A. The term revolumizing began to be used in 2004, when poly-L-lactic acid (Sculptra) first was discussed in the United States. I was on that original advisory board and among the first dermatologists to be educated by our European colleagues about reshaping the tired-looking, aging and gaunt face that is the result of atrophy of key fat pads in the face. Prior to Sculptra, we were doing what I call "local fill", just to nasolabial folds and individual lines around the mouth. We began to realize that even after you fill a fold, the patient may not look better. So now we do a better job assessing the facial fat pads which atrophy or shift. We now really restore more than just fill. The best candidates have sunken cheeks and hollowed eyes and temples. They often have high cheek bones too. Be sure you see a board certified dermatologist or facial plastic surgeon who can best decide if you are a candidate for revolumizing. And although I think Sculptra is the best for volume restoration, Restylane, Juvederm and Radiesse can be used as volumizers as well.
Q. Is it possible to damage a nerve with Sculptra?
A. I suppose anything is possible, but of all the fillers on the market, Sculptra may be the least likely to damage a nerve. This is because it is a watery material that would not compress a nerve like a gel-type filler could. You do get very numb from the Sculptra injections, but it's from the anesthetic mixed with the Sculptra. That numbness typically lasts one hour, and then is gone. The nerve most likely to be irritated from a filler injection is the infraorbital nerve on the mid-cheek, but any nerve could be irritated at any time from any filler. In my 27 years of injecting fillers, I have never seen nerve damage.
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