Health: Fill ‘Er Up


Chances are if you’re past 50, the face you see in the mirror is leaner than the one you had at 20. The apple of your cheek has dissolved, your jawline is less defined, and those smile lines from the corners of your nose to your mouth have deepened. So when a woman bumps into a friend of a certain age who looks particularly good, she’ll say, “You look terrific” — but what she’s thinking is, “What work did she have done?”


Chances are if you’re past 50, the face you see in the mirror is leaner than the one you had at 20. The apple of your cheek has dissolved, your jawline is less defined, and those smile lines from the corners of your nose to your mouth have deepened. So when a woman bumps into a friend of a certain age who looks particularly good, she’ll say, “You look terrific” — but what she’s thinking is, “What work did she have done?”

That’s exactly what was going through my mind during my last visit to Betsy Rubenstone, an aesthetician at Penn’s Center for Human Appearance. After I told her she looked especially youthful and healthy, she revealed that she’d been treated with a product called Sculptra. “It’s injected into parts of your face to restore fullness,” she explained. And while the thought of elective facial injections would send most people running, there is a subset of women who are not “most people”: To us, a few needles are nothing in the name of looking good. I practically ran out of her office to find some for myself.

Sculptra is a biodegradable poly-L-lactic acid made from the same material as dissolving stitches. About 10 years ago, doctors in Europe began experimenting with it to treat facial wasting in HIV patients. Its success attracted the attention of cosmetic surgeons, and in 2004 the FDA approved it for HIV patients. (Any cosmetic use is off-label.) It’s still fairly new to Philadelphia, but its popularity has been fueled by a demand for non-surgical facial restoration, or NSFR, for which, unlike surgical face-lifts, the risks are low and the satisfaction rate is high.

Sculptra is injected in a lattice pattern into the deeper layers of skin, where it’s thought to stimulate the growth of the body’s own collagen. Eventually the Sculptra gets absorbed, but the skin thickening it causes gives shape and fullness to the face that can last from two to three years.

For my treatment, I opted for Dr. Scott Bartlett, a plastic surgeon who does cosmetics at Penn and reconstruction at CHOP. I was in and out of his office in under an hour. First, I spent 20 minutes lying on the table, my face smeared with anesthetic cream to deaden the pain of the injections that would follow around my cheekbones and under my eyes. After the injections, Dr. Bartlett massaged my face and sent me home to ice and take arnica for the bruising. It didn’t help much: By the next morning, my two black eyes suggested I’d lost a prizefight. The red-to-black-to-yellow bruising endured for about five days. A month later, I returned for my second treatment. Some people need three or four.

I didn’t see a vast immediate change — but Dr. Cherie Ditre, director of cosmetic dermatology at Penn, cautions not to expect anything dramatic for two to three months. For me, the results have been more subtle than “wow.” My mirror tells me I look less tired and drawn, and my cheekbones are more prominent again. Best of all, people who haven’t seen me in years have marveled at how little I seem to have changed. Of course, I know what they’re really thinking.