Dr. Toth’s Technique
Dr. Toth uses a mixture of Sculptra (Dermik Laboratories/Aventis Dermatology) and local anesthetic in sterile water. “I use Sculptra exclusively because it is a good substance and it promotes collagen formulation,” he says. “The product seems to last a significant amount of time.”
Dr. Toth typically relies on one portal of entry for a single injection, then bends the needle and moves it around.
The range of filler for any one patient varies greatly and treatment is highly individualized.
About 80% of the time, Dr. Toth injects just behind the ball of the foot. “However, you biomechanically have to figure out the problem of the bones, how they move, and predict where most of the forces reside,” he explains. “Intuitively, if someone has pain in a particular area, you would inject directly under that area. But it is not that simple for the foot. You actually inject strategically around that area and then massage the filler to where you want it to go. In that sense, Sculptra is very much like Play-Doh.”
Additionally, as women age, their estrogen level deceases, “which means their fat content decreases too,” Dr. Toth says. “But everyone decreases their fat content differently. Some people still have certain areas that are fine and do not need filler, while others have areas that do. The map is different for everyone.”
Where Sculptra is placed and spread to is an important consideration, according to Dr. Toth. “Otherwise, when the patient starts walking on the filler, the filler will dissipate and disappear.”
Preparation takes about 5 minutes, followed by 3 minutes of actual procedure and 10 minutes of massaging, for a total of between 15 to 20 minutes. Dr. Toth uses a block of ice to help numb the skin, whereas massaging evens out the formed colloid. “You do not want to be injecting and leaving the filler as is, because you may cause more pain than benefit,” he states.
Dr. Toth’s patients are roughly equally split between having one or two feet treated. For the second foot, he waits 3 or 4 days, rather than scheduling both feet at the same time and risking a reaction.