Plastic Surgeon Dr. Dean Kane of Baltimore Answers Question Regarding Sculptra Nodules: Collagen or Granuloma?

Dr. Dean Kane | Baltimore MD

Sculptra Patient at the Center for Cosmetic Surgery & Medi-Spa

Q. Is the tissue generated by Sculptra ‘pure collagen’ or ‘granulomas’? Are there any reports that proof it’s collagen indeed? I would like to have Sculptra injected to improve previous lipo and BBL results. Fill some dents and add a little more volume to the hips. I don’t have enough fat to shift + I think Sculptra can be done more precisely then fat injections. Every dr. claims something different about Sculptra, some say the extra volume are granulomas and some say it’s collagen. How can I be sure of this product, are there any documents en test results?

A. Great question, difficult answer. 

Sculptra, poly-L-lactic acid (PLLA)  is FDA approved as a dermal “filler”. This occured in 2004, for the treatment of HIV treated facial fat loss (also called facial lipoatrophy). The nodule concerns following the first FDA approval developed because of the concentrated use of this suspension medication. Changes in the preparation and post-injection massage has substantially reduced even tiny granule formation to a minimum when performed by skilled injectors.

After the injection, swelling and bruising may take 1 to 3 weeks to resolve. It will take around 1 to 1.5 months to grow natural collagen gradually. Patients must properly massage the injection site and surrounding tissues process in order to ensure that the injectable solution is smooth, level and evenly distributed inside the skin.

Initially, the patient can expect lumps due to swelling and the controlled collagen induction. Without proper massage to break up the suspension, areas of PLLA become micro-concentrated further stimulating collagen formation into spicules, granules and then larger nodules. If caught in the lumpy phase, deep massage is all that is required. Spicules and granules may be treated with lidocaine break-up, dilute steroid injection and further massage. If a “delayed onset nodule”, develops there are 2 treatment arms:

  1. Without inflammation, delayed nodules are removed by intralesional steroid and/or excision and found to be collagen histologically.
  2. With inflammation, a subsequent infection is presumed and the nodule is treated with antibiotics, steroid or excision. They are found to be granulomas on histology. 

It is strongly recommended to obtain consultation from a skilled and talented Board Certified Injector. Skills are essential with this finicky product but the results are amazing! It is typical for us to perform 2 to 3 staged injections to the areas 6 weeks apart with follow-up every 6 months for further injection of Sculptra as needed or should any of the above side-effects or complications occur. 

I hope this is helpful. All the best!


Read more about similar topics:

Sculptra

NCBI Article on Sculptra

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.

Give us a call at  410.602.3322  or email Lauri@DrDeanKane.com and make an appointment soon. We’re located on Reservoir Circle just a block off the Baltimore beltway, convenient to greater Baltimore, Annapolis, the Eastern Shore, Southern Pennsylvania, Delaware and Carroll County.

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