The addition of Sculptra to the esthetic dermatology landscape in September 2004 brought a new opportunity for facial rejuvenation. Sculptra, which is polymerized lactic acid (PLA), received approval from the Food and Drug Administration for the treatment of HIV-associated lipoatrophy. Since its approval, it has gained acceptance among cosmetic dermatologists and plastic surgeons, and its inclusion in any update of esthetic dermatology is certainly warranted. Its uses for esthetic indications are now being substantiated by clinical trials and, as experience with this product increases, it is likely that it will be more widely used for these reasons.