What can I do to correct this bad outcome around my marionette areas?

Dr. Dean Kane Q & A Q. I had Sculptra injected January 20, 2016 two viles all around my face (temples, cheeks, jaw line), and two more viles injected on March 4th, 2016. On March 4th, more was injected near the marionette lines that really bug me per my request.  After that I noticed bulges going on after the Sculptra at the marionette line area so on March 24th had two viles of Juvederm Ultra in the that area to smooth it out. A. Sorry for your concern. ​This is best improved at this time, (4 months and 1 month following sessions 1 and 2) with deep massage from inside and outside of the mouth 3 to 4 times daily to break up the concentration of Sculptra injected. Your injector may consider diluted steroid injection to stall the process of granule or nodule formation. I find Sculptra to be an excellent minimally invasive skin firming bio-stimulant and do not use it as a filler. ​I instruct my patients to be more assertive than the manufacturer recommends in massage, particularly in areas of pooling such as around the eyes and the marionette folds. Following injection, assertive 6 minute massage, 6 times a day for 14 days with particular emphasis on those areas of pooling such as the outer-lower eye and marionette folds (from inside and outside the mouth). I would not use fillers in these areas until the tissues are smooth as it may further stimulate collagen production in an already over activated area. I hope this helps! All the best!  
This information is not meant as medical advice. It is provided solely for education. Our practice would be pleased to discuss your unique circumstances and needs as they relate to these topics.
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