Sculptra Granulomas

Q: Dr. Eppley, I am interested in your suggestion as to whether micro fat injections might be able to break up Sculptra granulomas. I developed Sculptra bumps about 15 months after initial injections. My doctor has been injecting them with a mixture of Kenalog and 5 FU. They are improving slightly after 3 months of multiple injections but,they are still quite visible. Have you had success breaking up Sculptra granulomas with fat injections? Thank you.

A: Breaking up fSculptra granulomas with fat injections can be effective in some by two mechanisms. First you have to mechanically break up the granulomas with a small cannula. That is the first step in their treatment by fat injections in the procedure. Then the fat injections are placed to prevent the scar tissue from reforming or the granuloma recoalesing. So technically the fat injections do not break up the granulomas per se. But are the prequel to the fat injections.

But in looking at your pictures you have far too many garnulomas on the one side of your face for any form injectable therapy to be effective. The best approach in your case is to have them excised through an anterior facelift approach. One could also argue that a layer of allogeneic dermis (Alloderm) could applied over the excised area to ensure maximal contour smoothness.

Dr. Barry Eppley
Indianapolis, Indiana