What should I ask my doctor before getting a Restylane or Juvederm injection? I don't want to look lumpy or unnatural. It's for naso-labial folds and my eye area.
Restylane vs Juvederm
Doctor Answers (36)
Top 6 Are Questions to ask about Facial Fillers: Juvederm and Restylane
Facial fillers are one of the most common non-invasive treatments around the world. In the United States, Juvederm and Restylane have become the two most popular hyaluronic acid type fillers. Important questions to ask your physician:
How much experience have you had with facial fillers in the lips, tear trough area, or nasolabial folds?
Have you experienced any complications with fillers in the lips, tear trough area, or nasolabial folds?
How would you treat the complications (nodules, bumps, overcorrection, undercorrection) if I developed any?
Can you show me before and after pictures of the fillers?
What options do I have for anesthetic before the procedure?
Can you go over my post-procedural instructions before treatment?
Experience with either Restylane or Juvederm is essential
Juvederm and Restylane are very similar products, both of which are hyaluronic acid-based fillers. Both are manufactured in Europe. The manufacturing process is slightly different between the two products. I find that Juvederm goes in a little smoother and has a silkier texture as compared to Restylane.
The critical factor when injecting these products is having someone, preferably a board certified Plastic Surgeon or Dermatologist do the procedure. I find that that injecting the lower eyelid area the most difficult - conservative injection is critical. If one is over-zealous with this area excessive puffiness may result. It is important also that your physician has a sense of aesthetics, and that you do not get an unnatural "weird" look. The physician should also feel comfortable treating the potential risks of the procedure such as lumpiness or excessive augmentation
The choice you make will depend on how you look for the next 6 months
Does your doctor perform the injections himself? Is he even interested in performing the injections? Many otherwise fine surgeons view fillers as a nuisance, or delegate this task for business reasons.
Others are cavalier and will inject anything new, whether it is legal in this country or not, whether or not it has been proven safe (and no, that doesn't just mean FDA approval, as the many reports of granuloma formation for FDA approved substances shows).
Where and how fillers are injected will directly impact how you look the next 6 months of your life. And if you are receiving ill advised injections such as silicone, for the rest of your life.
Once you have screened for credentials (i.e. board certification), you should have confidence that your doctor has your best interest in mind. You should feel confident that he has a plan based on carefully listening to your needs. You should feel confident that he is safe. You should feel confident that he is aware of the risks and benefits of fillers, not only by themselves but as a plan for your overall rejuvenation over time.
Many patients have expressed dissatisfaction with their fillers in the blogs. When you look more carefully, there are 60+ women who would benefit from skillful plastic surgery but instead have placed all their hopes in a few syringes of Restylane, an unrealistic and ill-informed plan destines to produce dissatisfaction when the results don't deliver. Apparently nobody ever told them that their skin was sagging and that is why the $2000 they just spent for Restylane did not fix their problem.
Your doctor should discuss all the options with you, not just pump fillers.
If you don't get a definite yes on all these counts, you should move on. It's that important.
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Juvederm for the Lips or Tear Troughs, Everywhere Else it Doesn't Really Matter
If cost is a consideration (and both cost about the same per syringe), I often recommend Restylane. The reason is that Juvederm has 0.8cc in a syringe, while Restylane has 1.2cc in a syringe. Therefore, you have more material to use with one syringe of Restylane, enabling more folds and wrinkles to be improved. Unfortunately, Juvederm doesn't come in any other size, while Restylane also has a 0.4cc syringe (which is cheaper because it is 1/3 the amount of a 1.2cc syringe).
Similary, if a person needs more than one syringe of product for correction, it takes 3 syringes of Juvederm (2.4cc) to equal the amount of product in 2 syringes of Restylane (total 2.4cc). This means you have to spend money to purchase an extra syringe of Juvederm.
I think the decision of which to use between these two fillers should be a mutual one between you and your treating physician. Treatment goals, area to be treated, cost, and amount of product required are all key factors.
