Juvederm is there, but you need more!

Juvederm is comprised of hyaluronic acid (HA) which is naturally occuring chemical found in human skin.  In fact, HA is a sugar molecule.  It's physical correction of wrinkles is due to  HA soaking up water like a sponge and the molcule becoming larger.  It needs to be injected into the skin, typically into the deeper layers. Immediately after injection, there is some swelling and even minor bruising which can make the area treated appear more full.  This usually dissipates in one-two weeks. This effect may amplify the feeling of under correction after the swelling is gone.

Your response of not seeing or apprciating the product in the areas treated is  probably due to the Juvederm not injected in the proper level of skin and/or not enough product was used.  More commonly, it's due to the later problem.  Oftentimes, because of cost, not enough syringes were used.  In general for patients 40 years or older, it takes on the average at least two to three syringes to treat a bilateral anatomic area . With the number of anatomic areas that were treated, you probably need more Juvederm.

I hope this helps!

Stephen A. Goldstien, MD, FACS

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I would agree with Dr. Weiner in that you had a number of areas treated and so effective treatment would realistically require at least 3-4 syringes.  Undertreatment is one of the main causes of suboptimal outcome; simply put, if you don't use product and spread it out too much, you're not going to see very much difference and are really wasting your money.  I would talk to your dermatologist and express your concerns.