Our 61-year-old patient came in today for her third 2 vial Sculptra injection. Her treatments began only 3 months ago, and she is beyond thrilled. Final Sculptra results will be seen in 6 to 12 weeks. Her goals were to treat the puffiness and dark circles under her eyes. Given her busy work schedule, eyelid surgery will be pushed off until the fall. The timing couldn’t be better as she presented with both "peaks" of excess fat and "valleys" of hollowness under her eyes. She does have a negative vector and is therefore a higher risk for surgical fat removal. Building up supportive volume under her eyes and cheeks before surgery will reduce post-operative risks and will be best accomplished with Sculptra as she doesn’t have sufficient fat for fat transfer to her face and fat transposition also wouldn’t give her sufficient cheek volume. One can appreciate that even the dark circles from excess pigment have been improved by filling in her cheeks and eye hollows which can cast a shadow on the eyes. Her jawline was also filled giving her a more defined jaw and chin. I will send updated photos after her final Sculptra and blepharoplasty surgery.