INTRODUCTION
Sculptra® poly-L-lactic acid (PLLA-SCA, Galderma) is a regenerative biostimulator containing microparticles of PLLA, a biocompatible, biodegradable, synthetic polymer from the alpha-hydroxy-acid family.1 PLLA-SCA works as a regenerative biostimulator to gradually build collagen and elastin fibers over time, remodel the extracellular matrix, and potentially have effects on adipose tissue in the injected area to help regenerate and restore the skin's inner structure and give the appearance of fuller and more youthful-looking skin.2-9 In the United States (US), PLLA-SCA is approved for correction of nasolabial fold contour deficiencies and fine lines and wrinkles in the cheek region using reconstitution volumes of 5 mL or 8 mL sterile water for injection (SWFI) with the optional addition of 1 mL 2% lidocaine.10
As aesthetic patients achieve a younger appearance through facial rejuvenation, they are often left with an abrupt contrast between their facial and non-facial (body) skin, such as the chest décolletage, and therefore frequently request cosmetic enhancement of this area.11 Initial clinical trials and other clinical reports suggest that treatment of wrinkles with PLLA-SCA in the décolletage area is effective and well tolerated, with satisfactory aesthetic outcomes.12-15
Since the initial approval of PLLA-SCA in 1999 and 2004 in the European Union and the US, respectively, the amount of SWFI used to reconstitute PLLA-SCA has gradually increased. Based on medical literature and physician experience, practitioners have reported improved clinical outcomes with increased reconstitution volumes up to 2 times larger than the volume recommended by the manufacturer, usually in combination with anesthetic solutions such as lidocaine 2%.6,16 There is also data that shows that an increased reconstitution volume helps to reduce the frequency of nodules and papules.11,17
As aesthetic patients achieve a younger appearance through facial rejuvenation, they are often left with an abrupt contrast between their facial and non-facial (body) skin, such as the chest décolletage, and therefore frequently request cosmetic enhancement of this area.11 Initial clinical trials and other clinical reports suggest that treatment of wrinkles with PLLA-SCA in the décolletage area is effective and well tolerated, with satisfactory aesthetic outcomes.12-15
Since the initial approval of PLLA-SCA in 1999 and 2004 in the European Union and the US, respectively, the amount of SWFI used to reconstitute PLLA-SCA has gradually increased. Based on medical literature and physician experience, practitioners have reported improved clinical outcomes with increased reconstitution volumes up to 2 times larger than the volume recommended by the manufacturer, usually in combination with anesthetic solutions such as lidocaine 2%.6,16 There is also data that shows that an increased reconstitution volume helps to reduce the frequency of nodules and papules.11,17
