Juvederm Voluma vs Sculptra

Since one of the physicians I have seen ( Sculptra lover ) scared the heck out of me by saying that another round of Juvederm Ultra plus is going to do more damage then good in the long run , someone please advice me if I still should use hyaluronic acid as a filler or choice for my upper face ( cheek area ) or switch for a different filler ? Only had 4 syringes of Juvederm Ultra plus . Thanks a lot !

Answers (13)

Repeated filler treatments not damaging in long run

The scientific literature shaows that filler treatments, especially when given to full or near full correction, stretch out the fibroblasts, the cells that make the structural proteins of your skin. As the skin ages, the arms and body of the fibroblasts collapse and ball up, and these cells stop or reduce their production of collagen and other structural proteins.  The stretching actually makes them become more active again, to a similar level as young fibroblasts. So in the long run, filler treatments improve the health and texture of your skin by "waking up" your skin cells.  This effect occurs with any filler.

You should be able to continue your hyaluronic filler treatments without any concerns more than you would have for the first treatment.  Your dermatologist may have been trying to explain the truth that Sculptra can be better in the long run in that it stimulates your fibroblasts to make lots and lots of the structural proteins of the skin:  much, much more than you can achieve simply by stretching out the fibroblasts.  It does not give you immediate correction in the way that other fillers do, but with repeated treatments you can see more correction and in a very natural-looking distribution.  This corrections lasts much, much longer than any other filler can provide.  And a nice thing about it is that the proteins that result are only those that your own body produces on its own.
Sheryl D. Clark, MD

New York Dermatologist
10 reviews

Will Fillers In The Face Cause a Problem

All hyaluronic acid fillers (HA) are made of naturally occuring substances in your skin, there is no problem using these short or long term.  I am not a firm believer these promote any collagen growth however, which is where you gain permanent long term results.  That is why I am a fan of using Sculptra, which is a collagen stimuating agent, to give you long term lift and contouring; while also using the other temporary fillers for lines, volume, and shape.  Using both together or one alone, can still give good results.  It all depends on the techniques of the person injecting.  See a cosmetic dermatologist or plastic surgeon with experience in the use of fillers for pan facial volumization.  I wish you the best of luck, Dr. Emer.
Jason Emer, MD
Jason Emer, MD
Los Angeles Dermatologic Surgeon
230 reviews

Filler of choice

The statement about juvederm causing problems doesn't sound like logic. The truth is that our body tolerates the hyaluronic acid (HA) products exceptionally well, and then converts some of the volume to our own natural collagen with repeated use.  So if anything , additional juvederm, or more specifically any HA, will actually seem beneficial over time. The only thing I would add that might defend such a statement is that maybe it might look too focally augmented and no longer look natural.
Other studies have shown that it's safe to mix products like HA's, sculptra, or calcium products (Radiesse) in the same area of augmentation.
We are truthfully using a fraction of the sculptra and radiesse that we enjoyed for years, now that voluma has come along.  As another HA, it fills softly and subtly, is reversible, and unlike sculptra gives immediate volume. And it lasts for at least a year, possibly two.  And while there are still patients and sites that still might direct to a specific filler, we are using less sculptra now.
Continue to consult with physicians until you feel comfortable with the approach suggested.
Kevin Robertson, MD
Madison Facial Plastic Surgeon

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Volume Restoration

What your physician said makes no sense.  Juvederm Ultra, Ultra Plus, Voluma and Volbella are made of naturally occuring hyaluronic acid that is then cross-linked to provide stability and longevity.  They are safe, soft, natural and, if necessary, reversible.  As mentioned, Sculptra has its uses, however, in the vast majority of cases where volume fillers are indicated, a hyaluronic acid based filler would be the product of choice.
Andrew B. Denton, MD
Vancouver Facial Plastic Surgeon

Long term benefit of hyaluronic acid fillers

Quite the contrary, I often recommend hyaluronic acid fillers long term because of there study-proven stimulation of new collagen formation.  In addition, this benefit can reduce the need for filler over time.  Physicians may prefer certain fillers because they have more experience and/orsuccess with a particular filler, or their office may only carry a limited choice of fillers for economic or political reasons.  Both Sculptra and hyaluronic acid can be used to improve moderate to severe wrinkles.  I use both in my practice, as well as Radiesse.  I have not seen any long-term problems with any of these, but would advise that you find a cosmetic physician that offers the filler you prefer.
Karen Stolman, MD
Sandy Dermatologic Surgeon

Perhaps there was a miscommunication, Juvederm products are all made from hyaluronic acids.

