Be careful what you wish for.
I’ve had more than a few patients walk in my Chicago area office with silicone filled lips or problematic bumps on their face from Sculptra that were unhappy with their outcome but could not do anything about it.
One of the unhappy patients had silicone enhanced lips and had never even had a temporary filler prior to the silicone. This, I believe is absurd, as it is always helpful for a patient to see how they will look like prior to a permanent change. Her doctor suggested a permanent implant the first time she asked for lip enhancement. This is a doctor to run from. The patient turned out looking like a pair of walking lips. She can have the implants removed, but this is not a simple procedure like injecting hyaluronidase into an area that was over filled.
While a patient might look good and be happy with a permanent implant down the road, one should always recommend trying the look temporarily at first to make sure it works.
Sculptra and some of the other fillers that stimulate lots of collagen production deep in the dermis, can achieve phenomenal results, they can also create lumps and bumps that are often visible. Even in the hands of a skilled doctor, there is a risk.
Sculptra seems to be the best for HIV related facial lipodystrophy. These patients have lost so much volume in their faces that they really can’t look over filled compared to how abnormal they looked prior.
The over filled look, or even filling to perfection, can often look obviously abnormal. The planes of the face can become distorted. So if you think you want to fill to perfection, do it at first with a short acting filler. If you don’t love the look, it will be gone in few months. If you love the look, repeat it the next time with a longer acting filler. Just remember, it is normal to have some amount of smile lines starting in your twenties. Smile lines can actually add more dimension to your face which is usually more visually appealing and interesting.