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Marianne's Sculptra Journal
What: Sculptra (New-Fill) poly-lactic acid injectable catalyst.
Why: To fill in the emerging hollows under my eyes, and eventually augment my cheeks and fill out my emerging nasolabials as well.
With Whom: Gail Humble. M.D. of El Segundo, California (Los Angeles)
When: first treatment 11/11/2004; second treatment 2/9/05 (see second
page)
What Is Sculptra?
Sculptra is approved for the treatment of lipodystrophy in HIV
patients, however since it is FDA approved it can be used off-label to
treat any patient cosmetically. Sculptra is a suspension of
poly-lactic acid and when injected into the tissue works by irritating the
tissue at a cellular level, thereby triggering fibroblastic activity,
increasing the thickness of collagen in the area. The treatments
should be carried out slowly since the reaction of each patient is
different. Sculptra is not a filler, but rather catalyst to cause
your own tissue to grow, since this is dependent upon your own body, the
amount of collagen growth and retention/longevity varies from patient to
patient. Lumps and bumps, as well as redness of the area and
continued irritation are all possible, but treatable. I weight my
options and decided Restylane didn't last long enough and chose to go with
Sculptra which reportedly lasts, on average, 1 to 2 years.
Why I decided to Get
Sculptra
I have pretty much always had hollows under my eyes unless I was at my
heaviest (140 lb) however my normal weight is 120 lb and my yo-yo dieting
and aging process isn't helping much. I had gotten fat grafting May
5, 2004 to augment my cheeks and that really only made my under eye
hollows worse. So after Sculptra, formerly known as New-Fill) was
approved I made an appointment with my doctor, Gail Humble, M.D. for injections.
Dr Humble was part of the FDA trials for Sculptra and had a lot of
experience with the product compared to anyone else, plus she has been performing
my mini procedures for years so I feel very comfortable with her.
The Treatment
There really wasn't much preparation, however abstaining from alcohol, aspirin
and vitamin E at least a week pre-treatment can help keep bruising/bleeding
to a minimum. I am willing to bet I bruised and bled because I drank
the night before at a Spike TV Premier Party in Las Vegas.
All in all, I actually feel the downtime is VERY little, if at all, as
there is not much swelling. However, if you get a bruise, and I did, it
can last for quite a while. Warm compresses can help, but only if
your doc approves.
Dr Humble marked the areas
that would be injected with a surgical marking paint brush, then swabbed
the area for anesthetic injections. For cheek and under eye
injections of Sculptra, Dr. Humble administers an infraorbital nerve
block:
"Infraorbital nerve
block
For an infraorbital nerve block, the location of the foramen is
estimated by drawing an imaginary line from the supraorbital notch
inferiorly through the pupil (figure 4: not shown). The foramen is
located just inferior to the orbit on that line. The needle is inserted
approximately 1 cm inferior to the infraorbital foramen. The needle is
pointed upward toward the estimated location of the infraorbital foramen
and advanced. Paresthesias, if elicited, validate near proximity to the
nerve. Two to 4 mL of 1% lidocaine is injected." --Procedures in Primary Care,
Regional anesthesia; Nerve blocks of the extremities and face*
This type of anesthesia allows the
face to feel no pain, yet without the inconvenience, swelling and distortion of
local injections. After I was fully anesthetized, no
more than a few short minutes Dr Humble began my injections.
She injected small amounts and massage the area. What was funny is I
thought she was giving me local and not actually my Sculptra. It was very
easy. So easy in fact that after she finished the one side I still hadn't
realized it was complete on that side. Here are the pics of the whole process...
You can see in the pics above I have a
slight hyperpigmentation left over from bruises from Sculptra and fat grafting,
plus I have little
ridge of scar tissue from my fat grafting although I had a slight ridge there
before naturally (I will post these pics soon). it just seems more
pronounced to me now. Massage of the ridge and/or Sculptra
at the tear troughs will lessen the appearance. You can't really tell in person but in photos
you really can because of the flash and it
shows the most. The ridge creates a shadow when the flash hits my
face. BTW the ridge fluctuates, usually when I eat salty foods--definitely
scar tissue. You can see where the Sculptra formed above the hollow
in the tear trough area and to the side of it but right under you can see
little divots. I nee to get Sculptra here on my next treatment.
Next Treatment
My next treatment is in a week, Feb 9, 2005 - I will take pics and post an
update :) I hope this journal helps you know what to expect :) BTW I am waiting
for my befores from Dr Humble because mine didn't show my under eye
hollows, but here is one that kind of shows it (pre-Sculptra, post-fat). I
will look for a better one. You can surely see my Radiance lump in
my lower left bottom lip in this
pic, Thank God it is going away.
references:
Procedures in Primary Care, Regional anesthesia; Nerve blocks of the extremities and face
-- Dwight W. Smith, MD; Matthew R. Peterson, MD; Scott C. DeBerard, DO (VOL 106 / NO 4 / OCTOBER 1, 1999 / POSTGRADUATE MEDICINE)
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