Juvederm is an FDA-approved cosmetic dermal filler made from hyaluronic acid. Hyaluronic acid is a naturally occurring substance in your skin that helps to hydrate and add volume. Hyaluronic acid in your skin decreases with age and over time, and this loss of support and volume leads to the formation of wrinkles and folds – especially in your lower face. Juvederm corrects these processes by returning hyaluronic acid in your skin.

What does Juvederm do?

Juvederm can be used to “fill in” wrinkles, furrows and depressions around the nose and mouth, including the nasolabial folds, marionette lines, and smile lines. Juvederm temporarily adds volume underneath your skin to restore a smoother appearance to your face. It can also be used to plump the lips and decrease those smokers’ lines that you can get even without smoking. It can reduce eye bags, and fill the cheeks, making you look younger and refreshed instantly.

How does Juvederm differ from Botox?

Juvederm is a dermal filler – which means it acts by “filling in” wrinkles or creases in your face. It works best in the lower face where lines tend to be caused by loss of volume under the surface of your skin – especially the lines around your mouth and nose. In contrast, Botox works by relaxing muscles in your face that pull your skin into creases or furrows. It works best on the upper face where the muscles of your forehead cause lines between your brows and across your forehead. For best results, both are used together.

What is hyaluronic acid?

Hyaluronic acid is a naturally occurring substance found in all animals that helps hydrate and add volume and support to your skin. Hyaluronic acid has been used for more than 20 years for injection into arthritic joints to aid movement as well as for eye surgeries and wound repair. Uncross-linked hyaluronic acid in its natural form is in a liquid state. Cross-linking is the process through which hyaluronic acid is made into a gel product that can be injected into the skin for long-lasting results.

What is the difference between Juvederm, Restylane, and Perlane?

All of these products are hyaluronic acid fillers – which means that they are made from the same naturally occurring protein.

There are two considerations when choosing a hyaluronic acid dermal filler. The more “cross-linked” (this is a medical term that is used to describe how tightly the filler sticks together) a filler is, the longer it lasts and the more support it can give your skin. Therefore, a highly cross-linked filler is very desirable. The other consideration is that a filler has to be smooth and liquid enough that it flows evenly into the skin. The thicker a filler is the harder it is to inject in a smooth even line, which can lead to nodules and bumps under the skin. Generally speaking, the perfect hyaluronic acid filler will have a very high concentration of cross-linked molecules, but still be very even and smooth when injected.

We have chosen to use Juvederm in our practice because it has the highest concentration of cross-linked hyaluronic acid of any currently available hyaluronic acid dermal fillers. It also comes in a smooth consistency gel that flows easily into the skin during the injection process and provides a smooth, natural look and feel—so everyone will notice (but no one will know!). Juvederm is the only filler available with this smooth consistency gel—other existing hyaluronic acid dermal fillers are made of granular gels.

Juvederm has two formulations – Ultra and Ultra Plus. Which one will I need?

Juvederm is available in two formulations to allow us to tailor treatment to your unique needs.

Juvederm Ultra is less dense, and therefore is better for light to medium depth wrinkle correction, such as mild folds around the nose and mouth, plumping and shaping lips, and forehead wrinkles. Juvederm Ultra Plus is a more robust formulation for correcting deeper folds and wrinkles.

Are Juvederm injections safe?

Yes. We are not injecting a foreign substance – hyaluronic acid is a substance that occurs naturally in your skin. Juvederm merely replaces the hyaluronic acid support system that your skin has lost through aging. In fact, Juvederm is FDA approved and is a hyaluronic acid dermal filler that has demonstrated its safety and effectiveness in patients of all skin types and colors. Juvederm dermal filler does not require a skin test to test for allergies – since hyaluronic acid occurs naturally in everyone’s skin, there is no risk of an allergic reaction to it.

How soon will I see results from my Juvederm dermal filler treatment?

Results are immediate and natural. Most patients need one treatment to achieve optimal wrinkle smoothing, and the results last up to 6 months. About one week after your Juvederm dermal filler injection, Dr. Waples will have you scheduled for a follow up to evaluate your results. At that time, any small imperfections can be fixed.

Are there any potential side effects?

Side effects of your Juvederm injections may include slight bruising, redness or swelling. Most side effects are mild and last only a few days. The most common side effects include temporary injections site reactions such as redness, pain/tenderness, swelling, lumps/bumps, and bruising. As with any injection there is a very small risk of infection.

What should be done before a Juvederm treatment?

It is recommended to arrive for your Juvederm dermal filler appointment with a clean, cleansed face without make up. Avoid taking aspirin or ibuprofen before your appointment – both can increase bleeding or bruising at the injection site.

What should I do immediately after Juvederm treatment?

Refrain from vigorous exercise until the following day. Other than that you can return to your normal activities. Do not touch or manipulate the area which was injected.

Is treatment with Juvederm painful?

Injections may cause some discomfort during and after the injection. Juvederm now comes with lidocaine (a painkiller) mixed in with the gel which reduces the discomfort soon after it is injected. Juvederm is also injected using a very fine needle to reduce injection discomfort. You may choose to numb (anesthetize) the treatment area with topical numbing cream or an anesthetic injection to reduce discomfort – especially around the lips which are very sensitive.

How long does treatment usually take?

The injection process takes only about 15 to 30 minutes. If you choose to do topical numbing or anesthetic injection we recommend allotting an additional 30 to 60 minutes for the numbing medications to take effect.

Will I be able to feel bumps under my skin?

You may be able to feel the Juvederm under your skin, and these bumps can sometimes be seen as well. However they are not permanent.

To understand why let’s take a minute to review what hyaluronic acid does. Juvederm is filler – and you can think of it like the springs inside a mattress. It is placed under the skin where the skin is sagging, and it stays there providing support until it dissolves. As with the springs inside a mattress – the thicker and harder the support system is – the firmer and stronger the mattress is. That is the up side. The downside is that the thicker and harder the springs are – the harder the mattress is and the more you can feel the springs when you lie down on it. This is also true of Juvederm. When Juvederm is placed under the skin – especially if it is placed in an area where there skin is very thin, or if it is placed very close to the surface, you will be able to feel it when you press on the area with your fingers. If it is placed well – it should feel like a smooth, rubbery “pad” under the skin – giving support to the skin that was beginning to wrinkle.

These bumps will even out over time as the Juvederm dissolves. You can also “massage” the bumps out with your fingers just after the Juvederm has been placed. Do not attempt to do this after the Juvederm has been in place for more than a few hours. When you are getting your treatment, run your fingers over your skin, and if you can feel any bumps, you can ask us to even them out for you.