"Doctor, Which Is Better — Butt Filler or Sculptra?" — A Question I Get Every Day

"Doctor, Which Is Better — Butt Filler or Sculptra?" — A Question I Get Every Day

Let me give you the conclusion first.

It's not a matter of choosing one over the other.

Let me explain why in this post.

Butt Filler and Sculptra May Look Similar, But They Serve Different Purposes

Butt filler typically uses HA (hyaluronic acid) or high-viscosity products

to directly fill in areas that have lost volume.

The defining feature is that the shape is visible immediately after injection.

Sculptra works differently.

It uses an ingredient called poly-L-lactic acid (PLLA)

to stimulate your body to produce its own Collagen naturally.

That's why, unlike Filler, Sculptra

doesn't show noticeable results right after the procedure.

Volume gradually builds up over the course of several weeks.

Why Butt Filler Alone Can Look Unnatural

Let me share the story of a patient in her late 30s who came in last month.

She had received about 60cc of butt filler at another clinic,

and came to us saying she felt "like something was just sitting on top" when she sat down.

The volume had clearly increased, no question about that.

But because the Filler alone was trying to create structure,

there was a noticeable lumpiness to the result.

Here's the tricky part —

for a high-volume area like the buttocks,

simply filling in what's deflated isn't enough.

The skin's own Elasticity and thickness need to improve at the same time

for it to feel naturally soft even under pressure.

That's why my typical approach looks like this:

I first use Filler to build the structural foundation — above the tailbone, and along the sides where volume is lost —

and then layer Sculptra across the area to improve overall Elasticity and skin thickness.

In terms of ratio, it's roughly Filler 3 : Sculptra 7.

Sculptra is typically administered in 2 to 3 sessions, spaced 4 to 6 weeks apart.

Injecting too much at once increases the risk of nodule formation (lumping).

On the other hand, the longevity is impressive.

Filler generally lasts around 8 to 18 months depending on the area and product,

while Sculptra — because it works by building your own Collagen —

often lasts well over 2 years.

Who Is a Better Candidate for Butt Filler vs. Sculptra?

It varies case by case, but here's how I generally break it down.

If there's significant hollowing above the tailbone,

or a sharp indentation along the side profile, Filler comes first.

Because the shape itself needs to be corrected.

On the other hand, if there's overall sagging

and loss of Elasticity causing the boundary between the buttocks and thighs to blur —

in those cases, Sculptra alone tends to deliver very satisfying results.

That said, Sculptra isn't always the right fit.

Because results take time to appear,

I generally don't recommend it for patients with an upcoming event (wedding, vacation) around the corner.

You really need at least 3 months of lead time.

Last-Minute Questions Before Your Procedure

Q1. Does combining both procedures double the cost?

A. It depends on the case,

but compared to using a large volume of Filler alone,

the total amount used is often reduced —

so the cost ends up similar or only slightly higher.

For example, instead of using 80cc of Filler,

splitting it into 30cc of Filler plus 2 sessions of Sculptra

actually delivers more natural, longer-lasting results.

Q2. If I lose weight, will the results disappear too?

A. With Filler, since it directly adds volume,

weight changes don't have a major impact on the results.

With Sculptra, since the results come from your own Collagen building up,

rapid weight loss may make it feel like the volume has diminished as well.

However, the improvement in skin Elasticity itself tends to remain.

Q3. I'm concerned about nodules or lumping as a side effect.

A. To be straightforward,

nodule formation with Sculptra comes down to dilution concentration and injection depth.

If it's not properly diluted and is injected too superficially,

you may be able to feel small granules when touching the area.

For the buttocks, injecting at a sufficiently deep layer (subcutaneous fat layer)

and massaging for 5 minutes a day for 5 days post-procedure

resolves this in most cases.

If you're unsure whether you're a Filler type or a Sculptra type, feel free to send me a photo via KakaoTalk. This has been Dr. Wi Young-jin.