Poly L- Lactic – Acid: Sculptra Dermal Filler

Poly L- Lactic - Acid: Sculptra Dermal Filler

Best used: Stimulate dermal collagen, replace volume, improve skin qualityCaution: Nodules with low dilutionBest for: Volume loss, bio stimulation, atrophic scars, rejuvenation
Comments: Tried & tested dermal filler for nearly 2 decadesMode of action: Collagen stimulator, volumizerScience Score:



What is PLLA (Sculptra)?

PLLA is a collagen stimulator. It restores the deep, underlying structure of the skin by increasing collagen- subdermal volume, in turn diminishing facial wrinkles. This collagen stimulating dermal filler works with your innate immune system in the deeper layers of your skin to help revitalize production of collagen. This helps restore your skin’s inner structure and volume.

How does PLLA work?

Poly- L- lactic microparticles are absorbed by the skin, in turn stimulating collagen production. Collagen builds the scaffolding of skin, in turn restoring dermal volume. This reverses the aging process and reduces the appearance of wrinkles. 

Sculptra stimulates collagen growth which helps to restore facial volume and the look of fullness to wrinkles and lines over time. Hence Sculptra can improve skin laxity & aid in skin tightening. 

Lastly PLLA can improve skin quality, reducing the size of pores, as well as providing better light transmission & luminosity.

Why are dermal fillers an integral part of treating skin aging?

Volume. Volume. Volume. Volume replacement is integral to getting natural results. Lasers & chemical peels address the quality of skin, also known as texture. Non-surgical treatments such as radiofrequency, PDO threads & HIFU-Ultherapy address skin tone (improves skin laxity). Volume refers to the replacement of fat & dermal collagen. 

Sculptra also stimulates collagen, which improves skin integrity, laxity & increases skin tone. The use of Sculptra is hence extended to a tightening agent. Lastly, it can marginally improve the quality of skin.

Davin’s Viewpoint on PLLA or Sculptra

This injectable epitomises the term ‘repurposing’. The first mainstream use was over 20 years ago as a ‘filler’, namely, to replace severe volume loss in HIV positive patients with lipoatrophy. It was good & under the PBS- Medicare.  I believe that this is PLLAs true existence – namely volume replacement in patients with moderate to severe atrophy. Sculptra hence is an awesome filler in the true definition of a filler. 

Over the past decade it has a resurgence in improving skin quality (pigment, fine lines, pores, skin light reflex & luminosity), however the cost to benefit ratio does not make sense. One vial for one decade is Galderma’s guidelines. A 60-year-old will require a minimum of 5 to 6 vials, at a cost of $1100 to $1390 per vial. That means over $8000 worth of injectables. Compare this with $5 cost price of TCA at 15 to 25% with $3 worth of Jessner. Time & time again the Jessner TCA peel will easily outperform 6 vials of Sculptra. No marketing here, just the facts. Can it improve skin quality? Yes, with a wee bit of imagination. Will one simple laser session (yet alone 8 bucks worth of chemicals) produce far better outcomes? Does a bear shit in the woods? 

From 2023 & beyond the buzz word is biostimulator injectable. This means an injection that stimulates collagen skewed towards skin tightening with variable amounts of volume increase. The question is, are there better biostimulators than PLLA? Absolutely, especially if one is to avoid volume. PCL or polycaprolactone comes into mind. 

Hence in summary, PLLA is a time tested injectable that provides volume over fibrosis over improvements in skin quality. It still is a useful injectable despite its age.

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