Many of my patients have asked this week about the recent article in the New York Times  regarding Sculptra. I looked very closely at Sculptra (made of the synthetic material poly-L-lactic acid) when it first be came available as a “volumizer.”  My reservations to use it then remain the same; that is, pain, granulomas, and the need for multiple injection sessions and post-treatment massage. 

In my opinion, it is certainly not the best agent for most of the patients in my practice, who are seeking correction of fine lines, nasolabial folds, and more superficial wrinkles.  I have been very happy with Juvederm (hyaluronic acid).  Although it may last only 10 months, the total number of treatment sessions over a two year period do not seem to be any different than reported with Sculptra.  Although medical reports have shown collagen formation with both hyaluronic acid fillers and poly-l-lactic acid, how long the collagen lasts is not clear.  Juvederm hurts less and granulomas do not seem to be a problem. Its only disadvantage may be in the patient requiring large volumes. In that case, I would currently favor using the patient’s own fat.