Sculptra Overfilled (饅化)
w.14 · 6/19/2026🌐 繁中
Three years ago, due to orthodontic treatment, my cheeks looked a bit sunken, so I decided to get **Sculptra**. At the time, I had 3 vials injected initially, followed by another 3 vials two months later, totaling 6 vials in the cheek area. After the procedure, my face shape became very smooth and full, and I was very satisfied with the results. A year and a half later, I gained about 15 kg during my pregnancy. After giving birth, my weight gradually dropped, but I always felt that my face still looked "puffy" and unnatural. Upon closer examination, I discovered some lumps inside my cheeks; some are round and bead-like, while others are strip-shaped, and they feel quite firm to the touch. I have already received saline injection treatments, but I feel the improvement is not significant. Therefore, I would like to further confirm whether these lumps are related to the **Sculptra** I received previously, and if there are any other treatment options available to improve this condition.
1 Replies
劉達儒醫師🌐 繁中 Doctor
Hello, this is Dr. Liu. The situation you described could indeed be related to the **Sculptra** you received three years ago. However, it is impossible to make a definitive diagnosis online; a physical examination and an **ultrasound-guided** assessment are necessary. The main component of **Sculptra** is PLLA. Its mechanism of action is not simply "filling" like **Hyaluronic Acid**; rather, it stimulates collagen production. Therefore, its subsequent changes are slower and more susceptible to factors such as injection depth, dilution ratio, massage, individual constitution, and subsequent weight fluctuations. Furthermore, unlike **Hyaluronic Acid**, it cannot be dissolved directly with hyaluronidase. I am particularly concerned about a few points you mentioned: * You received a total of 6 vials in your cheeks three years ago, which is a significant amount. * You gained 15 kg during your subsequent pregnancy; as facial fat thickened, the volume from the original collagen stimulation may have become more pronounced. * The fact that you can now feel individual, cord-like, and firm bumps suggests this is more than just "facial fullness." It could be localized PLLA aggregation, uneven collagen proliferation, fibrosis, or a delayed nodule/**granuloma** reaction. Late-onset nodules and **granuloma** reactions to PLLA have indeed been documented in medical literature. Some people attempt saline injections, but if there are already significant nodules, cords, or **granuloma** reactions, the improvement is usually limited. At this stage, the most important thing is not to blindly inject anything else, but to clearly visualize what is inside. I recommend that you schedule a consultation for a high-resolution ultrasound examination. Ultrasound can help determine the location, depth, size, and morphology of these bumps—whether they resemble residual material, fibrotic nodules, inflammatory **granulomas**, or simply changes in fat thickness and tissue. Recent studies have shown that high-frequency ultrasound is very helpful for the localization of filler nodules and subsequent treatment planning. The treatment approach will depend on the examination results: * If they are inflammatory nodules, we might consider local intralesional therapy. * If they are distinct, localized, palpable lumps that affect your appearance, we can evaluate minimally invasive extraction or local management in some cases. * If the heavy sensation in your face is caused by overall collagen proliferation and fat thickness, the treatment strategy will be different. Therefore, what you need most right now is not to guess whether it is **Sculptra**, but to use ultrasound to locate it. You can prepare the following information: the original injection sites, total number of vials, injection intervals, photo records, the number and locations of saline treatments, and the areas where you currently feel the most prominent lumps. When you come for your visit, we can perform a physical examination alongside the ultrasound to determine the safest next steps. Please do not panic, but this situation definitely requires an in-person consultation; it is not suitable for an online diagnosis.