Juvederm Ultra and Juvederm Ultra Plus

Michael Elam, MD
Article by
Orange County Facial Plastic Surgeon

The following information has been prepared to familiarize you with the procedure known as Dermal Filling. You should read this information thoroughly and to discuss any questions, which might arise with your surgeon before you proceed with the procedure. 



With time, exposure to the sun and other elements the skin components begin to break down. When the skin loses structure and volume unwelcome lines and wrinkles appear. Healthcare professionals can correct these wrinkles and facial folds, with dermal fillers, helping to reverse the signs of aging.

The appearance of wrinkles and facial folds can be smoothed by adding volume with various forms of injectables or dermal fillers. Dr. Elam prefers to use hyaluronic-based injectables such as Juvederm.

Hyaluronic acid is a natural complex sugar found in all living cells, and one of the major components of the dermis connective tissue matrix, along with collagen and elastin. Hyaluronic acid retains water like a sponge, absorbing more then one thousand times its weight. This helps to attract and maintain water, hydrating your skin and increasing your volume and density.

Fillers used to be used mainly for the nasolabial lines, fine lines and lips. However, in recent years more advances have been made with fillers for around the lower eye, cheek area and the tear trough. As the mid face falls with facial aging a “hollow” often develops over the inferior orbital rim bone. Adding fillers deeply into the periosteum of the maxillary bone allows elevation of the cheek. Additional improvements of the tear trough may be achieved by injecting beneath the fat pads. This provides camouflaging the shadowing that occurs in the groove below they eyelid fat.

Depending on each patient’s particular desires and needs the choice of fillers is then recommended. Juvederm comes in two forms Juvederm Ultra and Juvederm Ultra plus. Juvederm Ultra gel is optimally formulated for versatility in contouring and volumizing wrinkles and folds while Juvederm Ultra Plus is a more robust formula for deeper wrinkles and folds.

This procedure can be done on a lunch break and requires no anesthesia and minimal recovery time. Dr. Elam is a Platinum partner injector, which is designated by Allergan Corporation based on the volume of Juvederm you inject.