There's all this hype about Evolence coming to the U.S. soon but I say what's the point in having another filler if it isn't better than what I already use... Is Evolence supposed to be better than Juvederm? Or does Evolence work in certain areas better than Juvederm? I normally get Juvederm in my lips and nasolabial folds and would really like to know how Evolence performs in those areas. Thanks!
Is Evolence Better Than Juvederm?
Doctor Answers 5
I Prefer Juvederm or Restylane to Evolence
Evolence is a porcine (Pig) derived collagen product used to provide soft tissue augmentation. Although no allergic reactions have been reported with Evolence, there have been several reports of nodule formation in the lips.
In my Raleigh, North Carolina Plastic surgery practice we do NOT use Evolence. I am more comfortable using Juvederm, Restylane, perlane or Prevelle Silk as a temporary filler and fat grafting for individuals seeking permanent results.
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Time will tell whether it lasts as long as claimed.
You know, it's always interesting to see what claims a company makes about the longevity of their injectable fillers versus what patients actually report to us. Evolence is being touted as lasting longer than previous collagens such as Zyplast and Cosmoplast (Cosmoplast is human collagen). The claims are that it lasts up to 12 months. The package insert only shows 6-month data showing that Evolence is no worse than Restylane.
Indeed, there is a recent study in the medical literature from this year suggesting that Evolence lasts up to 12 months. However, there is also a recent study from this year suggesting that NASHA gels (e.g., Restylane) lasts up to 18 months (Dermatol Surg. 2008 Jun;34 Suppl 1:S2-8;). Both studies included "re-treatment"--a second injection--as needed.
Of course, the real test will be patients' perception of the results. I'm pretty sure I've never seen a Restylane patient get 18 months (I usually tell them to expect 4-6 months from Restylane and maybe 6+ months from Juvederm).
Time will tell whether Evolence lives up to its hype. I hope it does, but I'm always a skeptic.
Evolence should not be injected into lips
Evolence is a collagen filler that has been shown in studies to last up to 12 months. It's an alternative to Juvederm, not necessarily better. It has been promoted as being a more natural filler, and if that's important to you, then you can switch. I have been cautioned by the company to not use it in the lips because it can cause nodules. However, Evolence Breeze will be able to enhance the lips when it is FDA approved in about a year. It has also been shown to have less bruising and swelling than the HA's like Juvederm and Restylane, which is one advantage. A disadvantage is that it can sometimes be felt for a couple weeks.
Steven Weiner, MD Facial Plastic Surgeon Destin, Florida
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Evolence and Juvederm quite different
Evolence is a collagen filler which has been shown to last 12 months (recent data) and is most commonly used for correction of nasolabial folds. Juvederm is a hyaluronic acid filler which has a gel consistency and can be used for correction. The differences in consistency can be appreciated in the skin after injection.
Evolence has a thicker consistency compared with Juvederm and may cause less bruising in nasolabial fold injections. Juvederm Ultra Plus is thicker than Juvederm and can be very effective for volumizing deeper nasolabial folds. I use the thinner Juvederm ultra gel in the lips and occasionally in the tear trough where finer correction is required. For nasolabial folds, I do prefer Evolence for many patients, but I would agree that it is not a product for the lips.
Jury is out on Evolence vs Juvederm
Injecting Evolence seems to give a more even flow when I have been injecting it. The company states that it provides more of a scaffolding effect. This seems logical since collagen is a support structure for the dermis with hyaluronic filling the other spaces.
One patient developed temporary erythema (redness) but this resolved after a few days. So far my patients seem happy with Evolence, but I am not sure whether they would have been just as happy with Juvederm or Restylane. I can compare it to Zyderm and Zyplast and it is softer than those substances, but that is not saying much.
The company says not to place it in the lips, so I would definitely not recommend it there. I was told the same thing. That it lasts as long as Restylane. Dr. Pearson summarized the situation with this filler very well. Time will tell regarding its longevity.
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