Sculptra® Aesthetic Secrets from Dr. Petti
What is Sculptra® Aesthetic and why is it important to your patients? To your practice?
Sculptra® Aesthetic is natural volumizer used to add support to sagging tissues of the face. Sculptra® Aesthetic restores the face with a natural, full and youthful look, as opposed to the sullen, sunken and sagging look that accompanies age. It is a “secret” way for my patients (and me) to achieve their youthful appearance and still look like themselves—-just a lot better. Today I had a 50 year old female doctor tell me that after her Sculptra® treatments, when she goes to the hospital, and patients and staff discuss her age, they all think she is 35! She loves this! Patients love how Sculptra® can restore a youthful shape to their face. Patients are relieved by the fact that they do not have to resort to surgery, as their sole choice for cosmetic facial rejuvenation, viewing surgery as a choice of desperation. Sculptra® has been used for decades in Europe and had been approved by the FDA for the past several years for cosmetic use here in the United States. The administration of Sculptra® requires great skill and meticulous technique in order to achieve results that hide the changes in the face that are associated with aging, and yet restore a natural result, maintaining the unique anatomical characteristics of each person’s face.
Sculptra® Aesthetic is made of a biocompatible material, poly-L-lactic acid and it is a collagen stimulator, so it is your own collagen that restores volume and youth to the your face.
My technique for placement of the Sculptra® Aesthetic is similar to my technique for a facelift in that I use the same plane (otherwise, know as a tissue space) that I work in when I do a facelift, so it is a “sculpted face”. The difference: with Sculptra®, I use an injection technique, rather than a surgical technique. I think of a facelift, or brow lift or cheek lift, when I place Sculptra® Aesthetic in the various areas of the face, and this helps me not only technically, but also it enhances my patients’ outcomes.
List top reasons patients want Sculptra® Aesthetic, decide to go with procedure
Patients decide they want to be treated with Sculptra® Aesthetic so that they look young, yet natural and non-distorted. Sculptra® restores a facial contour that is bright, cheery, and contoured, without the risks of surgery and anesthesia. Patients often want this before special occasions like weddings, reunions, graduations, anniversaries. There is not a need to plan ahead so far in advance as surgery and, there is little to no downtime. The expense of Sculptra® is less than surgery and the results can last up to 2 years. Multiple treatments are required to get the best results. Some individuals require 1 to 2 sessions, while others require 3 or 4. It is a very appealing aesthetic procedure for busy individuals who cannot take off much time from their work and family obligations. Men and women, young and old can be treated. I have used Sculptra® Aesthetic on young individuals in their 20’s that congenitally have flat cheeks, poorly defined jaw lines and small empty facial contours. It works faster on younger patients, so patients are encouraged to have the procedure while their ability to form collagen is optimal.
How do you determine Sculptra® Aesthetic is the correct procedure for a patient?
I determine this by listening and taking a good history from the patient, to see what they want, dream of, expect, and noting their desires/tolerance for recovery time and budget. Their expectations need to be identified and clarified through the consultation process. I examine the patient’s specific anatomy, we review their photos, discuss the Sculptra® Aesthetic procedure, and make a specific plan of “attack” of the aging process or whatever we are trying to volumize and contour for that individual patient. The treatment is customized and planned. The expectations are targeted, so that they are realistic, and the risks are discussed.
Patients may be bruised in the areas of treatment and a tenderness can be present, but these are temporary. I have my patients take a medicinal form of arnica montana to prevent and decrease any swelling and bruising. I also cool the skin prior to treatment and make certain patients are off aspirin, motrin and other arthritis medications.
What other procedures can supplement Sculptra® Aesthetic and why would you suggest combining them?
Sculptra® Aesthetic is a volumizer that stimulates the patient’s own collagen production in their tissue, therefore, it takes time to see youthful changes in the shape and contour of the face. Treatment results may take 6 to 8 weeks to first appear, then the results may progress over a period of several months. If a patient wants an immediate change, I utilize other “fillers”, such as JUVEDERM™, Restylane® and Radiesse®, depending on the anatomic area and tissue texture that I am trying to augment, shape and support in the face. These fillers can be placed beneath the skin, on top of the Sculptra®, adding support to the skin at a more superficial tissue level. The Sculptra® is placed deeper in the same plane of tissue that I work within when I do a facelift The fillers are placed beneath the dermis, immediately under the skin to support areas where the skin may fold and buckle, such as the tear trough areas of the cheeks and the smile lines around the mouth. The fillers can be done at the time of Sculptra® or the procedures may be staged and performed on separate appointments. Since Sculptra® is placed deep, it is not used in the areas of the lips or mid forehead. Fillers can be used in the lips. Fillers in these areas enhance the results of the Sculptra® which is most frequently used in the cheeks and temporal forehead areas. Sculptra® has powerful and pleasing volume enhancement outcomes in the cheeks and temporal forehead areas of the face.
What are the most popular nonsurgical or minimally-invasive procedures at your practice? Explain the reason for popularity, such as superior results, lasting results, increasing safety and effectiveness?
The most popular non-surgical procedure in my practice is BOTOX® Cosmetic. It has a result that is noticeable within a week, and the result can last 3 to 6 months or longer depending on the patient and the site of the BOTOX®. When used in a medical office setting, BOTOX® has minimal risk. It is not to be used in a “party” setting, as it is a powerful medication that can have significant risk when used outside of a medical practice setting. BOTOX® can enhance a person’s appearance by giving the aging face, as well as the younger face, a very rested and soft appearance Patients that are old and young are happy to look rested and inviting, rather than angry and hard. BOTOX® is affordable and patients will come back for repeat treatments, as they often find that they cannot live without it. BOTOX® is a simple procedure that patient’s state restore a “peaceful” look to their face giving them confidence and improved self esteem.
As far as minimally invasive non-surgical procedures, I favor SmartSkin CO2™ laser peels. This straightforward laser, performed under topical anesthesia, can smooth out wrinkles that are not treated by surgical procedures, such as facelift,, neck lift and eyelid/forehead lifts. The laser can smooth wrinkles and tighten the skin, and the treatments can be repeated. Patients who have the procedure just around the eyelids can have results that look as good as eyelid lifts, if done at the right age, and the laser treatments are repeated over time. The downtime is much less, in the order of days to a week, with the new fractional technique of the carbon dioxide laser peel. In my experience of over one and a half decades of performing carbon dioxide and other types of laser peel, I am still confident that this technique can restore youth to weathered, wrinkled skin. In my experience, there are no other techniques that can rival the skin smoothing and tightening that is obtained with carbon dioxide fractionated laser resurfacing.
I combine laser peels with my surgical rejuvenation procedures, such as eyelid lifts, forehead lifts, face and neck lifts, to give the entire surgical result a harmonized, natural appearance. I use the laser to blend the surgical and non-surgical areas so there is a homogeneous and more blended overall facial appearance. I use the laser peels on patients that have already undergone cosmetic surgery of the face and just need a “freshening” I find that most often these patients who have already had facial cosmetic surgery, do not need to have more skin pulled, removed and tugged, giving them a look from another planet. Since my name is on the work, I want it to look as natural as possible. If the best result will be achieved without surgery, than this is the choice I feel would be the optimal for the patient. Lasers have had a bad wrap over the years, but if used in experienced hands, lasers can be a surgeon’s best friend, giving the surgeon the power to offer their patients very natural results without surgery. Lasers can achieve many things surgery can never accomplish, so they are not to be scorned, and may even be adorned when applied to properly selected patients.
