What's the Right Juvederm Injection for Lips?
- Asked 5 years ago
Juverderm for Lip Augmentation
When Juvederm was released in Europe and Canada, it was available as Juvederm 18, 24, and 30. Both 24 and 30 were also available in HV.
Basically these different numbers mean a different viscosity, or "thickness" of the Juvederm. They are all hyaluronic acid products.
In the U.S., Allergan, the manufacturer, only released Juvederm Ultra and Juvederm Ultra Plus.
- Ultra used to be known as 24 HV
- Ultra Plus was the 30 HV
This is all quite confusing to the consumer, but the important thing to know is the US FDA approved Juvederm Ultra and Ultra Plus. One is thicker (Juvederm Ultra Plus) than the other; otherwise, there is very little difference.
I prefer using the Ultra in the lips as I find it flows quite smoothly and does not tend to lump. However, both Juvederm Ultra and Ultra Plus are very safe and effective agents for soft tissue augmentation, and I have used them for quite some time in my practice with terrific results.
Generally, I can get them to last about one year!
And always look for a doctor who has been properly trained, is board-certified in dermatology, plastic and reconstructive surgery, facial plastic surgery or oculoplastic surgery. And you want to make sure that the doctor you choose is well known and has years of experience in lip augmentation. You never want to bargain shop with your face.
I hope my answer has not added more confusion.
Technique in Addressing the Aging Lips
The variety of Juvederm used is really less important than correct technique. Understanding the changes that occur to the lip is essential and addressing these changes is crucial to making a patient happy.
Anatomic Changes to the Lips
As the aging process progresses, several factors come into play with the lips:
- The vermillion border or junction between red and white lip thins out, and becomes less full.
- The white portion of the lip elongates, and the red portion of the lip deflates, inverts, and becomes less obvious.
- Vertical lines begin to show on the upper and lower lip. This is generally more obvious in woman, partly due to thinner skin in women than in men, partly due to the exfoliative properties of repetitive shaving with men.
- The corners of the mouth or oral commissures turn down ward and a relative hooding of the upper over the lower lip occurs.
My preference is to use Juvederm Ultra for the aging changes mentioned above. I use Juvederm Ultra Plus for younger women who seek more volume to the lips.
- For the changes mentioned above, my first goal after achieving local anesthesia is to restore the vermillion border. A relatively small amount of Juvederm is required to do this.
The Juvederm is threaded just under the deeper layer of the skin (dermis), using a tapered technique, placing a larger amount centrally than laterally. After this has been achieved, the vertical lines around the mouth are addressed. It is very imporatnt to avoid overcorrection; the soution shouldn't create a secondary problem.
- The next goal is to create subtle central fullness into the body of the lip.
Two points are chosen just lateral to Cupid's bow (the peak of the upper lip) on each side, and a central point is chosen on the lower lip to achieve fullness. After creating the desired level of volume, the remainder of the syringe is used to correct and elevate the down turned corners of the mouth. This technique generally requires one syringe of Juvederm and achieves a very pleasing but subtle result.
Juvederm Ultra Plus for lip augmentation
Lip augmentation is a very fun procedure with immediate results! Juvederm Ultra Plus is a denser, thicker, product when compared to Juvederm Ultra.
I prefer to use the Juvederm Ultra Plus when I augment the lip. I feel that the product tends to last longer and give a nice smoother result.
If the patient has vertical lip lines, or wrinkles surrounding the mouth, I like to combine the treatment with Botox. I find that the Botox really smoothes out those lines, and it also tends to lengthen the duration of the Juvederm filler.
A nice nerve block before treatment really helps to make the augmentation very easy on the patient. Again, the type of Juvederm used really is physician preference.
Hope that helps.
The numbers reflect the thickness of the product, with...
The numbers reflect the thickness of the product, with higher numbers for thicker formulations.
In the US, only Juvederm 24 and Juvederm 30 are available.
- Juvederm 24 is called Juvederm Plus
- Juvederm 30 is called Juvederm Ultra Plus
- They differ in the thickness of the gel
Typically, I prefer to use Juvederm Plus in the lips, but one size doesn't fit all, and I have had great results for lip enhancement with both products. It is important to discuss with your doctor what your lips look like "before" and what you hope to acheive "after."
Injector is more important than product for good results
The results of the treatment is more technique driven than product. Juvederm 18 will generally yield a smoother look than the thicker products. Depending on your objectives and starting point, the smoother look may have been the most appropriate product for you. In the United States, we do not use the 18, 24, and 30 classification instead we use ultra and ultra plus.
Juvederm is great for thinning lips!
Juvederm is a soft and gel-like product that feels and looks very natural when injected into the lips. As always, the key to this treatment is proper training and injection technique.
It is my favorite filler to use in this location!
Juvederm for Lip augmentation
Since fillers into the lips is technically off-label, it is a matter of experience and judgment in deciding what works best there. Juvederm 18 may be a little bit smoother than the thicker versions but may also not hold its shape as well in a very mobile area such as lips.
Personally, I prefer Juvederm Ultra Plus for lips most of the time. Good technique is more important than choice of HA product, especially with lips.
Juvederm: Which One is "Best" for Lip Augmentation?
Juvederm 18 is the lightest or thinnest form of Juvederm and is not used in the United States.
Juvederm Ultra is equivalent to Juvederm 24 HV. Juvederm 30 HV is equivalent to Juvederm Ultra Plus. (HV stands for high viscosity.)
Whether a physician uses Juvederm Ultra or Juvederm Ultra Plus is not as important as to how it is injected. The amount, direction, and depth of the injection will have the most significant impact on the final result. Make sure your physician is experienced in injecting the lips and has the proper training and credentials.
In general, Juvederm Ultra Plus is better for restoring volume while Juvederm Ultra is better to address fine vertical lines. The Juvederm Ultra Plus may last slightly longer than Juvederm Ultra.
Be sure to communicate your goals to your physician. Only by understanding your goals can your physician try to meet and exceed your expectations.