It’s quietly worked behind the scenes in aesthetic doctor’s offices for nearly two decades, but today, Sculptra is firmly back in the spotlight. And this time, it’s wearing a new title: the natural filler. Once a niche treatment for restoring volume, Sculptra is now being embraced for what many experts say it does best—subtly stimulating your body to rebuild what it lost, from collagen to even fat.
Why the Buzz Now?
“Sculptra has been in our toolbox for a long time; it got FDA approval in 2004, but lately, more patients are asking for it by name,” says Newton, MA dermatologist Papri Sarkar, MD. “They come in wanting something that looks natural, lasts and improves skin over time.”
That appeal is tied to Sculptra’s unique mechanism. Made from poly-L-lactic acid (PLLA), it’s not a traditional filler. Instead, it’s a biostimulator, triggering the body to gradually produce its own collagen in treated areas. “Patients consider it more ‘natural’ because Sculptra itself doesn’t actually fill anything,” says Huntington Beach, CA dermatologist David Rayhan, MD. “After injection, your body builds collagen where the Sculptra was injected. It offers several advantages. There’s data showing the risk of clogging an artery and killing skin tissue is lower, and the results last much longer, sometimes years.”
Recent FDA labeling has also helped boost its visibility. In 2021, Sculptra was approved for a higher reconstitution volume (nine milliliters, including lidocaine), matching what many dermatologists had already done. Previously, it was mixed with only five milliliters. “At the lower reconstitution, there was a higher rate of nodules, which is why I think practitioners weren’t using it for some time,” says Dr. Sarkar. “The newish FDA approval is giving it more visibility.”
A Glow That Lasts
It’s also known for giving a “glow,” which has been studied and proven. In a RADIANCE study, results showed that Sculptra significantly improved skin texture, firmness and radiance after a series of treatments.
“A younger demographic is coming in for preventative treatments [and] asking for it by name,” says Dallas, TX dermatologist, Elizabeth Bahar Houshmand, MD. “I share with patients the wonderful skin luminosity it provides in addition to the gradual, subtle volumization. I highlight that it’s a procedure that will have long-term results and that it requires maintenance.”
New Findings on Fat Stimulation
Another significant discovery tied to Sculptra is its potential to stimulate fat, not just collagen. Miami, FL dermatologist Jill Waibel, MD, led a recent study published in Dermatologic Surgery that compared gene expression after Sculptra and another type of biostimulatatory filler made of calcium hydroxylapatite (CaHA). “We did a series of one to three treatments and took biopsies of the nasolabial folds pre-op and three months post,” she explains. “Both stimulated collagen, but Sculptra activated many more genes in the regenerative pathway,” says Dr. Waibel. “The study showed the real mechanism of action isn’t just stimulating collagen. It turns on fat. That’s huge. As we age, we lose fat, bone and collagen. We have a lot of answers for collagen stimulation, but very little for fat—and this is stimulating your own fat.”
The GLP-1 Connection
Then, there’s the recent surge of weight loss patients. Sculptra’s original aesthetic indication, treating facial wasting from HIV, has made it especially relevant again in today’s landscape. With the growing use of GLP-1 medications like Wevgovy and Zepbound, facial hollowing has become a common complaint among weight loss patients.
“I have had a few patients come in complaining of ‘Ozempic face,’” says Dr. Sarkar. “There are ongoing studies looking at filler alone or Sculptra plus filler for facial wasting after Ozempic. The combination is one I use often because you get some results instantly with filler and then a lovely boost about four to six weeks later with Sculptra.”
“Sculptra is often used for pan-facial rejuvenation—filling the temples, cheeks, laugh lines and jawline,” adds Dr. Rayhan. “If you lose weight because of GLP-1 medications, Sculptra can sometimes treat the gaunt look that occurs.”
Who It’s Best For
“Sculptra improves skin quality and elasticity by increasing collagen production,” says Shreveport, LA, dermatologist Skylar Souyoul, MD. “It’s a great product to use in your 30s and 40s as preventative maintenance. I also use it frequently in patients in their 50s and 60s to restore lateral facial volume while improving skin quality. Patients are more educated and are looking for longer term anti-aging solutions.”
It’s also a favorite among injectors themselves. “Sculptra, hands down, is my favorite injectable,” says Crestwood, KY dermatologist Tami Buss Cassis, MD. “It looks so natural with the volume restoration and overall improvement in skin texture and tone. I think the original marketing of ‘liquid facelift’ really was a mistake. It’s not that, but it definitely is a slow, steady, natural way to maintain facial volume and skin tone. I love to inject it to help me maintain my aging face.”
New Orleans, LA dermatologist Mary Lupo, MD, puts it best: “Sculptra has been my number one filler for over 15 years. My brand is natural results, and Sculptra helps me deliver that.”
One Caveat
As with any aesthetic treatment, Sculptra isn’t for everyone. “Some facelift surgeons comment that doing facelifts on patients who’ve had Sculptra can be more difficult since it can make the tissues more fibrotic,” says Dr. Rayhan. “If a patient is considering a facelift in the upcoming future, they should discuss this with their doctor.”
