Sculptra – Treating Lipoatrophy


With so many cosmetic surgery procedures that remove fat from various parts of the body, it may seem unusual to encounter one that puts fat back in! Lipoatrophy is actually one of the most apparent signs of aging. As we get older, our faces begin to sag and wrinkle. This is not only because of increased skin laxity and reduced elasticity, but we also lose what lies beneath the skin. Lipoatrophy is literally the atrophy of fat. Unlike muscle that atrophies with lack of use, fat atrophies with time. The earliest signs of lipoatrophy begin in our 20s and increase over time. Sculptra is one of the best known and among the more effective methods for restoring subcutaneous (below the skin) fat.

The main ingredient

The main ingredient in Sculptra is poly-L-lactic acid (PLA).  PLA is a synthetic dermal filler that is a polymer of molecules of lactic acid that occur naturally in your body. In other words, individual molecules of lactic acid are strung together like links in a chain. While the body is quite adept at digesting lone molecules of lactic acid, when they are polymerized into a chain, the body cannot break the large molecule down so easily. This means that PLA lasts longer than lactic acid injections alone.

Important principle

Another important principle of Sculptra or PLA is that, unlike other dermal fillers that aim to physically plump up the area by their own volume alone, Sculptra actually works to make the body create its own fullness in the desired area. The PLA microcrystals (chains) in Sculptra provoke an inflammatory reaction in the body, stimulating the production of collagen in the surrounding area. The process begins with white blood cells that gather around the Sculptra in the body. These cells attract fibroblasts, which then produce collagen as a sort of defensive mechanism. Where typical dermal fillers show maximal results in the two weeks after injection, results from Sculptra keep increasing for weeks and sometimes months after the treatment.


One main benefit of Sculptra  (PLA) for facial reshaping and wrinkle correction is that it is biocompatible. While the body mounts an inflammatory response against Sculptra as part of its mechanism of action, PLA does not precipitate an allergic reaction—another benefit of usually the naturally occurring substance lactic acid.

Patients who are squeamish about having fillers or implants made from cadaverous flesh used in their plastic surgery appreciate the fact that Sculptra is completely synthetic (man-made), yet also a natural-type substance. Some cosmetic products are harvested from donated cadaver tissue. Sculptra treatment for lipoatrophy has gained wide popularity in large part because it is so long-lasting, can provide large volume filling effects, and later “touch-up” work is usually minor if needed at all.


Patients need to be aware that results are not always immediate as they are with other dermal filler procedures. The initial swelling is usually related to the trauma of the injections. Within three weeks, the initial swelling will have gone; however, within two months, the collagen production has usually been stimulated to its highest level. The look at two months is what most patients can expect to see for about the next two years. After that time another Sculptra treatment may be necessary.

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