Sculptra is a biocompatible, resorbable injectable product composed of poly-L-lactic acid (PLLA). It falls in the class of a stimulatory product that creates its effect through encouraging neocollagenesis when injected.

Sculptra is a synthetic polymer from the a-hydroxyl-acid family that is similar to absorbable suture material.

Sculptra is ideal to be used for deep tissue filling or in the dermal subcuta-neous junction to smooth out and soften lines and wrinkles, restore facial volume, contour the face in a natural way. It is not meant to be injected intra-dermally.

As it differs from traditional, static dermal fillers such as hyaluronic acid and collagen, as a stimulatory product it causes the growth of fibrous tissue or collagen within the body, which then results in volume restoration gradually.

It requires a special understanding of how it works, where it can be used, and how it should be injected.

Sculptra (Polylactic acid) has been in medical use for over 40 years as screws, resorbable sutures, pins, plates, implants and as vectors for sustained release of bio active compounds.

Sculptra is used on most parts of the face (except on the forehead and above the lips). Common areas of use include cheeks, temples, inframalar region, chin, prejowl sulcus, and marionette lines.

More advanced areas include infraorbital regions and lateral brow.

Creative uses have been reported in the treatment of acne, deep acne scarring and varicella scars, chest wall, prominent facial asymmetry and the dorsum of the hands.

Sculptra is suitable for both women and men of different ages. It can help with deep folds around the mouth and nose, sunken cheeks, facial scars, deep acne scars and loose skin. Our surgeon will be able to assess your suitability for the Sculptra treatment.

In the 20s:	Collagen production slows down and then becomes dormant. This is an ideal time to start Sculptra to keep the collagen reserves active and for skin tightening.

In the 30s and 40s:	Sculptra is ideal for long lasting lines and wrinkle correction and enhances cheek volume and stimulates collagen in a natural way.

In the 50s and onward:	Sculptra is ideal to restore facial contours and volume and correct facial laxity and improve the jaw line and other areas and patients can achieve full face lifting without the need for aggressive surgery with the results lasting up to 5 years.

A clinical study at our clinic of more than 400 patients has shown that the improvements obtained with Sculptra have lasted for up to 3-4 years. Treatment usually consists of 2 to 4 sessions lasting up to half an hour; usually2-3 weeks apart with no ‘downtime’.

How long do treatment effects last?

Treatment effects will differ for each person. In a clinical study, the treatment results lasted for up to 3-5 years after the first treatment session, in most patients. Touch-up treatments may be needed to maintain the desired effect.

In capable hands, with the right training and experience, this is a very safe and effective procedure. Over time the technique has evolved to optimise the effects and reduce problems.

Immediate side effects may include injection-related events at the site of injection, such as minimum redness, slight tenderness or discomfort, some bruising and rarely swelling.

All of these side effects usually last only for a day or two.

A delayed appearance of small bumps under the skin in the treated area could rarely occur. Generally these bumps are not visible and may only be noticed when pressing on the treated area.

This rare side effect is usually an effect of the product being injected too superficially causing a lump of product or collagen to form, but vigorous massage usually prevents this.

Sculptra Clinical Safety

The safety of injectable Sculptra in humans has been assessed in patients in investigator-initiated clinical studies.

Sculptra has been found to be well tolerated with no serious adverse events reported.

The most common device-related adverse event was the delayed development of palpable, non-visible subcutaneous papules (very rare) that occurred at the site of injection.

Patient Expectations Before the Sculptra Treatment

With a stimulatory product of any kind, it is important to carefully and clearly explain the process and goals of the treatment before beginning treatment.

Sculptra in particular requires this education because it is administered in usually three or more sessions covering a 3 month period or more with ultimate results achieved over a 4 – 6month time frame.

Patients not willing or able to wait for improvement may need additional augmentation with a hyaluronic acid to tide them over in the mean time.

Because of the volume of the water in the suspension, patients will leave the office looking filled; however, they should be aware that the improvement they see immediately will be gone in 2 to 4 days and they will then await the collagen growth that can be seen starting at 2 to 4 weeks. Patients should also be cautioned to prepare for the possibility of bruising and avoid non-steroidal anti-inflammatory medications prior to an injection.

The nature of injectable Sculptra is that unless the patient has had three vials over time, they have not even had one conservative treatment. Using less than this amount results in overly subtle results that disappoint both the patient and the injector.

