Juvederm®

Introduction
Hyaluronic acid is a hydrating substance found naturally in skin and soft tissue, providing volume and youthfulness to our appearance. As we mature, there is depletion of hyaluronic acid in our skin and soft tissues, leading to wrinkles, folds, and sagging. Juvederm® is a hyaluronic acid soft tissue filler useful in correcting many of these skin and soft tissues changes. Juvederm® received FDA-approval for cosmetic use in 2006 and is available in four formulations in the United States, known as Juvederm® Ultra and Juvederm® Ultra Plus, Juvederm® Voluma (approved 2013) and Juvederm® Volbella (approved 2016) . Juvederm® Ultra and Juvederm® Ultra Plus are processed by a patented Hylacross gel technology delivering a natural feel and longevity of wrinkle correction and volume restoration through structure. Juvederm® Voluma and Juvederm® Volbella are processed by a patented Vycross gel technology, providing the ability to lift, volumize, soften, and/or contour depending on the formulation (please see Juvederm® Voluma and Facial Rejuvenation Philosophy).

Dr. Liu is a recognized expert in Juvederm (Ultra, Ultra Plus, Voluma, and Volbella) treatment techniques, training other physicians through Allergan Facial Aesthetic Training Programs and P.A.L.E.T.T.E. Live Injection Training Programs for advanced techniques.

How is Juvederm® used in facial rejuvenation?
The Juvederm® family is comprehensive in their ability to soften wrinkles, restore volume loss, and augment facial and body, if desired. Listed below are some examples of how Dr. Liu uses Juvederm®:

Wrinkles

• Smile lines (Nasolabial folds)
• Perioral rhytides (Smoker’s lines around the mouth)
• Marionette lines (Downward turn of the corner of the mouth)
• Glabellar lines (Frown lines)
• Forehead wrinkles
• Neck wrinkles
• Décolletage wrinkles (Chest wrinkles)

Volume Restoration or Lift

• Cheeks
• Under the eyes
• Chin
• Jaw
• Temples

Structural Contouring

• Lip
• Nose
• Cheeks
• Chin
• Jowls
• Eyebrows
• Hands
• Footpads

Left: Experiencing volume loss of both her upper and lower lips.   Right Juvederm used to augment volume proportionally

Left: -Patient Is Augmenting the Appearance of Her Lips Applying Lipstick Onto Her Skin   Right: Juvederm used to augment volume proportionally

Left: Patient Desires Smoother Nasal Bridge and Subtle Elevation of Nasal Tip     Right: Juvederm Ultra Plus to Smooth Nasal Bridge and Elevate Tip of Nose

Left: Patient complaining of looking tired around her eyes and mouth.   Right: Juvederm® Voluma injected into tear trough, superiolateral cheek, and oral commissure. After lift and volume symmetry of cheeks and chin were achieved, a small amount of Juvederm® Ultra was injected into dermal layer of the nasolabial folds and oral commissure to soften superficial wrinkles and achieve symmetry

Left Photo-Evolving forehead lines, crow's feet wrinkles, and volume loss of undereye.   Right Photo-Fine line filler technique used for forehead and crow's using Belotero and Refyne. Cannula filler technique using Vollure for undereye. Patient preferred not to have Botox to retain full motion of face.

What is the difference between Juvederm® Ultra, Juvederm® Ultra Plus?
The difference between Juvederm® Ultra and Juvederm® Ultra Plus are the size of the hyaluronic acid molecules and the amount of cross-linking of the molecules for stability. In general, Juvederm® Ultra Plus is used for deeper folds and larger volume restoration.
                       

What should I do before treatment?
Before treatment, you should discuss with Dr. Liu your medical history, including allergies and medicines. If you are taking blood thinners, ask your doctor if it’s safe to discontinue prior to Juvederm® treatment. Juvederm® treatment is contraindicated in certain situations; some of these are listed below:

1. History of multiple severe allergies
2. History of allergies to Gram-positive bacteria proteins

Does Juvederm® injection hurt?
Juvederm® injections are well tolerated. Various methods for comfort are available including gentle nerve blocks, topical numbing cream, cooling of the skin, and/or mixing of anesthetic solution with the filler.

What is the recovery time?
The majority of patients have none to minimal down time. Occasionally, a bruise may develop, which resolves in a few days. If you take a blood thinner medication, ask your doctor if it can be discontinued prior to Juvederm® treatment, to minimize the risk of bruising. There may be some swelling noted after the procedure, which can be minimized with ice and rarely lasts more than a day.

How long does it last?
Most patients can expect immediate and sustained results between 6 to 12 months.

Are there any side effects?
Side effects are uncommon and usually minor and temporary if seen. You may experience soreness or bruising at the injection site. Very rarely, people experience lumpiness or irregularity in the treatment area.  These typically resolve with gentle massage or observation.

What do I do after the treatment?
After care instructions will be provided by your treatment team.