“Trenches and pockets in cheek after juvederm ultra plus”
Juvederm: NOT worth it
Pain: Uncomfortable
I'm36 and had treatment for "lipo-deficient" cheeks with Juvederm Ultra Plus a week ago. About 1.5 vials in one side and .5 in the other, to make appearance even.
I would say the results were fair except I still swelling in one "pocket" next to left side of mouth (looks like I have something stored there or that skin was grafted on).
Bigger issues are it looks like I have 2 divets in one cheek (and awful brown needle marks still there). That was the cheek that had 1.5 vials. There's a trench-like depression about a pinky wide on my other side. That had half a vial.
I've been hiding my cheeks, which I had no marks or issues with before treatment. Is this common for it to come out so unevenly? Are 2 treatments necessary, or is this stuff always so unpredictable and uneven? I look terrible right now.

Sep 10, 2009Comments and replies (8)





337 posts
15 Sep 2009
Hi Hope - don't panic just yet! Some of what you are seeing is still swelling. Juvederm takes a couple of weeks at least to 'settle in' and blend with your skin. Further it is a 'water finder' and attracts/absorbs fluid in your natural tissue. This can create some bizarre results at the start. I would strongly recommend AGAINST having it dissolved with hyaluronidase (that comes with its own problems) until you are sure that you are looking at the final result and not swelling or settling. It honestly may take a few weeks for you to truly see how it is going to look. In my experience, Juvederm often feels 'hard' or 'firm' under the skin for a while (which could be creating the appearance of hills and valleys for you) and then it softens out and settles. I had major issues with hyaluronidase, mainly because it was put under my eyes. I am not sure whether it creates the same hypersensitivity reaction (massive swelling) if put in the cheeks or other areas of the face that are not so sensitive as the under eye area. If you are going to have it dissolved then find someone VERY experienced with hyaluronidase because a lot of your natural tissue is made up of hyaluronic acid (like juvederm) and you do not want to risk dissolving any of your natural tissue because you will be worse off than when you started before the juvederm. Trust me that you should wait for at least a couple more weeks. I was WAY TOO HASTY with 'corrections' and just ended up creating more and more problems. (Pity someone in the medical profession didn't suggest that I just wait it out!) My current botox disaster was the absolute end. It is irreversible by anything but time and it has forced me to be patient and wait it out. You should also take heart that it is way more noticeable to you than it is to anyone else. Keep photographing so you retain an objective perspective about what is happening to your face. Make an appointment with your doctor in two weeks' time so you have a specific date for review. In answer to your question about hyaluronidase swelling, the swelling under my eyes went away after about 6 weeks, but I still have puffiness under my eyes from the botox disaster so it is a little hard to tell. Keep us updated about your progress. Cheers
337 posts
17 Sep 2009
Hiya Hope - Where did you have the botox and how much? I think it is inadvisable to have filler and botox at the same time because if you don't like the overall result it is very hard to tell exactly what you don't like and (more importantly) what caused it. Could your 'trenches and pouches' be botox-related more then juvederm/restylane-related or perhaps caused in part by both? Possibly! Botox may also be contributing to the spongy feeling to your skin. It is very, very hard to tell exactly what went wrong when filler and botox are done concurrently. If your face has 'dropped' a bit from botox in crows feet area (cheek ptosis) then it could be causing some of the effect you don't like. Chloerose calls cheek ptosis the 'dented apple' because of the weird indentations, bunching effect, loose skin and shadows that cheek ptosis can create on the sides of the face, particularly on smiling or otherwise animating the face. Before you chase your perceived filler problem with hyaluronidase, you might want to consider that at least some of the effect might be caused by botox. It is just a thought and I might be completely wrong. However, I once had juvederm in my tear troughs at the same time as botox in my bunny lines/crows feet and ended up with 'divots' on either side of my nose when I smiled. I originally attributed this to the juvederm but now know it was caused by botox. I know the waiting is really hard but keep writing here instead of going to doctors to have more stuff done! Keep us updated as to how it is all going. Cheers.
337 posts
21 Sep 2009
Any improvement?
11 posts
23 Sep 2009
Not much. The swelling and bruising has gone down and the trench is now a ding, but I'll take it. No more fillers. Ever. Unfortunately I now have a fold running down my right cheek from my NF to the bottom corner of my mouth. Its hideous. I its becausehe had put some Restylane in one of my smile lines at my cheek and its pushing the whole area forward and up when my lips are closed. Awful. Just awful. I may try to see if he can dissolve the lump, but scared he will dissove everything in my cheek since its half inch or so away.
25 posts
1 Oct 2009
I wish we could do to our "doctors" what they did to us and see if they like it. If your doctor doesn't fix it, post his name on this site.