Juvederm -How many Mls is 'usually' needed - if I get more will it actual work or are my lines too far gone for fillers? (photo)

Dear Hughjars, Thank you for your very valid question. It is very important that your face is thoroughly analyzed first by a Board Certified Facial Plastic Surgeon who is very well versed with facial anatomy and with injectible principles, before any injections take place. Namely your injector must identify your best vectors for lift (everyone's vectors vary somewhat)  in order to use Voluma in the upper cheeks to indirectly lift your marionette lines. Subsequently the marionette lines are addressed with Juvederm, as is the pre-jowl area and the lips. In my practice a case like yours would take Voluma in the cheeks and two syringes of Juvederm to the marionettes and lips together. Sculptra could be used for your pre- jowl/ pre marionette area since that is so mobile, but Juvederm works well there too. I hope this information is helpful to you.  Best of luck in your quest !Dr. Anna PetropoulosBoston's North Shore, Danvers, MA

Every patient is different and requires different amount of product, however with that said- fillers- are not substitutes for surgery-- once the skin is sagging (cheeks, jowls, neck) - a facelift/ neck lift is indicated.

Dear hughjars, Typically 1-2 mL's of Juvederm are needed to have a noticeable result in the nasolabial area (marionette lines). If the doctor distributed just 1 mL for that area, plus the upper cheeks, it is not surprising that you don't see the results. When injecting into the mid face we typically use Voluma, and patients will use 2-4 mL's just for that area. I would recommend increasing the number of syringes she uses to get the result you are looking for. Good luck!

For the upper cheeks I prefer Juvederm Voluma. It sits on the periosteum  giving more of a lift to the mid and lower face, rather than chasing lines only to lower face. You're right, your pictures do look identical, I would say on average most people require 2-3 syringes when trying to achieve a certain result.  I would question the placement, return to your injector for evaluation. #juvedermultra   #marrionettelines   #LowerfacewrinklesBe well. 

Fillers can be used to lift and create volume.  When using fillers to lift around the mouth and jawline, often several syringes of different types of filler need to be used to create lift directly and indirectly to the area.  For severe volume loss, sculptra or fat transfer may be more economical due to the increased longevity.