Inexperienced medical student injected Sculptra under the eyes and now huge bumps.

Dear Dr , I have approx 3 very large nodules- 1 of which is directly under my left eye, which is very rubbery and has distorted rhe conturity of my whole bottom eye area. The other lumps are around my right cheek and face - which look quite horrendous in most down lighting. They have all been there for well over 3 years and do not look like they are going anywhere soon. The under eye lumps are kind of hard/ soft at times . Other times it feels like it's affecting the nerves in that area. It was injected with steroid- but this has caused further loss of fat down the face directly under the lump. I am very unhappy about this and have complex about these horrible deformitys . They developed very quickly after I was injected by a medical student - who had very little experience with Sculptra. Any suggestions ? As the eye stiffening is quite distressing in itself , so it is difficult to live with. Best wishes Gary

Thank you for writing Gary.  My heart goes out to you on this one and I know if you could have a “do over” on that day, you would take it.    Here are some thoughts for options in a situation like this.    Just so it’s clear, the current (they have changed over time) clinical guidelines on use of Sculptra do NOT recommend using Sculptra around the eye area for this reason.

  1.  You and others out there with a similar problem could choose to find the closest Sculptra expert  to you and get a second opinion.   I would recommend that you see Dr. Danny Vleggar who is Swiss and currently (double check this) has a clinic in France and one in Amsterdam.   At the very least, his office may be able to recommend someone closer to you.
  2. Steroid injections don’t work with these nodules usually…. and often make the area look worse because they tend to thin the already thin skin around the eyes even more and can cause redness.   Experts only with any steroid injections around the eyes PLEASE!
  3.  In our experience, and this is NOT published data, the only thing that helps  – besides surgery – is for a nurse or doctor to  numb the area with injectible lidocaine, and then take a 25, 27 or sometimes 30 gauge needle and use the needle tip to physically chip away (gently) at the nodule which injecting sterile water  (the same that is used for reconstituting it in the first place).  Then repeating that every 3-4 weeks.   These are NOT in general inflammatory nodules which is why steroid injections don’t work.   These are collections of too much Sculptra material in one spot.  Hope that makes sense.
  4. You have the option of having these surgically excised by a good plastic surgeon.
  5. Another option is for the doctor to “cushion” around these nodules with some hyaluronic acid filler done carefully to make the area look better while the bump is being addressed.

I hope this helps,  Dr. I

Dr. Brandith Irwin, MD

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