I have significant nasolabial lines not just to my mouth, but down past my lips. I went to a local plastic surgeon, paid my $500 only to see absolutely no difference (except to my wallet). I went back to him and he said that the Juvederm I received isn't really for the kind of lines I have, that it is intended for "folds" (this being after he's paid). I think it has everything to do with technique and how it is injected, but since I really didn't see any change, I'm wondering is he right?
Will Juvederm Work on Shallow Wrinkles?
Doctor Answers 15
Fillers for significant nasolabial folds
If the nasolabial folds are deep, there are two ways to address this.
1. Nasolabial folds form primarily because there is volume loss in the facial structures above, in the soft tissue, fat and even bone. So improving the volume loss above will help reduce the nasolabial folds as well. Usually some filler is added to the nasolabial folds themselves at the same time.
2. For deep nasolabial folds, a more robust filler like Perlane, Radiesse or Juvederm Ultra Plus would work better than Juvederm Ultra. These give a better lift to the tissue. Juvederm Ultra is excellent for lips and more shallow wrinkles.
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Radiesse is Best for Deep Nasolabial Folds
For deep nasolabial folds, my treatment of choice is Radiesse. It is injected deeper beneath the skin and will generate more volume to create a much better lifting effect for sagging skin. I use Juvederm as a more superficial wrinkle filler because it is injected in the skin, rather than beneath it. It works best for plumping up thinning lips, filling wrinkle lines on the lips, and for treatment of mild to moderate wrinkle lines on the face. I frequently see patients who have had Juvederm injected too deeply and are unhappy that the results seemed to have lasted only one month at most.
Juvederm - shallow winkles
I'm sorry you had a bad experience. I'm surprised you didn't see any difference. Juvederm is great for the areas you mentioned - the nasolabial folds and marionette lines. If you had deeply etched lines in your face, this should soften them, but superficial lines are really hard to treat. If you place the product too close to the skin to try to get rid of them, you just end up in bumps.
Dr. Cat Begovic M.D.
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Fillers and Folds
Juvederm can work very well for nasolabial folds and Marionette lines (the lines from the corner of the mouth down toward the chin). Sometimes it takes more Juvederm than was originally placed to achieve the amount of desired fill. There are other fillers like Radiesse, Restylane, Perlane and fat which are all options. I personally prefer Juvederm and Perlane for deep folds. I don't generally use fillers for fine lines that are the result of dynamic action, like "Smoker's lines" around the mouth or Crow's feet. I prefer laser therapies for the former and Botox for the latter.
Juvederm for shallow wrinkles
Juvederm injected at the right depth and plane can most certainly improve the lines you are describing. Restylane would be another reasonable option. There are various techniques to inject fillers at various depths. I'm a bit surprised that your physician would have treated you and then said that what they did wasn't really the type of treatment you needed...speak with him again and see what he's willing to do or seek a 2nd opinion. Dr. Benjamin Barankin, Toronto Dermatology Centre.
Juvederm for shallow wrinkles
Juvederm in the right volume and depth can certainly soften the lines you described. You might need additional product, a single vial may not have been enough, or perhaps the placement of the Juvederm was too deep so that no volume improvement was seen where you wanted it.
You can certainly obtain a second opinion with another accomplished physician in your area to see if additional filler would help. The response your original doctor provided was not satisfactory. If he felt your problem would not be helped with filler, he should have stated that prior to treatment.
Juvederm for nasolabial lines
With any filler, if you have substantial nasolabial lines, injecting just the wrinkles may not be the answer, even if more than one syringe is used,
You may need injections in the cheeks and on the malar bone under the muscle in order to get the best results. That may take 3 or 4 syringes.
If you are less than 65 years old, you may benefit from Sculptra, which is not a filler but a collagen sunthesis stimulator. The results are not immediate; you have to wait 1 to 2 months before you see any improvement.
But the results can last much longer (up to 2 years).
Juvederm and smile folds
Without examining you one can not comment on your case. You mention that you have significant lines but the surgeon said the Juvederm was for folds. Possibly your lines are narrow and thin creases that are superficial. Those type of lines can be difficult to fill with Juvederm or Restylane without leaving bumps. Sometimes, subcision helps lift these tight creases after which the filler works better. You may need to see a second opinion.
Juvederm improves shallow lines but needs to be injected carefully
Juvederm can be used to improve shallow lines but one has to be careful. If Juvederm is placed too superficially it creates what we call a Tyndall effect and the product can actually be seen in the skin with a bluish cast. It can also be bumpy if placed superficially. This looks terrible! The problem is some lines are very superficial. The other available products like Restylane and Perlane also have this same problem. The other product available now for superficial lines is Prevelle Silk, but it only lasts about 2-3 months. Soon, a new product will be available for superficial lines called Belotero and it will last longer. Until then, what the physician can do is thin out the Juvederm with some lidocaine and use a tiny 32 gauge needle to try to improve the lines as much as possible but still avoiding the Tyndall effect.
Another approach is to laser these fine lines. This is the definitive treatment, but you'll have to take time off for this treatment.
Juvederm and nasolabial folds and shallow wrinkles
Dear Rae, I'm sorry to hear you didn't notice an improvement. Juvederm usually is effective in treating the nasolabial fold area, however, it can often take 2 or even 4 syringes of the material to see the effect. You can add to the amount you already had injected without harm.
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.