Why is the Juvederm Lasting So Long?

A couple of things to keep in mind.  One is that hyaluronic acid (HA) products like juvederm, restylane, perlane, and belotero behave differently in different facial sites.  So mobile areas like the lips will break down faster than less mobile areas like tear trough and cheek. Second, as Dr Dembny noted, is that juvederm tends to swell more than restylane in the tear trough so most docs avoid it's use here.

Two studies worth mentioning.  One was a follow up on patients injected with HA in the tear trough, which recognized persistent volume/product in the tear trough at the end of the study 24 mos after injection.  So you may still have product there, or...

The second study of HA injected in the nasolabial fold found that 18 mos after a second injection patients continued to note augmentation of the fold.  A biopsy was done which showed the filler was gone, replaced by new collagen.  So fillers clearly induce collagen formation as they dissolve.  How much volume of collagen compared to the volume of filler is unclear at this point though.  

    The results after 2 years may be the result of scar formation and collagen deposition in addition to filler.  If you like the results you should probably do nothing.  If you are unhappy and there is still product, enzymatic degrading can be performed.

Juvederm has a high concentration of Hyaluronic acid and it is heavily cross linked so this gives it more persistence than some of the other fillers.  It's not uncommon to have it last a year or more but You are lucky to have it look the same after 2 yrs!  I have no idea what the world record is but I do know of others with the same experience.

When optimal correction is provided with the treatment, Juvederm can last up to one year; in your case longer. Juvederm does have very good persistence in the lips, especially if more than one treatment has been performed. It can last equally long in the tear troughs; but some individuals experience excessive swelling in this area with Juvederm, so Restylane is usually the preferred product for the tear trough. I don’t know what the work record is for how long Juvederm has lasted, but I’m glad it has worked so well for you. Consider yourself lucky, since in most patients these fillers don’t last much longer than a year.

Best wishes, Ken Dembny

I do have a number of patients who have had fillers like Juvederm, Restylane, Perlane or Radiesse that have had duration of effect that is much longer than we see on average. It is a function of where the filler is injected into, how deep, by whom, and how fast your metabolism is. 

It is impossible to know how long the Juvederm will last.  It can cause collagen stimulation to give a longlasting result.  I'm very happy that you like your results.

This is unusual but again the productt is the same for everybody but what differs is your bodies response to the juvaderm.Consider yourself lucky,

I have seen several cases similar to yours. And then there are the people in whom it lasts much shorter than we hope. It puts us in a difficult situation. We want to give our patients an accurate estimate. Currently, I tell the patient that it lasts 7-12 months, but that it is possible that the Juvederm could last less or more than 7-12 months. 

Remember that when lengths are given for how long fillers last, these are an average conducted in FDA studies. So to get an average, some people will have it last longer, and some people shorter time lengths. There is no public report available for who has had it last the longest, so just consider yourself lucky it's lasting, especially since you like it so much! Under no circumstances has an HA filler even been documented to be "permanent".