Facial Plastic Surgeon / Procedures / Skin / Juvederm
Juvederm® is a dermal filler composed primarily of hyaluronic acid. This is a substance already found in the human body that acts to provide volume to our skin. The other well-known filler composed of hyaluronic acid is Restylane®. In general, these two fillers are very similar in terms of their indications, risks, and longevity of results. They represent the two most commonly used fillers on the market. Based on their subtle differences, some surgeons may prefer to use one product over the other and vary this based on the location of injection.
These two products differ in the exact particle size of the hyaluronic acid they are composed of and the amount of cross-linking of the particles. Whereas Restylane® is more of a gel particle suspension, Juvederm® is thought to be highly cross-linked, producing more of a gel.
It comes in several forms, including Juvederm® Ultra, Juvederm® Ultra Plus, Voluma, and Volbella. The various formulations of Juvederm have different indications and uses for different parts of the face. Ultimately both Juvederm® and Restylane® work very well and are used extensively at this time. For more information on the use of hyaluronic acid fillers, please see the section on Restylane®.
The most common areas of injection include the cheeks, lips, nasolabial folds, marionette lines, frown lines, hollows above and below the eyelids, and hollows in the temporal area just outside of the eyebrows.
Juvederm® can also be used to add volume to the hands, soften the chin fold, improve the appearance of acne scars, improve nasal deformities, and treat various contour deformities from trauma, surgery, or syndromes of soft tissue atrophy.
To help with bruising and swelling, an ice pack can be used for 20 minutes every hour for the first 24 hours after treatment, but this is not absolutely necessary.
Patients are advised to remain upright and to avoid lifting, bending, or straining for the first day after treatment. After this time, all activities are unrestricted.
Makeup can be applied at any time after the procedure. The effects of Juvederm® are seen immediately, but may be distorted somewhat by redness or swelling. This can take up to one week to resolve completely.
Juvederm® is injected into the skin in tiny amounts with the use of a very fine needle or with a cannula which is our preferred method. Prior to treatment, the area is made numb with a topical or injectable anesthetic; any sedation or heavy anesthesia is not needed. This is a short procedure that is associated with minimal discomfort and produces instant results. There are a few precautions to take prior to your treatment.
For a week prior to the procedure, you should avoid any medicines like aspirin or ibuprofen that may cause increased bruising at the injection site. Your surgeon can provide a full list of medications to avoid.
Also if you frequently get cold sores, this procedure may cause a recurrence. You may be a candidate for an oral medication to be taken around the time of the procedure to prevent this from happening.
In general, Juvederm® is very safe and complications are rare. A small amount of redness and swelling is typical. If any bruising occurs, it should resolve within one week. These are not true complications, but part of the injection process.
Complications that can occur include small lumps, irregularities, asymmetries, worsening of small spider veins, infection, activation of a cold sore, and an allergic reaction. There have been reported cases of tissue necrosis and even blindness related to filler use but these are exceedingly rare. Most of the time complications are easily dealt with and in rare circumstances require the injection of a substance to neutralize the Juvederm®.
Also, patients who are pregnant, nursing, under 18, or have a history of keloid formation should not use Juvederm.