Will Sculptra Change the Filler Game Again?

Will Sculptra Change the Filler Game Again?
This article originally appeared on February 7, 2022 in Allure.
Armed with a new FDA label to fill facial fine lines and creases, this classic injectable is primed to become the next big thing for noninvasive treatments.

In the world of noninvasive aesthetic treatments, nothing comes close to the popularity and accessibility of facial fillers. This catch-all term encompasses the wide scope of unique gels that doctors use to accentuate bone structure, highlight our best features, and restore fullness that's lost with age. The majority of dermal fillers approved by the U.S. Food and Drug Administration (FDA) — and the most well-known among patients — are formulated with hyaluronic acid (HA), a temporary hydrating substance that occurs naturally in the body. But the classic, oft-overlooked category of biostimulatory fillers are finally getting their due, including the doctor-beloved Sculptra

The FDA just expanded Sculptra's approved use for treating fine lines and wrinkles, a new label that allows for more treatment possibilities and a wider patient audience, meaning Sculptra's time spent in the shadow of HA-based fillers may be coming to an end. 

What is Sculptra, and how does it work?

Sculptra is a biostimulatory filler — like Radiesse and Bellafill — that triggers the natural biological process of collagen production. It was initially formulated and FDA-approved in 2004 to increase collagen production for the treatment of HIV-associated lipoatrophy, or severe fat loss, in the face, says Michael Somenek, M.D., a Washington, D.C.-based board-certified facial plastic surgeon and participant in the recent FDA study trials. He says that, over time, doctors "started to notice the continued improvements with collagen stimulation and volumization to the face," leading them to explore additional applications. 

Sculptra's syrupy gel formulation is made of strong polymer called poly-L-lactic acid, a substance similar to dissolvable sutures, according to Dr. Hayag, that jumpstarts the body's natural process of collagen production to reveal a longer-lasting fullness than HA-based fillers. Once Sculptra is injected, PLLA creates a biostimulatory effect within the tissues, explains Dr. Somenek, which, in turn, "improves the collagen locally, right below those wrinkles." As collagen synthesis progresses over the next six to 12 weeks, Dr. Somenek says that this extra boost will improve the skin tone while "over time, softening the appearance of those wrinkles."

New York City-based board-certified dermatologist Marie Hayag, M.D. is a self-confessed Sculptra die-hard who had been using the filler off-label for years to thicken crepey skin and smooth deep skin creases. "The best way to think of Sculptra is the process being similar to growing your lawn with seed, not sod," she says. "It's a slow, gradual effect, but it gives the best and most natural results over time."