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Scultpra nodules
May 11, 2010

I have developed several visible nodules on my face from sculptra treatments. One of them is rather large. It appeared 3 or 4 months after treatment and has now been there about 8 months. Can i expect it to diminish and eventually disappear over time, I hope?

Response from Dr. Pierone

When I was learning to inject dermal fillers, I practiced on my own face and ended up with a Sculptra nodule under my left eye. It took a long time, but it eventually went away. Sculptra nodules diminish in size and eventually disappear over time. Sculptra is not a permanent filler, so Sculptra nodules follow a similar time course and gradually fade over 1 to 3 years.

It is also possible to treatment Sculptra nodules by subcission - cutting the nodule into smaller clumps with a needle and injecting a small amount of a corticosteroid. One risk of this procedure is producing pigmentary changes of the skin overlying the nodule from the steroid. Another approach is to use an alternative filler (Radiesse works well) to fill in around the edge of nodules and make them less noticeable. Since the Radiesse does not last as long as Sculptra this correction may need to be repeated to maintain the camouflage of the nodule.

One can lower the rate of Sculptra nodule formation by making sure the Sculptra is evenly dispersed in sterile water at the time of injection, which is not always an easy task, even with experience. Diluting the Sculptra by using more sterile water than recommended on the package insert appears to lessen the risk of Sculptra nodules. Also, mixing Sculptra several days before the treatment also leads to better dispersal of the agent and should lower the risk of nodules. Finally, massage of the injected area has been proven to decrease the chance of nodule formation.

Hope this helps.



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