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Sculptra

Skilled surgeons need the right filler products. Sculptra?

Most old sayings have a contradicting flip-side: too many cooks might well spoil the broth; but we are also assured that “many hands make light work”.
However, what is the positive reflection of bad workmen blaming their tools … skilled surgeons needing the right tools perhaps?
This – yet to be written adage – would be a highly appropriate quote when it comes to the world of cosmetic rejuvenating treatments.
It is hard to think of other branches of cosmetic medicine where the relationship between the facial surgeon and the product used is so critical. In the wrong hands the results achieved by even the finest products, can at best be disappointing and at worst disfiguring disasters. While another procedure using the same ingredients carried out by a highly skilled and experienced practitioner can lead to the miraculous natural and youthful appearance we all crave.
For would- be patients the message is clear: it is not enough to select a known brand name, it is also crucial to research thoroughly the person who will be carrying out your treatment.
“When I look at a face I see it in three dimensional form”, explains ophthalmic, oculoplastic and aesthetic surgeon, Jane Olver. “I aim to make the face look healthier and more youthful by getting rid of the older, long face. Older faces have the apex of the triangle facing upwards with descending cheeks and jowls – while the opposite triangular shape is true of younger faces.
“I want to make the face aesthetically more pleasing from every angle – not just from the front view but also from the side.”
In some cases of age related facial volume loss, Jane works with Sculptra – poly-L-lactic acid – to produce a more natural result.
Although Sculptra has existed for more than twenty years, nowadays it is used in a less concentrated form. Originally known as ‘New Fill’ it was available for HIV patients with exceptionally thin faces.
“If the mixture is too concentrated it can cause lumping – which probably accounted for some of the bad press in the early days and prevented Sculptra from having widespread acceptance by the cosmetic industry.
“Today the suspension particles are mixed with water and anaesthetic at least two days before treatment”, explains Jane.
Sculptra is not a “walk in” treatment.
“First the patient must have a proper and detailed assessment – we then prepare the suspension a few days before the appointment so that the poly-L-lactic acid particles are properly suspended. The water delivers the particles to the exact spot they are needed”, said the Clinica London founder.
Half an hour to one hour before the procedure begins, local anesthetic cream is used to reduce any discomfort from the injections. Multiple, small injections are then carried out slowly and precisely while the surrounding area is held tightly to help reduce bruising. Afterwards the patient rests quietly in another treatment room where ice packs and a specific facial massage takes place.
For the following five to six weeks Sculptra patients are advised to massage with cream the treatment sites for five minutes five times a day to help blood circulation, encourage the Sculptra particles to grow the patient’s own collagen and also to reduce the remote risk of swelling.
The reason that Sculptra requires more preparation time and after care is because of the unique way in which it works. For this reason it is currently not widely available – it is only sold to and used by specifically trained and qualified practitioners.
“It is not a substitute for Restylane or other gels, but it can successfully give more volume around the eyes, cheekbones, in front of the ears and the nasal fold of an older face.”
Jane continues: “One or two days after treatment, the water in the suspension will have disappeared causing the initial volume effect to vanish. However the water will have delivered the particles to the right areas – whether the tear troughs, cheeks or nasolabial fold. These particles then cause the patients’ own collagen to form causing natural contours.
Risks of Sculptra: “Particular care must always be taken using Sculptra in the peri-orbital area of the face as there is a remote chance of it causing loss of vision because of the small blood vessels around the eyes which link to blood vessels supplying the eyes.” This is an extremely rare but devasting risk. A consent form with the risks of Sculptra should always be signed.
So eventually the Sculptra solution itself does not exist – it merely provides the particles which enable the body to produce its own collagen which form the focus for the growth of tissue where required. After the water used in the suspension disappears, the laying down of collagen will begin some two weeks later and will continue for the next six to eight weeks, by then the volume improvement will be clearly noticeable. Although time scales vary from patient to patient the benefits should be visible for at least two years.

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