Juvederm

Juvederm is a non-surgical, efficient and safe option for the treatment of lines, facial folds and wrinkles. A product of Allergan, Inc., the same people who made BOTOX, it is a non-animal, injectable dermal filler composed of hyaluronic acid (HA). This acid is a substance that naturally occurs in the skin, moisturizes it, gives it volume and provides a cushioning effect. The loss of HA causes the skin to age. Juvederm rejuvenates the face through the replenishment of lost hyaluronic acid. It is the sole HA filler approved by the FDA and the effects last up one year. It is also the sole approved HA dermal filler to have proved its efficacy and safety in individuals of color.

Cosmetic surgeons use Juvederm to smoothen signs of aging in the face and lend it a natural appearance. It is commonly used to correct nasolabial folds and smile lines. However, there is a possibility that in future it could be confidently and safely used on the lips for the purpose of augmentation.

Before its entry in the US market, a clinical assessment was done in the US that compared Juvederm to Zyplast, a bovine collagen. 146 subjects had one nasolabial fold of theirs injected with Juvederm and the other injected with Zyplast, and were then followed for a period of 24 weeks. Almost 90% of the subjects agreed that the fold treated with Juvederm looked better than that treated with Zyplast.

The hyaluronic acid found in Juvederm is a very purified form of the hyaluronic acid got from bacterial fermentation. The concentration of cross-linked HA found in Juvederm is more than that seen in any dermal filler presently on the market. The high degree of cross-linking is achieved through the use of Hylacross technology, and results in a smooth consistency, long-lasting gel. This is unlike natural hyaluronic acid which is liquid in nature and quickly metabolized. The smooth flowing nature of the gel would additionally give the administering plastic surgeon good control, enabling him/her to deliver customized facial contouring. It would also possibly reduce the discomfort that may accompany the injection procedure.

Juvederm gel is colorless and biodegradable. A synergistic and more lasting effect could be achieved by a combination of Juvederm and BOTOX. While BOTOX would paralyze the muscle that causes the wrinkle, Juvederm would fill in any etched line that remains.

There are two formulations of Juvederm: Juvederm Ultra and Juvederm Ultra Plus. Outside the US, these are known as Juvederm 24 HV and Juvederm 30 HV respectively. Juvederm Ultra, introduced into the skin with a 30G needle, offers versatility for increasing the volume of folds and wrinkles in the face, and contouring them. Juvederm Ultra Plus is a robust preparation for the rectification of facial wrinkles and folds of greater depth. A 27G needle is used to administer Juvederm Ultra Plus to patients.

The Juvederm treatment is a very simple procedure. Prior to starting it, the area to be treated is numbed using a numbing cream. The procedure involves administering Juvederm at specific points beneath the skin by way of a series of small injections. This would take approximately 15 minutes.

Post-procedure redness, swelling, bruising and sensitivity is possible but would subside in three days. Another probable but more severe side effect is the formation of facial granulomas caused by reactions of the immune system.

For some hours after the procedure, one must avoid undue facial expression. If there is pain, it would be temporary. Heavy exercise, consumption of alcoholic drinks, and extensive exposure to the heat or sun should be avoided for the initial 24 hours. One can apply makeup on the day subsequent to the injection.

At our state-of-the-art facility, Dr. Christopher T.Chia, a board-certified and thoroughly experienced plastic surgeon performs all Juvederm treatments.

The correction achieved through a Juvederm treatment usually lasts anywhere from six months to a year. The implication is that repeat and touch-up injections may need to be done to keep up the results. Fortunately, repeat injections usually require only half the quantity of injectable material used the first time.

It is important to know a patient’s medical history before proceeding with a Juvederm treatment as certain people should not have this procedure done. The safety of Juvederm for use in patients who are aged below 18, expectant or breastfeeding, or with a history of pigmentation disorders or a lot of scarring, has yet to be established. The treatment is not recommended for those with a history of anaphylaxis and those who are allergic to gram positive bacterial proteins, trace amounts of which are there in Juvederm. The patient should inform the surgeon if he/she is on ibuprofen, aspirin or any such medication as these can cause more bleeding or bruising at the injected area. Any intention to do chemical peeling, laser treatment and similar procedures after the Juvederm treatment should also be discussed with the surgeon beforehand.
The risk of infection would be greater than normal if Juvederm is done on patients undergoing therapy for immunosuppression.

Juvederm shows great promise in restoring youthful characteristics to facial skin. The initial consultation would help to determine whether Juvederm or an alternative treatment would be more suitable for you.