Using poly-L-lactic acid (PLLA) to mimic volume in multiple tissue layers.

Area of Science:

• Dermatology
• Plastic Surgery
• Aesthetic Medicine

Background:

• Sculptra received FDA approval for HIV-related lipoatrophy in 2004.
• Sculptra Aesthetic gained FDA approval for cosmetic use in 2009.
• Facial volume changes across structural layers are increasingly understood.

Purpose of the Study:

• To share the methodology for using Sculptra in both clinical applications.
• To detail soft-tissue and supraperiosteal injection techniques.
• To emphasize the importance of patient selection for optimal outcomes.

Main Methods:

• Detailed illustration and discussion of soft-tissue injections.
• Detailed illustration and discussion of supraperiosteal injections.
• Review of facial volume changes relevant to injection methodology.

Main Results:

• Patient selection is critical for successful Sculptra outcomes.
• Tissue quality significantly impacts the amount of product and number of sessions required.
• Correction is more challenging in severely lipoatrophic or elderly patients with poor skin integrity.

Conclusions:

• Successful Sculptra treatment relies on appropriate patient selection.
• Achieving optimal aesthetic results is contingent upon starting tissue quality.
• More challenging cases may require increased product and treatment sessions.