Hi Have juvederm. The doctor said to come back for a top up in 7 months. I had 6 syringes,,,cheeks, NL folds, marionette lines etc. Cost was $3087. In 5 weeks it was gone,,totally. The doctor offered to give me two more syringes at cost. $600 for me, $600 out of their pocket. I just asked for either a $600 refund or put it towards botox. The doctor would do neither. What would you do to help your patient in this situation. What was the point of getting more Juvederm? Thank you Terrie
How Would You Handle This Situation? Juvederm Only Lasted 5 Weeks, Doc Is Charging More For Top Up?
Doctor Answers (7)
Juvederm for volume filler
I can't see why you would need so much Juvederm. I use Radiesse and the most I have used in one setting is two syringes. I bring the patients back in 3-6 months to see if they require more volume. I also limit the use of Juvederm to the lips, not the other places as you mentioned. Price break or no price break, I would seek a different option for your needs - like a different product (Radiesse, Restylane) or autologous fat transfer.
Juvederm lasted 5 weeks.
Juvederm is not my first choice for facial shaping with fillers as it's a bit too thin. I prefer using Perlane which can shape each cheek with 1 to 1.5cc's each and fill out the NLF's to a greater extent.
Second Opinion on Filler Touch Ups
My first suggestion would be for you to schedule a time with the physician to look at your before and current after photos. It is nice to see a side by side comparison of the changes or lack of changes. Also find out whether you recieved Juvederm Ultra or Juvederm Ultra plus and the amounts used in each location. Using 6 syringes is not all that unusual but the fact that you don't see any results is a bit strange. My immediate thought without seeing you or your chart is that it may have been spread to thin. Meaning you really needed more in the cheeks, jowls and NL creases or a hardier filler (Radiesse/ Artifill) thus making your results hardly noticeable.
If after reviewing your pictures and you confirm that there were no discernable changes then I would not recommend using the same type of filler. Change to one that has the capability of lasting longer and stimulating some collagen response or worse case scenario have the hard discussion of whether you were really a surgical candidate and the results that you desire can not be obtained with filler. Although we can do wonderful things with fillers, sometimes it is not the best approach. Seek out a second opionion from a plastic surgeon and take a copy of your chart so that they can compare knowing what has been done previously.
Good luck and I hope you find a good resolution to your situation.
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Top up of fillers
This is tough. First I simply cannot imagine a case where six syringes of any filler would be used and you'd literally have none after 5 weeks. While there should be some initial swelling which will go down, that much Juvederm simply just cannot be gone from the entire face in that amount of time. That part is really just hard to imagine on its own. If you had six syringes and literally have nothing left, then I would have a difficult time encouraging you (or any patient) to get more of the same filler, whether a price break was offered or not. I can't comment on what the doctor is offering and really what the philosophy of doing more of the same filler is... while I understand the issue of not wanting to "refund", and I appreciate the price break portion, I'd be more likely as an injector to give you a price break on a different type of filler than the same one.
Juvederm gone in 6 weeks?
I would strongly encourage a review of your before pictures to get a sense of the changes to your face after 6 syringes of Juvederm were placed. Juvederm is a great product but not my favorite choice for most areas of the face. It is my choice for lips and anywhere you want to softly fill an area, but it is too fluid to do deep filling and volume restoration. There are better products for facial rejuvenation. That is why I tell patients that a properly volumized and restored face often needs 4 or more different kinds of fillers and collagen stimulator to give optimal results. Every filler and volumizer has its place on the face. No one can do it all.
Juvederm and treatment
Our office policy is that if you need more filler, then you pay for it. The filler does not go away in five weeks but swelling does, and that is why sometimes patients feel the filler disappeared. Good luck.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.