Sculptra: The Liquid Face Lift

The youthful Mick has fullness in the upper cheeks, temples, and jaw. The Mick today has deep lines in the lower face, collapsing and flattening of his face from volume loss in the upper cheek regions.

Are you suffering from Mick Jagger Facial Disorder (MJFD)? It turns out that eventually all of us will succumb to some variation of these facial aging changes. As we age, thereis progressive loss of fat and thinning of the glycoprotein matrix in the deep dermal layers of the skin. The loss of tissue volume in the midface results in an overall elongation of the face, sagging, loss of elasticity, and wrinkles. These changes are most apparent in the midfacial region, that is, the cheeks. The face begins to resemble a balloon that has been deflated. The cheeks collapse inward and look concave, and the "parentheses lines" around the sides of the mouth deepen. Injecting the lines around the mouth will only partially correct the problem.

Ultimately, the underlying cause needs to be addressed: the facial tissue volume needs to be restored to lift the sagging cheek off the perioral area. The collapsing cheek presses on the corners of the mouth causing the corners to fold inward and pull down the corners of the mouth with lines deepening toward the chin. This contributes to an unhappy appearance.

If you study a young person's face, they do not appear younger merely because of the absence of wrinkles. They have a pleasing fullness and smoothness to their facial contours. There is a firmness and roundness to their faces. If you examine photographs of yourself in your 20's or30's you will observe that there is increased tissue volume in the mid-third of the face with an attractive convexity to the cheeks and temples. As the natural facial fat pads are metabolized over time, an overall flattening of the face develops. This is best appreciated by looking at a side profile of yourself. The anterior plumpness and projection of the cheekbone regions disappear. You become aware of looking tired and having "dark circles" under your eyes. The loss of tissue volume in this area accentuates the underlying bony structure of the orbits of the eye sockets and the concavity causes underlying veins to become more prominent contributing to a perceived darkening of the skin.

Many people become obsessed with removing all wrinkles without having had a thorough analysis of the causes contributing to the aging changes of their face. These individuals often decide to have a facelift for correction. Having plastic surgery performed without replacing volume loss or addressing poor collagen production results in wrinkles being eliminated by pulling the skin taut over the facial bones and removing the excess skin. The result is a tight, gaunt, smooth face with accentuation of the bony outline of the skull. This is not a youthful look.

The FDA (U.S. Food and Drug Administration) has approved an injectable filler, called Sculptra® that helps correct the volume losses described. Sculptra® is composed of poly-L-lactic acid. This polymer is also used to manufacture absorbable surgical sutures. Sculptra® has been used in over 30 countries worldwide since 1999. It is a biocompatible, biodegradable, non-animal synthetic polymer that acts as a biostimulatory filler to activate your own skin cells to produce collagen. Current studies have shown that the results can last for 25 months and there have been reports of it lasting longer in some cases. No skin testing is necessary prior to having the treatment. The volume enhancement is a gradual process. Correction occurs over several weeks. Treatments are performed every 4-6 weeks and typically anywhere from 3-8 sessions may be needed to see improvement. The number of treatments required depends on the extent of volume replacement that is needed and this varies from individual to individual. Anesthetic is mixed with Sculptra® to minimize discomfort from the injections. Possible side-effects are those associated with all injectable filler: bruising, swelling, pain, itching, redness, and lumps. These generally resolve spontaneously over time. These potential side effects are associated with any injectable filler or volumizer.

Sculptra® offers a great way to stimulate your own collagen production and recapture volume lost over the years. It helps rebuild the deep collagen foundation in the sub-dermal layer of the skin, strengthen skin support, restore elasticity, and firm the skin. The treatment offers a gradual natural improvement option. It can be combined with other filler such as Juvederm® and Restylane®, which still have a place for corrections in the higher levels of the skin for lines due to tissue weaknesses in the dermal layers. The best way to decide which fillers are appropriate for your face is to make an appointment to see Dr. Wong for a detailed evaluation. She will be able to make recommendations that are tailored for your skin type, texture, and specific concerns.