Fast facts

Juvederm


What it is: A dermal filler (cosmetic injection) FDA approved for the correction of moderate to severe facial wrinkles and folds. Juvederm is a hyaluronic acid gel and is available in various formulations, including Juvederm Ultra and Juvederm Ultra Plus.

Juvederm injections are absorbed by the body over time but results may last up to one year.  Juvederm products are manufactured by Allergan, the same pharmaceutical company behind Botox Cosmetic.


What it addresses:

- Thin lips
- Hollow cheeks and under-eyes
- Facial wrinkles and folds
- Some nose irregularities
- Acne scars and skin depressions


MORE INFORMATION

Question

Juvederm gone in a week?

I had Juvederm injected in the periorbital lines, nasolabial, chin, upper and lower lips. It has been a week and the swelling is gone and so is the Juvederm. Except for some (uneven) fullness in the upper lips, everyone I know said they don't see any difference. Neither do I. What happened? I went to a very well known dermatologist who is supposd to have a lot of experience.


Asked by: berykute1
Encino,Ca

Answers (6)

Sort by: Most recent | Most helpful
1
November 18, 2008

Juvederm is there, but you need more!

Stephen A. Goldstein, MD
Stephen A. Goldstein, MD
Board Certified
Plastic Surgeon

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

 

2
November 1, 2008

It's not gone, but it may be too deep, or just not enough

It is highly unlikely that the Juvederm is gone, but there are a few possible explanations. If your doctor injected the Juvederm, especially the Juvederm Ultra too deeply, then the Juvederm may have flattened under the pressure of the overlying skin. That is why Juvederm needs to be injected at the correct level. Juvederm Ultra Plus is thicker and tends to hold up better even when it is injected fairly deeply.

Another possibility is that you just need more Juvederm. If you had very deep folds, then it may take a lot of tubes to get the desired correction. Patients frequently ask that we treat the areas they want treated within their budget...but that is not always possible. If the doctor was "trying to be nice", he may have spread too little Juvederm over too many areas leaving you with an inadequate correction in all the areas.

The other possibility, which I think is the most common, you may indeed have a significant correction, but you can't see it without before and after pictures. If the doc took before pictures, you might want to ask him to take some after pictures and show them to you side by side.

Michael Sinclair, MD
www.epilution.com

3
October 23, 2008

Juvederm probably isn't gone, but you may need more

Felix Kuo, MD
Felix Kuo, MD
Board Certified
Dermatologist
Answer by Felix Kuo, MD

Initially after Juvederm, all the treated areas will appear more full because of the associated swelling.  This product attracts a lot of water in the skin.  After about 1 week, most of that swelling is gone, and it may appear as though there is no product left. It is very soft so you may not feel it either.  Probably, it is is not gone but you need more.  

One factor in how long Juvederm lasts is the layer of the skin where it was injected.  Placing the filler in the dermis / dermal-subcutaneous junction will result in a longer lasting result than if majority of it was placed in the subcutaneous fat.  Only a very experienced physician would be able to recognize this difference. 

Another factor of longevity is where in the face it was injected.  For example, If placed in an area where there is not a lot of movement like the infraorbital hollows, the product will last longer than in the lips where there is more movement.

4
September 22, 2008

It's an art..........

I would think that much filler would be evident at only one week out.  One possibility is that the fillers were placed perhaps too deeply, and they will fail to achieve correction, and thus you see nothing.  Another possibility is that there really IS a correction, but without looking at before and after pictures side by side, it can be impossibile to appreciate changes.  Your friends' opinions of whether or not you look corrected are not reliable.  My advice would be to go back and have a sit down discussion with your doctor about what you think of your treatment.  When everyone calmly sits down to really figure out what went on, things can work out fine all the way around. 

5
September 20, 2008

Juvederm probably not gone, but correction is hard to see

Steven Weiner, MD
Steven Weiner, MD
Board Certified
Facial Plastic Surgeon

You're probably saying, if I can't see it, then it really doesn't matter if it is there or not.  My first question is how many syringes were used.  You mention a lot of areas to correct.  I would use at least 3 or 4 syringes for this.  Any less than this, you will be spreading the filler out too thinly.  If someone comes to me and says I want all those areas and can only afford 1 or 2 syringes, I typically will ask which area is most important and fully correct it.  The filler is probably not gone, but the changes are so minimal that they are hard to see.

There are people who rapidly metabolize HA.  Usually this doesn't occur in a week though.  For those people, Radiesse is a good solution, except for the lips.

One other point, I prefer Restylane around the eyes because to me, Juvederm spreads more and the corrections are often less noticeable. 

Steve Weiner, MD  Facial Plastic Surgeon, Destin, Florida.

6
September 20, 2008

Juvederm gone in a week?

Gregory A. Buford, MD
Gregory A. Buford, MD
Board Certified
Plastic Surgeon

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. 

Comments (3)
berykute1
berykute1
9/22/08

He used 3 1/2 syringes of juvederm ultra! I have pictures posted under the comment "not happy with Juvederm" I do see the lumps in the area between my eyebrows.

Gemma
Gemma
9/29/08

I have had similar results with the same product and had one full vial in my bottom lip. For me, it stabilized and looked great approximately between weeks 2-7 and then suddenly seemed to deflate. I still have some surface bruising spots as well (ten weeks later) and I can feel it in my lips when I 'bite' them but I don't see the results as well as I did three weeks ago. At what point should it stabilize and now that you know both of us have had the recommended amount injected, can someone please address this issue again? I too had a reputable doctor. And what other alternatives are there for the lips if Juvie Plus does not work for us?

berykute1
berykute1
10/29/08

A month has gone by and all I have is large puffy lumps under my eyes that were injected and doc will not answer my calls!

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