Sculptra Overfilled (饅化)
w.14 · · Last reply 🌐 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
Dr. Ta-Ju Liu · Board-certified dermatologist🌐 繁中 Doctor
Hello, I am Dr. Ta-Ju Liu.
Direct Answer: The lumps you are describing could indeed be related to the Sculptra (舒顏萃・童顏針) injected three years ago, but a definitive diagnosis cannot be made online. What is needed most is not guessing whether it is Sculptra, but using high-resolution ultrasound to locate it before deciding on a management plan.
Possible Conditions to Differentiate
The main component of Sculptra is PLLA. Its mechanism of action is not simply filling like hyaluronic acid, but rather stimulating collagen proliferation. Therefore, subsequent changes are slower and easily influenced by the injection depth, dilution ratio, massage, individual constitution, and subsequent weight changes. Moreover, unlike hyaluronic acid, it cannot be dissolved with a dissolving enzyme. Your key points:
1. A total of 6 vials were injected into both cheeks three years ago, which is not a small amount.
2. Gaining 15 kg during pregnancy thickened facial fat, which may make the original collagen proliferation volume more prominent.
3. The palpable, bead-like, cord-like, and relatively firm lumps are more than just "plump cheeks"—they could be localized PLLA aggregation, uneven collagen proliferation, fibrosis, or delayed nodules/granulomatous reactions. Late-onset firm nodules and granulomatous reactions associated with PLLA are indeed documented in medical literature.
Some people try saline injections, but if they are already obvious firm nodules, cord-like structures, or granulomatous reactions, the improvement is usually limited.
General Treatment Approaches
- Ultrasound can determine the location, depth, size, and morphology of the lumps: whether they are residual material, fibrous nodules, inflammatory granulomas, or changes in fat thickness and tissue. Recent studies also mention that high-frequency ultrasound is very helpful for locating filler nodules and planning treatment.
- Treatment methods depend on the examination results: inflammatory firm nodules may require consideration of localized medication injections; for well-defined, concentrated, palpable lumps affecting appearance, minimally invasive extraction or localized treatment can be evaluated in some cases; if the facial heaviness is caused by overall collagen proliferation and fat thickness, the strategy will be different.
- Before your in-person consultation, you can prepare: the original injection sites, total number of vials, injection intervals, photo records, the number and areas of saline treatments, and the locations where the lumps are currently most palpable.
When to Seek Medical Attention Promptly
If the lumps suddenly become red, swollen, hot, painful, rapidly enlarge, or are accompanied by a fever, please seek medical attention as soon as possible.
There is no need to panic too much, but an in-person consultation is strongly recommended for this condition; it is not suitable to rely solely on online judgment.
Online replies are for general health education purposes only and do not constitute a diagnosis, nor can they replace an in-person consultation and ultrasound examination.