Ask a doctor

Juvederm or Other Filler for Parentheses Around Mouth?

I am going to get Juvederm injected in the "parenthesss" around my mouth. My dermatologist recommended it specifically, but after reading the above questions and answers I am worried that I might be choosing the wrong filler.

Do you have any thoughts? It is my first injection, so I don't know how I will do with it. I just want to get the most bang for my buck, Thanks!

Doctor Answers 11

Juvederm filler for "parentheses"

For this area of the face, several fillers work very well including Perlane, Juvederm Ultra Plus and Radiesse. You need to know that there are two forms of Juvederm - Ultra and Ultra Plus. Ultra Plus is thicker and I think a better choice for the parentheses. You can expect to have a few days of swelling/redness and/or bruising so I recommend a cover-up makeup as needed. You should be reassurred that lumpiness can be massaged out and if you hate the results (after the injected areas have settled down, usually 7-10 days), the product can be dissolved with hyaluronidase.

Good luck.


San Diego Dermatologist
5.0 out of 5 stars 5 reviews

Juvederm for Nasolabial folds, (the Parenthesis)

There are many good choices for this area.  Juvederm, Restylane, Radiesse, Autologous Fat, all have their place.  For a first time injection, Juvederm is a good choice.  Be sure and research your injector.  What is their experience?  How long have they been doing this?  How many have they done?  What happens if there is the (rare) problem.  Best to see a few injectors and then decide.

Jeffrey Roth, MD
Las Vegas Plastic Surgeon
4.5 out of 5 stars 11 reviews

There's a first time for everything

Dear First Time,

For your first time Juvederm is a good choice for your parentheses. The results will last from 6-9 months. At this time in your young rejuvenation journey a short duration for the product is probably preferable just in case you don't like the results. You can graduate to other products or procedures as you and your physician progress. Good luck!

Choose the doctor well, don't focus on the filler

Juvaderm is an excellent choice for nasolabial groove treatment (parentheses). Other Hyaluronic Acid fillers are also good alternatives. But, your most important decision is not the choice of material.

Your most important choice is an experienced physician to discuss your goals, carefully assess your face, suggest treatment alternatives (that might include something other than filler), and perform the filler treatment well.

You aren't simply buying a syringe of HA filler. You are buying the experience of a professional. As you can tell from other posts, many doctors emphasize the same point.

My analogy is "the witch or wizard is more important than the wand. Are they a good witch or a bad witch?"

Sutton Graham II, MD
Greenville Plastic Surgeon
4.5 out of 5 stars 4 reviews

Jueverm Injections for the "Parenthesis" Around the Mouth

Hi First Time Filler,

Juvederm is an excellent filler for the areas of your concern.  More important than the filler is the physician you choose to place the filler.  Choose your injector carefully.

Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
5.0 out of 5 stars 28 reviews

Fine choice

These rhytids respond well to any of the hyaluronic fillers such as Restylane, Perlane or Juvederm or the collagen filler Evolence.  Other fillers such as Radiesse or Sculptra are more meant for deeper tissues.

So go ahead and enjoy.

Juvederm is my top choice for nasolabial folds

Juvederm is my preferred option for the "parentheses" around the mouth. Your doctor is correct! It is a hyaluronic acid, which is already in your body and not considered a "foreign substance." It has better flow characteristics than Restylane or Perlane (other hyaluronic acids). Juvederm tends to last 6-9 months on average.

Radiesse is another option. It is made out of calcium hydroxyapatite, a substance found in your bones. It can last longer than Juvederm: 10-14 months in my experience. If your folds are very deep then Radiesse can be a good option, but I still prefer Juvederm. Good luck!

Sirish Maddali, MD
Portland Plastic Surgeon

Juvederm for lines around mouth

 Juvederm or any of the hyaluronic acids are great fillers for the peri-oral lines.  They should be done by an experienced injector to get a great result.

Steven Wallach, MD
New York Plastic Surgeon
4.5 out of 5 stars 20 reviews

Plenty of good options including Juvederm

Juvederm is an excellent choice for this area. It should last at least 6-9 months, and if you have it "topped off" before it is all gone then you get a very long lasting correction. Another good choice is Evolence, a collagen product that lasts up to a year, and has very little swelling after injection. Restylane and Radiesse also work well there.

Richard Baxter, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 33 reviews

Juvederm is my first choice in this area

My short answer is that I think you're making a great choice with Juvederm in this area. The options include Juvederm Ultra, Juvederm Ultra Plus, Restylane, Perlane, Collagen, Radiesse, and your own fat, among others. The reasons why I don't like the others as my first choice in this area are:

Fat: obviously safe (it's your own fat), and what is left after about 6 months is permanent (around 50% of the injected fat is absorbed by 6 months). But you usually need some type of anesthetic, in the OR, to do it well, so there is more cost; swells more than the off-the-shelf products, so there is more downtime.

Radiesse: Great product for very, very deep parenthesis (nasolabial folds) but in my judgement better for areas that need volume, like cheeks or hands. More expensive that Juvederm, but still a nice product if injected properly by an experienced injector.

Collagen: becoming less and less utilized-- usually need a skin test and the results are usually no better than Juvederm, which does not require a skin reaction test/

Restylane: this is the big competitor, and I think many folks would use Restylane as their first choice which is perfectly acceptable and they can get very nice results with it. The reason I prefer Juvederm Ultra to Restylane is that Juvederm Ultra has more cross-linking (means it will typically last longer, at least in my experience), is softer in consistency while Restylane is a bit more granular, and Juvederm Ultra I find is a bit more hydrophilic (attract more water) which means it can plump up the areas that you inject it in a bit more.

Perlane: made by the same company as Restylane, just a thicker product

Juvederm Ultra and Juvederm Ultra Plus are the same thing except Ultra Plus is a bit thicker, thought to last longer.

I hope that helps, Good luck!

Dr. Salemy

Shahram Salemy, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 119 reviews

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.