Juvederm vs. Restylane
There is very little difference between the two products as far as longevity is concerned — clinical studies led to the labeling with the products. Restylane was the first to market and did a six month clinical trial – it worked and it became the label. With the right injector, Restylane lasts longer than six months. They next did a trial where they did two injections at 4 month intervals and showed that they could get results up to 18 months – so not bad. Juvederm's clinical trial was 9 months – extended out to one year. It worked. The most important thing is to find a skilled injector who knows the subtle differences in flow characteristics of the products and is comfortable with each of them.
Juvederm or Restylane for Lip Augmentation
The answer is to first choose the right doctor, then be sure your doctor is using the right material. I use Hyaluronic acid products, including Juvederm Ultra, Juvederm Ultra Plus, Restylane, Perlane and Prevelle. For permamnet lip augmentation I use autologous fat injections.
In my plastic surgery practice, patients seeking natural looking lip enhancement should ask the following questions:
- How much experience does the surgeon have with soft tissue augmentation by injection?
- Does the surgeon numb the area prior to injecting the lip? It is easier to get a perfect result if the patient is comfortable.
- Have other options been discussed? Fat grafting is a permanent method of filling lines and enhancing lips. Individuals requiring more than one syringe of Restylane for the result they desire may want to explore fat grafting, a safe and permanent alternative to Restylane.
- Does the physician have patient photos to share with you and patients to speak to about their experience with lip augmentation? Amost all plastic surgeons have performed lip injections on many staff members. You should be able to see their work in person on both front office staff, medical professionals and aestheticians.
Restylane vs Juvederm
At my Medical Spa, I use both products for the naso-labial folds and tear trough areas. Probably more important than which hyaluronic acid filler you use is the experience of the injector - does your doctor understand the anatomy of the area. This is especially true of the tear trough area.
This area is very complex and improper application of either filler in this area can cause problems. I suspect that when some practicioners have problems they blame the product and not their technique.
I would highly recommend an experienced Board Certified Plastic Surgeon who understands the surgical anatomy of the tear trough and upper cheek - the orbital septum, arcus marginalis, lateral canthal tendon attachments, medial obicularis muscle attachments on the orbit, the SOOF layer of fat below the obicularis muscle and the orbital-cheek fat junction.
Most of the problems that I see in the tear trough region involve poor understanding of this anatomy and improper injections - trying to "fill" the depression. Many of these improper injections require an enzyme (hyaluronidase) to correct the excess Restylane or Juvederm.
Restylane and juvederm
Every doctor and every patient are different. Both juvederm and restylane are hyaluronic acid fillers. My personal preference is to use juvederm. It lasts longer, and is easier to inject. The cost is about the same.
Restylane, Juvederm, Radiesse and Fat
Different Strokes for different folks.
Fine lines around the mouth- Juvederm or Restylane (juvederm is smoother and lasts longer)
Nasolabial Folds - If the folds are deep without fine wrinkles use Radiesse, Juvederm or Fat. Both synthetic fillere are long lasting. Juvederm is easier to inject and less painful. Fat will last the longest and is all-natural.
Nasojugal Gooves - The creases below your eyes are best treated with Fat,Restylane or Juvederm. Both synthetic fillers do well although it is easier for the surgeon to apply Juvederm and shape it to the deformity. The best way to treat this area by far is fat injections. The volume necessary to adequately correct these depressions may sometimes be up to 4cc per cheek. That is only available at a reasonable cost when injecting your own fat.
Larger Lips - Juvederm or Restylane, although both will not last as long as if they are injected into other areas of the face.Fat is still great in the lips. It will last for a long time and the volume necessary is not a limitation.
Both products are equivalent
Juvederm is slightly more of a smooth product but clinically patients usually obtain equivalent clinical results with smooth surfaces after both Restylane and Juvederm. The level of placement should not be too superficial with either product so the result should be smooth. Injections around the under eye areas are injected usually below the muscle which is under the skin. Lumpiness should not occur. Bruising which is temporary is the same for both fillers. It comes down to which filler the individual prefers, but there is no consensus that one is better than the rest.