As most of you know I think Sculptra (when done well) is a wonderful product.  The results are noticeable, but not puffy and sometimes you can get an almost facelift like effect with it.  It's also low maintenance once correction is achieved, usually one treatment once a year.  It builds your own collagen so your skin glows and feels and moves naturally. And, it's easy to adjust for weight and age changes.

BUT, this product is difficult sometimes for doctors and patients and here's how most really great Sulptra docs use this product.  It requires a lot of the doctor and some massage from you, the patient.

Most experienced Sculptra dermatologists, and some plastic surgeons, use a 8.0 or 9.0cc dilution per vial for most facial treatments.  Sometimes more dilution for off face areas and sometimes less in certain specific situations.  The mixing is done with sterile water and sterile lidocaine (the proportions can vary).  Even then the material tends to settle and must be constantly, but gently resuspended both in the vial and in the syringe it's put into.

Then it must be injected gently and evenly into the skin in right plane and distribution.  This is important because it can't be too superficial.  The placement is different than for most Juvederm/Restylane, etc.  Then it must be massaged well in the clinic and the massage instructions for home (this is your part) carefully followed. 

If there is the rare bump that develops they are usually invisible.  If they are visible though, many clinics have the patient massage (always with lotion) for about a minute twice a day until it shrinks for at least 1-2 weeks.  If it doesn't shrink then the doctor can inject some sterile water (like the sterile water it's mixed with originally) into the bump.  This hurts a little so it can be mixed with a little lidocaine if desired.   This can be repeated if needed.  Usually that will do it.  I hope this helps! 

PS -  Dr. Bauer Germany and Dr. Vleggar in Switzerland are world renowned experts in this.

Dr. I