Juvederm
As you age, your skin changes. One change that occurs is that production of a naturally hydrating substance called hyaluronic acid (HA) goes down. Over time, the loss of HA in your skin results in facial wrinkles and folds, like those “parentheses” lines around your mouth. JUVEDERM® injectable gel replaces the HA your skin has lost, bringing back its volume and smoothing away facial wrinkles and folds. A breakthrough in HA dermal fillers, JUVEDERM® is the first smooth-consistency HA gel and the only HA filler that’s FDA approved to last up to a year!* Read on to learn more.
Q: What is JUVEDERM®?
A: JUVEDERM® injectable gel replaces the HA your skin has lost, bringing back its volume and smoothing away facial wrinkles and folds. A breakthrough in HA dermal fillers, JUVEDERM® is the first smooth-consistency HA gel and the only HA filler that’s FDA approved to last up to a year!*
Q: What is JUVEDERM® made of?
A: JUVEDERM® is a cosmetic dermal filler composed of non-animal stabilized hyaluronic acid. Hyaluronic acid is a natural substance that already exists in the human body and is used to provide volume and fullness to the skin. The hyaluronic acid is biodegradable and completely biocompatible with human hyaluronic acid.
Q: Is JUVEDERM® an FDA approved product?
A: JUVEDERM® was first FDA approved in the United States in 2006 for injection into the mid-to-deep dermis for correction of moderate to severe facial wrinkles and folds (such as nasolabial folds), often referred to the parentheses lines around the mouth and nose. In 2015, JUVEDERM® Ultra XC was FDA approved for injection into the lips and perioral area for lip augmentation in adults over the age 21 to instantly add fullness to the lips for up to 1 year. In clinical trials, 79% of subjects showed a meaningful lip fullness three months after treatment. Additionally, more than 78% subjects reported an improvement in their overall satisfaction with the look and feel of their lips at one year after treatment. There are other areas in which JUVEDERM® is injected to improve lines and wrinkles, but these uses and areas are considered off-label at this time.
Q: What makes JUVEDERM® different?
A: While other HA fillers on the market have a more granular consistency, JUVEDERM® injectable gel is the first smooth-consistency HA gel. This is due to an innovative manufacturing process called HYLACROSS® technology. HYLACROSS® gives JUVEDERM® its unique smooth-gel properties as well as an optimal gel structure that holds up over time. That’s why JUVEDERM® injectable gel is the only HA filler that’s FDA approved to last up to one year.
Q: How do I choose between Restylane® vs JUVEDERM®?
A: This all depends on the person and the location where the product is going to be injected. Dr. Tang can talk with you about the relative pros and cons of each for your individual situation. Restylane® and JUVEDERM® both contain hyluronic acid and are used to soften lines and wrinkles and are used to restore volume. Even though Restylane® and JUVEDERM® have many similar properties, they are very different. Some patients simply love one or the other. Some say there is a better “look” to one product over the other which is something that a person will know only after they have tried both.
On one hand, JUVEDERM® is definitely smoother. Once JUVEDERM® is injected into the skin, you don’t feel it. So for the lips and the nasolabial folds, these are great areas to do JUVEDERM®. If you are person who doesn’t want to “feel” the product, JUVEDERM® probably will be the better choice.
On the other hand, some patients like the feel of the product because they feel better knowing that they have the product and it is doing something in that desired area. For underneath the eyes, Dr. Tang prefers to use Restylane® because he can have more control of where the product goes. Also, for this area the granular consistency in Restylane® seems to give a better correction.
Longevity is also an issue. Restylane® around the nasolabial areas lasts about 4-6 months. For JUVEDERM®, it could be the same or it can last longer. JUVEDERM® uses hylacross technology which provides more cross-linking between the different HA molecules. This means it takes more time for the body to degrade it. Some of patients have had it last 9-12 months. Longevity is certainly a determining factor for a lot of patients.
The JUVEDERM® representatives say that injected JUVEDERM® is less painful. That does not mean that that is necessarily the case.
Cost could be an issue. JUVEDERM® is slightly more expensive. Restylane® does have a rewards program which gives cash back with every treatment and eventually a free syringe, which is always nice. JUVEDERM® does not have a rewards program.
Another difference is that the JUVEDERM® syringe has 0.2 cc less per syringe than Restylane®. Whether that makes a difference in correction requiring more syringes is still open for debate. This could theoretically require more syringes which will increase the total cost.
