Facial Sculptra Injection Reversal
Q: Dr. Eppley, I am interested in Sculptra injection reversal. I had Sculptra injections about 6 months ago and it has given me a square chin and is making me very depressed. The doctor is using an enzyme to dissolve the other fillers I had put into my face but, of course, the Sculptra won’t dissolve. Do you recommend trying to get rid of the dissolvable fillers anyway as there’s quite a large amount too? Would appreciate any help.
A: As you may know Sculptra is not like the more commonly used hyaluronic-based fillers. It is composed of PLA particles (small bits of resorbable polymers) which create their effect by inducing collagen formation around them. Such PLA particles are not responsive to enzymatic digestion as they are a chain-liked polymer strand. Their resorption will eventually occur through a hydrolytic process (water absorption) but this is a slow process that could take 12 to18 months with the presumption that the reactive scar tissue will fade away as well as the stimulus is removed.
There is no known method to remove the Sculptra filler from soft tissues that would not potentially cause other long-term issues, particularly in the chin area. Steroid injections or liposuction should be avoided due to potential soft tissue deformities from them. 5FU injections are the only injectable strategy that would not cause a potential soft tissue problem but whether they would be effective in this situation is unknown.
One other potential treatment option, if the Scupltra was injected down at the bone level (your injector would know this), is to remove the material from the bone surface through an intraoral approach.
Dr. Barry Eppley