Fillers have evolved from a product to fill in wrinkles to a variety of materials that stimulate collagen production and enhance facial volumes and the integrity of the skin. Aging of the face is now understood to be a collapse of the skin, fat, muscles, and reabsorption of the bones of the face. An important rejuvenation procedure available today is to restore lost volume. For that reason fillers have become the treatment of choice in facial rejuvenation and an essential component in virtually every facial treatment. Facial filler options can be safe, simple and effective facial rejuvenation treatments. Hyaluronic acid fillers restore lost volume to facial cosmetic units such as the cheeks, under the eyes, the lips, or to wrinkles and furrows, for an immediate anti-aging effect. Commonly there is little downtime or the risk of allergic reaction. Results can last months-years.
Juvederm-ultra XC and Voluma
Juvederm is a dermal filler that was FDA-approved in June 2006 for the treatment of moderate to severe facial wrinkles and folds such as nasolabial folds (the lines extending from the nose to the corners of the mouth).
The filler is an injectable hyaluronic acid, a natural complex sugar that bolsters skin elasticity, providing a smooth and supple appearance. It is biocompatible, supplementing the body’s natural hyaluronic acid, which age has depleted.
The product can be injected into fine lines and wrinkles around the mouth or lips or be used to help to restore volume to the cheeks, chin and the area around the eyes. Treatment areas also include the “marionette lines” and the corners of the mouth that commonly will slope downward over time. Juvederm is useful for enhancing lip volume, for reshaping cheek contours and for filling acne or traumatic scars.
The transparent Juvederm gel is injected with a syringe into the skin and soft tissues of the face. The product improves your appearance by lifting and adding volume to the wrinkles, scars and folds in the treatment area. After many months, the biocompatible compound is naturally absorbed into the body. The Juvederm Ultra XC tends to last 6-9 months and the Juvederm Voluma is FDA approved for up to 2 years.
One advantage to Juvederm is its pliant gel consistency, which may provide a smoother, more natural-looking appearance than some of its more rigid predecessors. Another advantage is that Juvederm may last longer, maintaining the improved appearance for longer. The benefits may last even longer if you have a follow-up treatment a few weeks after the first treatment.
Juvederm Side Effects
Side effects with Juvederm are rare, but may include redness, tenderness, or pain at the injection site. If these occur, they usually subside within three days. Rarely, discoloration may occur, but this is reversible. Firmness, swelling, bumps and bruises are also rare side effects, and should subside within seven days. Hyaluronidase is an injectable medicine that can be used to erase the effects of the hyaluronic acid gel if indicated.
JUVÉDERM® XC injectable gel is indicated for injection into the mid-to-deep dermis for correction of moderate to severe facial wrinkles and folds (such as nasolabial folds).
JUVÉDERM VOLUMA® XC injectable gel is indicated for deep (subcutaneous and/or supraperiosteal) injection for cheek augmentation to correct age-related volume deficit in the mid-face in adults over the age of 21.
IMPORTANT SAFETY INFORMATION
JUVÉDERM® XC and JUVÉDERM VOLUMA® XC should not be used in patients who have severe allergies marked by a history of anaphylaxis or history or presence of multiple severe allergies, and should not be used in patients with a history of allergies to gram-positive bacterial proteins or lidocaine.
- JUVÉDERM® XC injectable gel and JUVÉDERM VOLUMA® XC injectable gel must not be injected into blood vessels and should not be used in vascular-rich areas. Use in these areas, such as glabella and nose, has resulted in cases of vascular embolization, occlusion of the vessels, ischemia or infarction, or blindness. Symptoms of vessel occlusion and embolization include pain that is disproportionate to the procedure or remote to the injection site, immediate blanching extending beyond the injected area, and color changes that reflect ischemic tissue such as a dusky or reticular appearance
- Product use at specific sites in which an active inflammatory process or infection is present should be deferred until resolved
- The safety for use in patients under 18 years for JUVÉDERM® XC, and for patients under 35 years or over 65 years for JUVÉDERM VOLUMA® XC, has not been established
- The safety and effectiveness of JUVÉDERM® XC for the treatment of anatomic regions other than facial wrinkles and folds, and of JUVÉDERM VOLUMA® XC for regions other than the mid-face, have not been established
- The safety for use during pregnancy, in breastfeeding females, and in patients with known susceptibility to keloid formation, hypertrophic scarring, and pigmentation disorders has not been studied
- Use with caution in patients on immunosuppressive therapy
- Patients who are using products that can prolong bleeding (such as aspirin, nonsteroidal anti-inflammatory drugs, and warfarin) may experience increased bruising or bleeding at treatment sites
- If laser treatment, chemical peel, or any other procedure based on active dermal response is considered after treatment, or if the product is administered before the skin has healed completely, there is a possible risk of an inflammatory reaction at the treatment site
- Patients who experience skin injury near the site of implantation may be at a higher risk for adverse events
- Dermal filler implantation carries the risk of infection. Standard precautions associated with injectable materials should be taken
- The safety of JUVÉDERM VOLUMA® XC injectable gel for use in patients with very thin skin in the mid-face has not been established
- The long-term safety of repeat treatments with JUVÉDERM VOLUMA® XC has not been established
- Patients may experience late onset nodules with use of dermal fillers including JUVÉDERM VOLUMA® XC
- JUVÉDERM VOLUMA® XC should only be used by healthcare professionals who have appropriate experience and who are knowledgeable about facial anatomy and the product for use in deep (subcutaneous and/or supraperiosteal) injection for cheek augmentation
The most commonly reported side effects for JUVÉDERM® XC injectable gel were temporary injection-site redness, swelling, pain/tenderness, firmness, lumps/bumps, bruising, discoloration, and itching. They were predominantly mild or moderate in severity, with a duration of 7 days or less.
Side effects for JUVÉDERM VOLUMA® XC injectable gel in > 5% of subjects were temporary injection-site tenderness, swelling, firmness, lumps/bumps, bruising, pain, redness, discoloration, and itching. They were predominantly moderate in severity, with a duration of 2 to 4 weeks.
To report an adverse reaction, please call Allergan Product Surveillance at 1-877-345-5372.
JUVÉDERM® XC and JUVÉDERM VOLUMA® XC injectable gels are available by prescription only.
Lipoaugmentation restores a youthful contour by transferring a patient’s own fat from an undesired area to a collapsed cosmetic unit of the face. This procedure restores sunken eyes and cheeks, thin lips and mouth, and ill-defined jaw lines and chin creating a more youthful appearance. See a more complete description under Lipoaugmentation of the Face.
Get your free cosmetic surgery consultation with Dr. John Rachel, a board certified cosmetic surgeon.