Q: What should patients do prior to treatment
A: JUVEDERM® requires no pretesting, but you should take a few precautions before being treated. Avoid using aspirin, non-steroidal anti-inflammatory medication, St. John’s wort, omega 3’s, or high doses of Vitamin E supplements prior to treatment. These may increase bruising or bleeding at the injection site. Also, if you have previously suffered from facial cold sores, there is a risk that the needle punctures could contribute to another recurrence. You should notify your injector prior to having your injection so that you can get started on prophylactic antibiotics.
Q: Is JUVEDERM® safe?
A: Yes. JUVEDERM® is composed of non-animal stabilized hyaluronic acid. Hyaluronic acid is a substance found naturally in the human body. JUVEDERM® is fully biocompatible. There is limited risk of animal-based disease transmission or development of allergic reactions to animal proteins. No allergy testing is required before use. The most commonly reported side effects are temporary injection-site redness, swelling, pain/tenderness, firmness, lumps/bumps, and bruising. These effects typically resolve in less than seven days.
Q: What are the precautions for the use of JUVEDERM®?
A: There are several precautions to consider:
- The safety of JUVEDERM® for use during pregnancy, in breastfeeding women, or in patients under 18 years has not been established.
- JUVEDERM® injectable gel should not be used in patients with a history of allergies to Grampositive bacterial proteins.
- The safety of JUVEDERM® in patients with increased susceptibility to keloid formation and hypertrophic scarring has not been studied. JUVEDERM® should not be used in patients with known susceptibility to keloid formation or hypertrophic scarring.
- The patient should be informed that he or she should minimize exposure of the treated area to excessive sun, UV lamp exposure, and extreme cold weather until any initial swelling and redness has resolved.
- If laser treatment, chemical peeling, or any other procedure based on active dermal response is considered after treatment with JUVEDERM®, there is a possible risk of eliciting an inflammatory reaction at the implant site. This also applies if JUVEDERM® is administered before the skin has healed completely after such a procedure.
- The safety and effectiveness of JUVEDERM® injectable gel for the treatment of areas other than facial wrinkles and folds (such as lips) have not been established in controlled clinical studies.
Q: How long does JUVEDERM® last?
A: JUVEDERM® is proven to deliver long-lasting results. It has been FDA approved to last up to one year.
Q: How often should I have JUVEDERM® treatments done?
A:Treatments are typically scheduled at 6 months to 12 months intervals depending on the treated area. Dr. Tang will discuss the appropriate follow-up treatments during your visit.
Q: Will I have any scars from the injections?
A: No.
Q: Will I be able to go back to work after the JUVEDERM® injections?
A: Most of the time patients are able to go back to work the same day or the next day. All patients will have some redness and swelling immediately following the procedure. These usually last 1-3 days, and the redness and swelling are easily covered with makeup. Some patients will have some bruising, which may last several days to one week. Some areas tend to bruise more easily than others; for example, around the eyes. However, there is no absolute way of predicting who will bruise beforehand. There are several things you can do to help lessen bruising including icing, arnica, and avoiding medications such as Aspirin, anti-inflammatories, Vitamin E, and omega 3’s prior to the procedure. Dr. Tang will discuss all available methods to minimizing any potential bruising prior to the procedure.
Q: Do the injections hurt?
A: JUVEDERM® is injected directly into the skin in tiny amounts using an ultrafine needle, resulting in minimal discomfort. The procedure is simple and convenient, and the results are practically instantaneous. That said, some areas are more sensitive (for example, the lips). To optimize your comfort during the short procedure, we anesthesize the area prior with a topical anesthetic and often will use dental blocks (similar to what dentists use). Medications prior to the treatment are not necessary.
Q: Can JUVEDERM® be combined with lasers?
A: Yes. JUVEDERM® can be combined with different types of lasers including laser resurfacing, IPL photofacials, and tightening lasers. Dr. Tang will discuss with you which types of treatments will provide the most optimal results.
Q: How much do JUVEDERM® treatments cost?
A: JUVEDERM® is a customized procedure based on your specific needs, so the cost will vary from patient to patient. In general, the cost of JUVEDERM® will be depend on the number of syringes used. The Rejuve staff will be able to give you an estimate prior to the procedure at no extra charge.
Q: How is JUVEDERM® different from Botox®?
A: JUVEDERM® is a natural, cosmetic filler. In contrast, Botox is a compound that blocks nerve transmission which relaxes the underlying muscles. They are used for different indications and because of this, they can be combined to enhance each other’s effects.
Q: How is JUVEDERM® different from bovine collagen?
A: Bovine collagen is derived from animals (cows) and requires an allergy test. JUVEDERM® can be administered without pretesting, so no waiting is required. With JUVEDERM® there is no risk of animal-based disease transmission or allergic reaction.
Juvederm: Before and After
*The below pictures are actual patients, but individual results will vary and these results may not occur in all patients.
