedtime and for three days- think washing machine agitation). Also one should put the product deeper than other fillers and stay away from around the eyes and none in lips!

Are physicians (derm, plastic) the only ones who can inject Sculptra here in the US? Can anyone fill me in on the state laws on injecting Sculptra?

Sculptra injections are in demand in our practice. To achieve great results, you must master the injection techniques. Yes, extensive training is required.

Tori, here in CA, RNs, NPs, and PAs can inject Sculptra, Botox, Perlane, etc. but under physician supervision.

i have tons of photos of adverse reactions from allergic reactions to the product. Why inject anything that works by causing an allergic reaction? There is not one controlled study showing it causes collagen deposition.

I still feel that Sculptra injections are unpredictable. I'd rather stay on the safe side than administer this!

I've been injecting Sculptra for years. If expectations are discussed before the procedure and if the injector is highly skilled, it is always a home run treatment!

I've been thinking of adding Sculptra to our practice and I have heard great things about it. However, I've had experience with physicians who have had problems with nodules that had to eventually be surgically removed. We get fantastic results with Perline especially for cheek restoration and Juvederm for the lips. In my opinion, Sculptra has been great for some practices. I like the fact you can get great results from the initial treatment of Perlane and Juvederm instead of having patients come back repeatedly for Sculptra just to get a good result - too much unnecessary trauma for the skin.

You must always consider the outcome post procedure and the risks associated with it. Do outstanding results outweigh the chances of an irreversible damage?

The placement of Sculptra depends on the area and the concern you are attempting to address. Whether it is bone loss, volume loss, or dermal thinning.

any input on Sculptra for facial contouring?