I have had Juvederm injected in my horizontal forehead lines by a plastic surgeon in Dec. They said they used a half of the syringe and I could come back in 6 months for another set of injections with the remaining product in the syringe. I read on your forum this should not be done. Is this standard? In addition, I felt that the injection sites were too few and lumpy. Any suggestions or comments. Thank you
Reuse Juvederm Syringe for Future Injections?
Doctor Answers (33)
Discard Old Filler Syringes
It is not suggested that half used syringes of any filler product be reused at a later date. Many physicians who attempt to save money for their patients, will label and save half-used syringes for use at a future appointment.
It is not recommended that this be done for a variety of reasons, but primarily you don't want the remaining product in the syringe to become dried out or contaminated. The syringes come sterile in the original packages, and once the product has been opened, you cannot guarantee sterility.
Also, it is possible that labels could get mixed up when a large number of syringes are stored.
The manufacturers of these products warn against this practice. Naturally, this means that it could cost you slightly more, but better to be safe than sorry.
I disagree with "you can always find another area to use extra filler".
Aside from the question of whether it is safe to reuse a syringe within a specified time period, I really disagree with several of the physicians here who say there is no reason to have any left over, because "you can always find other areas to put it." In my opinion, this kind of thinking leads to people ending up over time looking like a distorted version of themselves, and not just like a younger, more rested version. If you have had the right amount for you, and you don't want to risk saving it..... toss it and lose the money, I say. Get a smart, conservative board-certified dermatologist or plastic surgeon, and make this decision together.
Juvederm- saving the syringe for future use?
Typically an experienced injector can estimate how much filler you will need for any given area before beginning the procedure. If you know you only need half of a syringe to start, you can just buy a smaller volume to begin with. Then if you need more you can come back and buy more. The product is sterile until it is opened. One it is opened and used, it is no longer technically sterile. I personally would not save a syringe for 6 months. I do think it is reasonable to keep the product around for a couple weeks if you have some left over and may do a touch-up on the followup visit. If that is done, to avoid potential contamination, I recommend removing the needle used, recapping the syringe, and using a new needle on the second injection. It is also important to keep that syringe clearly marked with the patient name. Regarding the lumpy and irregular appearance, that is related to your injector's judegement and technique. First, the treatment needs to be appropriate to solve the problem. For example, Botox is typically used to soften horizontal forehead lines. Really deep lines may not be fully corrected and may be addressed with filler. If filler is chosen, it much be injected with proper technique to be successful, and avoid irregularities like those you describe. The bottom line is choose your injector carefully!
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Juvederm, like other prefilled syringes should be used once opened.
The risk of incubating an infection in the syringe over those months is far greater than the slight potentiial financial savings
First and most important question, should someone be using Juvederm in the forehead. I think that this is generally a poor choice. While there may be some exceptions, there are better products to use in the forehead such as Botox and even surgery (brow lift). As you now know, with a few exceptions, Juvederm is not good in the forehead. Usually storing Juvederm is not even an issue because it's easy to find places the product will make a difference and you can easily use the full syringe. When doing just a small little touch up, I have stored the product in a refrigerator for up to 6 months. I know this is in contradiction to what the company recommends and most of the authors on realself answering this question. However, I have done this at least 20 times and never had problems. I think the patient should be allowed to make thier own decision on this, but have the option to keep it for 6 months.
Storing open product is not safe
We do not store any open Juvederm. There is a risk of contamination and infection, even if you keep the product in the fridge. Actually there is always some place else where one can inject the not used product: nasolabial, cheeks, ....
There are some physicians that save the remnants and give patients 6 months or even a year later the remainder of the juvederm. These are the risks of doing do:
When Juvederm or any filler is administered into your skin it is injected. Once you open the juvederm and use it there is a good chance that bacteria may enter the juvederm syringe. The small amount of bacteria from your skin or needle tip usually don't cause a problem right after the juvederm syringe is opened and used. However, when it is left in a refrigerator or closet, the bacteria have the ability to multiply tremendously. If you then take that syringe and reinject it into the skin several months later, there can be thousands or even millions of bacteria that are potentially injected under the skin. Bacteria love foreign substances to hide and reproduce in. So not only are they injected under the skin, they have a great scaffolding (the juvederm) to grow and multiply in the skin. The result - massively bad skin or soft tissue infection. I would not risk this with a family member so I do not do this with any patient.
Poor practice to reuse syringe
Because Juvederm (as is true with all cosmetic dermal fillers) is a sterile product, it is very poor practice to store unused product for future use six months later. Not only is this discouraged by the manufacturer, it is generally considered unnacceptable to ever store product even for a short time. Doing so for up to 2 weeks is understandable for specific situations; however, this should be far and few in between.
In an effort to avoid wasting a very expensive product, most patients will always benefit from using the remaining amount somewhere else. Also, when very little product is needed or wanted, reaching for a 1/2 syringe of Restylane (Medicis) will avoid unused amounts.
With regards to the lumps in the forehead - this is generally related to poor technique during and after the treatment. Permanent lines/wrinkles that cannot be resolved with Botox often respond well to fillers. We suggest you contact your physician to discuss resolving the lumps of product with hyaluronidase.
Reusing Juvederm or Restylane Syringes can be safe
Unlike many of the other opinions here I feel it is very safe to save a partial syringe as long as it is done carefuly, FOR THE SAME PATIENT and for a limited time. A recent study showed complete safety with no bacterial contamination when partially used syringes of hyaluronic acid (Juvederm, Restylane) were capped off and saved for up to three months.
As long as the contents of the syringe are kept sterile and only used on the same patient, I see no reason not to give patients the benefit of using the remainder of a syringe that they could not finish on their previous visit.
The manufacturers, such as Allergan, do not recommend saving partially used syringes but they also make many other recommendations for FDA approval purposes that physicians do not have to follow, such as diluting Botox with a type of saline that stings more and so most of us do not use it.
If your injector reuses your Juvederm syringe, ask how they prevent contamination
Some injectors may elect to do this. This approach must be used with caution, as there is the potential risk for contamination and ultimately, infection.
If you and your injector elect to do so, you may want to ask them about this and the methods they use to help prevent such a problem.
Additionally, there is a "shelf life" to all injectables.
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.