Sculptra Nodules/Bumps

劉達儒醫師🌐 繁中 Doctor

Hello, this is Dr. Liu. I have reviewed your photos. The temple area I have circled for you is indeed where the lump appears most prominent at the moment. Are there any other locations where you feel lumps? If you are willing, please provide photos from different angles and under different lighting conditions. I can perform a preliminary assessment to see if this is the only area or if there are other suspicious nodules. However, photos only allow for a preliminary assessment. To truly confirm the extent, depth, and nature of the **Sculptra** nodules, a high-resolution ultrasound examination is still necessary. Given that you currently do not have redness, swelling, heat, or pain—and no obvious signs of inflammation—I do not recommend that you rashly attempt steroid injections, especially not blind injections. In areas with thinner tissue like the temples and cheekbones, steroids can cause skin atrophy, depressions, or tissue thinning, which would make the problem even harder to correct. **Sculptra** lumps or **granulomas** are different from **Hyaluronic Acid**; they generally cannot be treated with hyaluronidase. My approach is to first use **ultrasound-guided** localization. If it is confirmed to be a treatable nodule, I will then evaluate whether it is suitable for removal or reduction via **pinhole extraction** (minimally invasive). You have already tried saline injection and subcision without improvement, and you even feel that the lump has spread. Therefore, I advise you to stop blindly stimulating the tissue. See clearly before taking action. If the ultrasound confirms the precise location of the lump, we will aim to treat it with the least amount of damage and the highest level of precision, rather than resorting directly to steroids.

劉達儒醫師🌐 EN Doctor

Hello, and thank you again for your detailed message. I have carefully reviewed the additional photos you sent. When the skin is gently stretched under the right lighting, the contour of the lump does become much clearer, which is very helpful for assessment. For this type of lump, my usual approach is needle-puncture minimally invasive removal through a very small entry point, rather than steroid injection. Because this is not a steroid-based treatment, it does not carry the same risk of causing further steroid-related tissue atrophy. The goal is to remove or reduce the problematic lump while minimizing additional trauma to the surrounding tissue. As for whether the area can become flat again, in many cases there can be meaningful improvement in smoothness and contour, but the final result still depends on factors such as the degree of fibrosis, prior inflammation, and how the tissue has healed over time. A direct examination would allow a more accurate judgment. Regarding the depressed area near the eyebrow / forehead, yes, this can also be addressed. If the lump is treated and there is still a contour defect or hollow area, it may be possible to improve the surface with a gentler filler material that is less likely to form lumps, or with other options such as thread lifting or fat grafting, depending on the condition of the tissue. This part would still be best decided during an in-person consultation. Thank you for sending the stretched-skin photos. They are very useful, especially since this type of protrusion may look subtle at rest but become much more visible under certain lighting angles. You are welcome to come in for a formal assessment, and we can discuss both the lump itself and the nearby depressed area in more detail.