Equally important is the use of preoperative photography, which reminds everyone of the amount of improvement as it comes on gradually. Just as the signs of aging occur gradually and are not realized by the patient until advanced, improvement over time with a stimulatory filler can be overlooked at first.

Once volumization has been achieved, results can be expected to last for 2-4 years.

With a stimulatory product of any kind, it is important to carefully and clearly explain the process and goals of the treatment before beginning treatment.

Sculptra in particular requires this education because it is administered in usually two – three or more sessions covering a 3 month period or more with ultimate results achieved over a 3 – 6 month time frame.
Because of the volume of the water in the suspension, patients will leave the office looking filled; however, they should be aware that the improvement they see immediately will be gone in 2 to 4 days and they will then await the collagen growth that can be seen starting at 2 to 3 weeks. Patients should also be cautioned to prepare for the possibility of bruising and avoid non-steroidal anti-inflammatory medications prior to an injection.

The nature of injectable Sculptra is that unless the patient has had two – three vials over time, they have not even had one conservative treatment. Using less than this amount results in overly subtle results that disappoint both the patient and the doctor.

Once volumization has been achieved, results can be expected to last from 2 – 5 years (non-smoker patients have longer lasting results, due to smoking reducing the blood supply to the skin, according to Dr Ayham Al-Ayoubi).

Who can benefit from Sculptra?

Sculptra is suitable for both women and men of different ages. It can help with deep folds around the mouth and nose, sunken cheeks, facial scars, deep acne scars and loose skin. Our surgeon Dr Ayham Al-Ayoubi will be able to assess your suitability for the Sculptra treatment.

In the 20s:	Collagen production slows down and then becomes dormant. This is an ideal time to start Sculptra to keep the collagen reserves active and for skin tightening.

In the 30s and 40s:	Sculptra is ideal for long lasting lines and wrinkle correction and enhances cheek volume and stimulates collagen in a natural way.

In the 50s and onward:	Sculptra is ideal to restore facial contours and volume and correct facial laxity and improve the jaw line and other areas and patients can achieve full face lifting without the need for aggressive surgery with the result lasting up to 5 years.

How long do treatment effects last?

Treatment effects will differ for each person. In a clinical study, the treatment results lasted for up to 3 – 4 years after the first treatment session, in most patients. Touch-up treatments may be needed to maintain the desired effect.

Where can Sculptra be used?

Sculptra is used on most parts of the face (except on the forehead and above the lips). Common areas of use include cheeks, temples, inframalar region, chin, prejowl sulcus, and marionette lines.

More advanced areas include infraorbital regions and lateral brow.

Creative uses have been reported in the treatment of acne, deep acne scarring and varicella scars, chest wall, prominent facial asymmetry and the dorsum of the hands.

How does Sculptra work?

Sculptra Aesthetic works to replace lost collagen in a series of treatments administered by Dr Ayham Al-Ayoubi himself at our clinic. On average, two – four injection sessions are needed over a period of 3-8 weeks. The number of injection sessions and the number of injections per session vary from person to person.

Sculptra treats most areas of the face that may have deeper lines, wrinkles and folds. The results should be noticeable after approximately 2 – 4 weeks (however, in some patients this may take longer or require more treatments).

Unlike surgical options, Sculptra can provide gradual, natural-looking results through less traumatic treatment. Results usually start to become visible after 2- 4 weeks. Patients can achieve a full face lifting effect which usually lasts up to 3 – 4 years.

With the natural ageing process, our skin loses its full, firm, youthful appearance and becomes thinner and starts to wrinkle and fat tissue, which also helps to fill out our faces, is lost, causing skin to sag and wrinkle further.

For some people, the loss of fat tissue and the reduction in skin volume can make their face look thin and narrow and due to this look tired and appear older than they actually are.

Sculptra works by stimulating the build-up of your body’s own collagen to get rid of lines and wrinkles and restore a more youthful appearance but with gradual, natural looking results.

Sculptra requires planning over 12 – 16 weeks as 3 treatment sessions are usually needed with a minimum interval of 2-3 weeks between each Sculptra session. Final results are at 6 – 10 months. Younger patients starting in their twenties report changes at 3 – 4 months, often after their first treatment.

