Please could you explain how Juvederm (and fillers in general) work - is it by: A)The filler substance that's injected into the area 'pushing' out against the skin thereby making it look tighter, OR B)The chemicals in the Juvederm (the HA) actually reconditioning inner skin layers to make skin more elastic (and therefore youthful)? C)Or another way? The question I’m trying to get to is how ‘naturally’ does Juvederm work from within - and whether the results ultimately look natural?
How Does Juvederm (And Other Fillers) Work?
Doctor Answers (9)
Natural results will dermal fillers depend on technique of injector
You are correct in both of your first two statements. There are injectables that claim to actually stimulate your own collagen several months after a series of treatments, but those are gradual improvements. Otherwise there is Juvederm, one of the most natural looking fillers that gives you instant results by filling in lines and hollow areas and plumping the skin to it's original state. Although the product is great, the "natural look" comes from the technique and experience of the doctor so look for someone you can trust and who has an excellent reputation.
How does Juvederm and other fillers work
Juvederm Prevelle and Restylane consist of Hyaluronic acid, which is the ground substance in which are situated Collagen and Elastin fibers as well as the cells (fibrocytes) that produce all of the above.
The injected hyaluronic acid is chemically and physically cross linked to avoid rapid degradation.
By injecting hyaluronic acid, your skin can regain thickness and substance. Also, once injected, the hyaluronic acid absorbs water from its environment and add to the above effects.
Sculptra is a polymerised natural substance (Polylactic acid) which when injected, gradually stimulates collagen production by your fibrocytes.
Radiesse is a calcium salt that provides immediate gain of thickness and substance and also stimulates collagen production .
About 2 years ago, research done at University of Michigan, showed that all the above fillers can stimulate collagen production simply by virtue of stretching the collagen fibers.
How do fillers like Juvederm work?
Fillers like Juvederm Restylane, Perlane and Radiesse are volume fillers that incrase the tissue layers that they are injected into. Restylane and Juvederm are meant to be injected within the dermal layers, of the skin to fill in fine lines, wrinkles, folds and the borders of the lips. Thicker fillers like Perlane and Radiesse are meant to be placed within fat tissue layers and folds for shaping and filling in folds. The effects last only as long as the injected material. Once the body dissolves, the filler, the volume is lost.
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How does Juvederm work?
Juvederm (and Restylane) are made of hyaluronic acid, a natural component of the skin that progressively decreases with age. Hyaluronic acid is the fluid matrix that provides stabilization to the intercellular spaces that contain collagen and elastic fibers. Hyaluronic acid has the capacity to bind large quantities of water and keeps the skin firm and moisturized. The results, when Juvederm is expertly injected, should always look natural. However, your results will always depend upon the skill and experience of your physician injector.
Fillers work in different ways
Most of the fillers have the immediate result of filling space with immediate correction of volume loss and filling of lines. and adding volume. This happens by filling up space with a product like putting the jelly in the jelly donut. The collagen formation that occurs as these disappear is probably somewhat variable. Sculptra works a bit differently by filling over time with repeated treatments to build the final effect which should then stimulate a good amount of collagen formation. This is just my personal experience.
Juvederm and other filers
All fillers work by restoring volume to the face. Some are injected more superficially than others to fill fine lines, and some are injected more deeply to add volume to true hollows and depressions. Fillers such as Radiesse and Sculptra provide a scaffolding on which we hope that your body will respond by laying down new collagen for a more long lasting result. The Hyaluronic Acid fillers such as Juvederm and Restylane may also promote collagen formation especially in some scars. Not all fillers achieve the same result for every patient!
Juvederm works for facial wrinkles
Juvederm is an injectable hyaluronic acid which fills wrinkles and restores volume. It is a clear and colorless gel that is injected directly into wrinkles to fill loss of tissue and hide stretching and tissue descent due to age and gravity. It is then slowly broken down by the body and causes a scar reaction that may lead to collagen formation. I have seen it last up to a year. Many people will need repeat injections as the product slowly is degradated.
Leo Lapuerta jr. MD
Dermal fillers and how they work
Dermal fillers are used to restore volume to the skin as well as decrease the appearance of fine lines, wrinkles and depressions. The most common area to fill are the Nasolabial creases that extend from the corner of the nose down to the corner of the lips. Typically there is a depression that forms next to the nose and then as it gets closer to the lips it turns into a crease. So more product is injected next to the nose to lift the depression and then small amounts, in thread form, are injected into the remaining crease. Restylane, Perlane and Juvederm are hyaluronic based fillers and tend to have a softer more natural appearance. Ultimately it is the skill of the injector that truly is in control of whether your outcome looks natural or overdone.
Radiesse is a calcium based filler that I like to use primarily in the cheeks and along the jawline to add structure and restore volume. It tends to feel a little more rigid initially but then softens to conform to the bony structures. Due to the initial rigidity I do not feel that it is ideal for around the mouth as it can alter the smile for that 3 month period of time.
When looking for a good injector, ask to look at before and after pictures. If the pictures that they display look overdone and not so natural, it is a red flag that their vision of "natural" is different from yours.
How Does Juvederm (And Other Fillers) Work?
The hyaluronic acid fillers (Juvederm, Restylane etc) work by being directly injected into the deep dermal layer of skin in areas of folds, shadowing and areas lacking volume. This acts to immediately plump the skin, fill lines and folds, and camoflauge assymetries. They create a scaffolding that is hydrophilic which promotes your own skin to fill the scaffolding with water and eventually stimulate your own collagen and elastin production to acheive a natural improvement and enhancement that is of your own tissue. With repetitive treatments in certain areas long term improvement can be seen.
In my opinion, Juvederm acheives a more natural result as the product has more cross-linked product which is what you are paying for. The uncross-linked properties are what makes it have a gel like consistency and let's us, as physicians, physically inject the material. Restylane has more of this material and less true product so you have to overcorrect and guess a bit as to the ultimate effect. Juvederm is more predictable in my hands and acheives a better, more natural result without lumps or bumps ever being an issue.
In general fillers are wonderful for patients and is a very exciting option to have available for natural enhancements.
Hope this helps!
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.