Perhaps there was a miscommunication, Juvederm products are all made from hyaluronic acids. Hyaluronic acids naturally occur in the body. Juvederm is a widely used product with minimal side effects. 


Juvederm versus Sculptra

I am not a big fan of sculptra unless you truly have wasting of the tissue.  Also, I disagree that Juvederm Utra is going to do any damage.  If you have had good luck with Juvederm, I'd stick with it and perhaps seek treatment with someone with whom you can agree upon a treatment plan.

Fillers for upper face

Juvederm Ultra Plus is different than Juvederm Voluma, though they are both Hyaluronic Acid Fillers.

Juvederm Ultra Plus is used to temporarily add volume and improve deep facial wrinkles and folds, lasting 9 months to a year.

Juvederm Voluma is specifically formulated to correct volume loss and enhance contour to the mid cheek area creating a more youthful appearance. Voluma instantly provides a smooth, natural-looking appearance to the cheek area that last up to 2 years with optimal treatment.

Sculptra is used to correct shallow to deep facial wrinkles and folds, it is specifically designed to stimulate natural collagen growth over an extended period of time with multiple sessions. Once you are done with your Sculptra treatment sessions the results can last up to 2 years.

Physicians have different preferences when it comes to what they like to inject, however I don’t see how Juvederm Ultra Plus can cause harm. It’s difficult to comment on that statement without knowing your medical history. Consult with a Board Certified Dermatologist to see which option is best for you and how many sessions/syringes you would need.
Nissan Pilest, MD
Nissan Pilest, MD
Irvine Dermatologic Surgeon
25 reviews

Fillers And Volumizing Fillers Are Safe & Natural & May Be Injected For Aesthetic Reasons As Often As Needed

I have been using natural fillers of all kinds for three decades, starting with the original Zyderm collagen back in the early eighties. While there are many short and long-term concerns with the use of non-natural, foreign-to-the-body materials, such as silicone, bio-Alcamid, and Artefill/Artecoll--products that I choose not to use, I am not aware of any concerns, regarding the amounts of natural materials, such as hyaluronic acid (the main component of Juvederm and Restylane) materials or the number of times they may be used. In fact, they can be used to correct the aesthetic problem and as often as needed to maintain or improve the correction. In addition, hyaluronic acid-based fillers and volumizers can be easily dissolved with a natural enzyme, hyaluronidase, if this is ever needed or desired--adding an incredible level of safety to the hyaluronic acid class of products.

While I am not a fan of Sculptra for a variety of reasons, despite not being a normal component of the body, it, too, is subject to our body's own metabolic breakdown products and will disappear with time. However, there is no known enzyme to hasten its dissolution if this were needed. Moreover, unlike its hyaluronic acid counterparts, Sculptra's results are not immediate. In fact, it usually takes several sessions to achieve optimal correction. 

Given the above, I would have more hesitation with Sculptra use than with the Juvederm Ultra Plus. My suggestion is a second opinion with a board certified aesthetic core physician with extensive experience in injecting all of the available agents. 
Nelson Lee Novick, MD
Nelson Lee Novick, MD
New York Dermatologic Surgeon
39 reviews

Cheek volume fillers

Your surgeons answer may be related to his examination, and they may be stating they dont think you would benefit. We do not have a picture to review.

The fillers used for volumizing have included all of them but primarily Radiesse, Sculptra, and now Voluma.
Voluma is the only one that has approval for that indication. The others are used off label.

Voluma has the advantage of lasting up to 2 years. It is reversable since it is hyaluronic acid based.

Radiesse is a good choice and can be more cost effective, it lasts longer than  1 year, but is not reversable.

Sculptra has not been consistent for me, and is not as reliable in the  upper cheek.

Be aware it can take multiple syringes.
Benjamin Van Raalte, MD
Benjamin Van Raalte, MD
Davenport Plastic Surgeon
48 reviews

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.

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