Juvederm Surgery

Juvéderm (pronounced /ˈdʒuːvɨdɜrm/), one of the newest of the so-called “injectable fillers,” is used by cosmetic, dermatological and plastic surgeons to soften deep folds and reduce wrinkles in the faces of patients. The substance is largely hyaluronic acid, a substance normally found in the skin, muscles, and tendons of mammals. Approved in June 2006 by the U.S. Food and Drug Administration, Juvéderm’s prime use is removing nasolabial folds, or “smile lines,” creases of skin which run from the corners of the nose to the corners of the mouth. It is also used as a lip augmentation agent, and to fill in hollow places and scars on the face. However, all hyaluronic acid facial filler products are eventually absorbed by the body, usually within six to nine months, causing the patient to undergo repeat injections to maintain the younger look.^[1] Juvéderm is also used by physicians to plump lips, which also lose fat and internal shape with normal aging.

Current usage

Juvéderm’s current competitive edge in cosmetic surgery is possible because, according to the manufacturers, Juvéderm is “cross linked.” In hyaluronic acid’s natural form, the substance is a liquid which the body metabolizes in about half a day. Cross linking is a process that chemically binds the individual chains of the acid so that it is changed into a gel that lasts much longer once injected inside the face. Several other facial fillers used in Europe and the U.S. -- like Restylane, Belotero and Hylaform—are also cross-linked, with competition driving the other fillers toward even more highly cross linked compounds, according to Professor Berthold Rzany, professor of dermatology at the Charité Universitätsmedizin Berlin Germany.

Much of Juvederm's competitive edge is actually its ease of use for physician injectors. A free-flowing product for injecting into sensitive areas makes the process much more pleasant for doctor and patient. The new addition of lidocaine integration has subjectively improved the experience for the patient. Nissan Pilest, board certified dermatologist, associate professor at UCI School of Dermatology, medical director of a private practice and Juvederm training physician in Irvine, Ca., relates that Juvederm is a prime selection for most patients.

Mechanism of action

Juvéderm works well for cosmetic and plastic surgery applications because hyaluronic acid can absorb up to 1,000 times its own weight in water, thereby adding new volume under the surface of sagging skin. Older faces take on more youthful aspects because hyaluronic acid is known to bind with collagen—the material that supports human facial skin—and elastin to move more basic nutrients into the skin.

When the University of Michigan organized a study on the dermal filler Restylane -- a close chemical sibling of Juvéderm—researchers found that hyaluronic acid stretches cells in skin known as fibroblasts in a way that causes the skin to create new collagen. The new collagen helps decrease the appearance of facial creases and wrinkles. An unexpected—and welcome—finding cropped up: hyaluronic acid also seems to stop the breakdown of existing collagen.

What are the Benefits of Juvederm?

Most cosmetic or plastic surgery procedures used to correct the above facial items involve surgery which has its own set of risks and drawbacks. While complications rarely occur at the hands of experienced, board-certified cosmetic and plastic surgeons, other drawbacks include going under anesthesia, dealing with pain and bandages and taking required time away from work and other activities for healing. However, an injectable filler like Juvederm can accomplish the same facial rejuvenation so the patient can leave the doctor's office immediately and fully resume his or her normal activities by the next day. Moreover, the cost is less than surgery. 

Potential risks and side effects

Patients, physicians and researchers say usual, expected side effects include temporary redness, pain and tenderness during injections and swelling and bruising at the injection sites. The more serious side effects include immune system reactions that result in facial lumps and bumps known as granulomas, bothersome reactions that are very difficult for physicians to treat.^[5] According to Allergan, Juvéderm should not be used in patients with severe allergies, particularly those who have allergies to bacterial proteins or patients with a history of anaphylaxis, which is a potentially life threatening hypersensitivity to some drugs and proteins.

What Are the Costs of Juvederm?

Costs vary according to the region of the nation in which you live. According to the American Association of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery, the national average for a vial of Juvederm runs between $300 and $500. One-half vial of Juvederm treats one nasolabial fold.