Sculptra provides an alternative option to both traditional surgery and some less longer-lasting non-surgical treatments.

The science behind Sculptra involves more than 45 years of use in human medical applications. From absorbable sutures to resorbable screws, it has proven to be biocompatible, well tolerated, and effective.

Sculptra over the course of time

The patient received injections four times at intervals of 4 weeks.

How is Sculptra treatment performed?

Sculptra is formulated of mirco particles of poly-L-lactic acid, which are mixed in with 5ml of sterile water and 1ml 1% Lidocaine.

The treatment consists of the product being injected deep into the fatty tissue of the face. It is uncomfortable rather than painful and the session lasts about half an hour.

The mechanism of action is the stimulation of a foreign-body reaction and stimulation of collagen production (characterized by increased macrophages, mast cells, and lymphocytes).

The resulting tissue is natural with normal contours, restored mid-face volume, a firmer jaw line, better cheek bones and apple cheeks.

The Sculptra particles show signs of breaking down around 6 – 9 months and are gone by 9 -12 months.

The duration of the effect has been repeatedly demonstrated in prospective clinical studies of at least 4 – 5 years. Follow-up reports are showing good continued persistence of results.

Are skin tests required before treatment with Sculptra?

No, skin testing is not required prior to use.

Are the results from Sculptra immediate?

No. After the first treatment, it may appear that Sculptra worked immediately. Typically, patients will experience some degree of edema associated with the injection procedure, which will give the appearance of a full correction by the end of the injection session (within about 30 minutes).

The patient should be informed that the injection-related edema typically resolves in several hours to a few days, resulting in the “reappearance” of the original contour deficiency. Sculptra takes time to gradually correct the depression in the skin.

How many treatments are required?

Each patient should be evaluated individually. More than one treatment session may be required. Patients with severe facial fat loss may require 3 to 6 treatment sessions.

How quickly can my patients return to their daily activities?

Most patients feel comfortable going back to their normal activities following the Sculptra treatment.

Possible side effects?

In capable hands, with the right training and experience, this is a very safe and effective procedure. Over time the technique has evolved to optimise the effects and reduce problems.

Immediate side effects may include injection-related events at the site of injection, such as minimum redness, slight tenderness or discomfort, some bruising and rarely swelling.

All of these side effects usually last only for a day or two.

A delayed appearance of small bumps under the skin in the treated area could rarely occur. Generally these bumps are not visible and may only be noticed when pressing on the treated area.

This rare side effect is usually an effect of the product being injected too superficially causing a lump of product or collagen to form, but vigorous massage usually prevents this.

Sculptra Clinical Safety

The safety of injectable Sculptra in humans has been assessed in patients in investigator-initiated clinical studies.

Sculptra has been found to be well tolerated with no serious adverse events reported.

The most common device-related adverse event was the delayed development of palpable, non-visible subcutaneous papules (very rare) that occurred at the site of injection.

What is the difference between Sculptra and Dermal Fillers?

In the arena of facial fillers and volumizers, Sculptra is one of a few stimulatory products as opposed to the traditional immediate fillers like collagen or hyaluronic acids.

Unlike other dermal fillers, Sculptra stimulates your own collagen production over several months to restore volume. This new volume is therefore your own body at work making new collagen. It feels plump and smooth and appears very natural.

Sculptra works differently from traditional fillers. It’s a unique collagen replenishing treatment that helps to gradually and subtly reduce lines, wrinkles and folds. By helping to replenish your own facial collagen and restore lost volume, it can give you a fuller, more natural look that can last from 2 – 5 years.

The main ingredient of Sculptra is poly-l-lactic acid, which has been successfully used in surgical operations for more than 25 years. Sculptra is long lasting, biocompatible, and biodegradable.

Sculptra does not take up space and create immediate results but rather causes the growth of fibrous tissue or collagen by the body, which then results in gradual volume restoration.

A clinical study by Dr Ayham Al-Ayoubi of more than 400 patients at our clinic has shown that the improvements obtained with Sculptra have lasted for up to 4 – 5 years. Treatment usually consists of 2 to 4 sessions lasting up to half an hour; usually four weeks apart with no ‘downtime’.

Compared with having conventional line fillers every 6 months, Sculptra is very cost effective and your requirement for the product may diminish after the first course of treatment.