Benefits

The benefit of Juvéderm is that it is effective in treating; hollows underneath the eyes, creases around the corners of the mouth, minor scars, vertical wrinkles between the eyebrows and providing lip augmentation that can give a more fashionable appearance. Since it is mostly composed of a naturally occurring substance in the body, it is highly compatible with human tissue.

The main benefit with an injectable filler like Juvéderm is that one can avoid the normal risks, downtime and pain associated with standard surgical procedures. Although complications with standard surgery are rare with board-certified cosmetic surgeons, there are still the disadvantages associated with anesthesia, bandage dressings and recovery times necessary for healing. These issues are eliminated with injectable fillers. The overall costs are much less, as well.

Procedure

There is usually very little pre-injection preparation for Juvéderm. A topical anesthetic (with possibly an oral sedative) will be given and the injections will begin, once the medications take effect.

The cosmetic surgeon will use a tiny needle to inject small amounts of the filler at specific locations on the face in order to increase the volume needed to achieve satisfactory results. The procedure will usually take around 15-30 minutes to complete and that will depend on the size of the area that is being treated

Recovery

One of the main advantages of Juvéderm is the minimal recovery time needed after the procedure. The patient is usually able to return to their normal activities directly following the procedure – but are cautioned against strenuous activity, heat exposure, sun exposure and alcohol use for a period of time.

There may be some puffiness after the procedure and some bruising (rare). Other skin treatments, such as laser therapy, chemical peels, etc. should be postponed until after the Juvéderm treatment in order to avoid possible inflammation risks.

Risks Associated with Juvéderm

Although risks are minimal with Juvéderm, there are some normal, expected issues that can include redness and tenderness which are temporary. More serious, but rare, complications can involve infection and immune system issues that can result in granulomas (facial bumps). This will preclude the use of Juvéderm in patients who are subject to severe allergic reactions to bacterial proteins and certain other drugs.

Procedure Costs

The region where you live will determine the cost of Juvéderm treatment. However, national averages for treatments utilizing one vial of Juvederm run between $300 and $575. To put this in perspective, a half vial of Juvéderm will treat one major facial fold.

Types of Juvederm

 Now the company Allergan has different versions of the injectable gel on the market which include Juvederm Ultra, Juvederm Ultra Plus, Juvederm Ultra XC, and Juvederm Ultra Plus XC. If they don’t stop making Juvederm variants I am going to tell you to just go and get Restylane lol. But Restylane will probably come out with these different versions to compete.

What are the two basic types of Juvederm?

There are two basic types of Juvederm which are Juvederm Ultra and Juvederm Ultra Plus. From everything I’ve read (and I’ve read a lot because I sit around all day reading beauty stuff) Juvederm Ultra Plus is a thicker material and the thickest one that Juvederm puts out. That would make Juvederm Ultra Plus the superior choice for creating facial volume. If you have very deep nasolabial folds and deep crevice deflated areas, then your doctor would probably use the Ultra Plus version for that. Basically, it’s for deep line filling in a woman’s face. Doctor’s like the stable thick consistency of Ultra Plus for creating volume and they also say it lasts reasonably well. If you only have fine lines the Juvederm Ultra Plus is too thick and the Juvederm Ultra is the better choice.

The basic version of Juvederm (Juvederm Plus) is a lighter consistency. Let’s say you are a woman who just needs a little judicious lip volume. If that is the case, you could get Juvederm Ultra for as cheap as you could find it offered by a good doctor, and just get the basic plumping. You wouldn’t really need the thick stuff and why pay more money for it. Use the Juvederm Ultra for more superficial wrinkles and lines and the Ultra Plus for deeper lines and volume filling. I’ve also read that the viscuous thickness of the Ultra Plus makes it last a few months longer but it may be just that you get more of it because your wrinkles would be deeper. Obviously if you got more cc’s injected then it’s going to take it longer for it to totally deflate itself. If your facial wrinkles are really fine I don’t think you would want the Ultra Plus as it could look lumpy in that case. Ultra Plus is more for deep groves. Likewise you don’t want trout pout by getting too much Ultra Plus pumped into your lips. If you have a decent doctor then he knows what to do.