How is Evolence Different from Restylane or Juvederm Injections?

How is this new filler Evolence different from the HA fillers we know and love, i.e. Restylane or Juvederm?

Doctor Answers 11

Evolence is a cross linked collagen. HA, or hyaluronic...

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Evolence is a cross linked collagen. HA, or hyaluronic acid, which is the primary ingredient in Juvederm and Restylane, are a different co

mpound and most of the effect of the substance in facial filler applications is due to water absorption from surrounding tissues.
Johnson & Johnson (the maker of Evolence) obtained FDA approval to market the compound in the United States on June 30, 2008. They have indicated that it will be available as soon as they can train physicians in its use. Additionally, J&J has applied to the US FDA for an indication that Evolence lasts up to a year, though this indication is currently being investigated.
According to the J&J website:

"This new generation collagen filler is intended for injection into the mid-to-deep dermis for the correction of moderate to deep facial wrinkles and folds, such as nasolabial folds. The most common side effects of EVOLENCE®injections are usually injection-site related and include mild swelling, redness, and pain. Other rare side effects include the development of small areas of firmness under the skin at the treated sites that may be noticed when the areas are pressed upon."

Dallas Facial Plastic Surgeon

Evolence is a long lasting collagen filler

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Evolence is the latest Dermal Filler to be FDA approved. Of all the fillers, it is the most natural, and causes the least swelling and bruising. It is a collagen based filler but overcomes the hurdles that prior collagen fillers had. There is no need for pretesting to see if you have an allergy to it. Also, while prior collagen fillers had a very short duration of about 2-3 months, Evolence is approved as a 6 month duration filler, but in studies it has been shown to have up to a 12 month duration.

The longevity of Evolence is based on it's glycomatrix technology. After the collagen is purified, a process is used that is similar to what occurs in the human body. The collagen strands are linked with ribose, a naturally occurring sugar.
The collagen is Porcine based. Similar to what is used in heart valves, lenses, and surgical meshes. The collagen is cleaved in a process using natural enzymes (pepsin) resulting in a collagen that is so natural it is actually integrated into the bodies own collagen matrix. Blood vessels and cells grow into the Evolence after it is placed!

Hyaluronic Acid fillers (Juvederm, Restylane, Perlane) cause some minor swelling based on the fact that water is absorbed by these fillers. Water absorption adds to the fillers longevity. There is no water absorption with Evolence, therefore the swelling is minimal or none after injection. In addition, collagen is a natural hemostatic agent, meaning it will minimize any bleeding that occurs after injection. This means there is less bruising with Evolence as well.

Unfortunately, Evolence is not indicated for lip enhancement. However, within the next 6 - 12 months, another filler called Evolence Breeze should be FDA approved, and that will be a great filler for the lips - long duration, minimal bruising and swelling.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.9 out of 5 stars 75 reviews

Evolence vs Restylane vs Juvederm

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Restylane and Juvederm have become the work horses of the injectable filler market. These hyaluronic acid fillers are derived from genetically engineered tissues and are thus safe and reliable.

Evolence is derived from porcine collagen. Pig DNA is very close to human DNA hence the reason we use it for heart valves and the like. Unlike the older collagens that were made from beef and caused allergic reactions, Evolence doesn't require skin testing and isn't known to cause allergic reactions.

Evolence can be injected slightly deeper than the HA's and is much more malleable and in my opinion much better to work with. However, it cannot be injected into the lips.

The other downside it that J & J who owns this Israeli company is shutting it down due to lack of revenue. My opinion is that they didn't market it well enough because around here plastic surgeons and the like bought it up as fast as they could get it. I'm sure someone will buy the company the re-market Evolence under a new name

Evolence is Collagen based

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So what's so new & exciting about Evolence? Evolence is a collagen based filler which is used to correct moderate to deep facial wrinkles (most commonly the nasolabial folds).Unlike other fillers composed of hyaluronic acids (Restylane, Juvederm), Evolence utilizes a specially formulated GLYMATRIX collagen which slowly integrates with the Patient's tissue. Unique to this collagen based filler is that no skin testing is required. This is because the proteins in the collagen that cause reactions (immunogenic peptides) are removed during the synthesis of the filler. To date no incidences of clinical hypersensitivity have been reported.

Also of great interest is that the GLYMATRIX collagen is non-hydrophilic. This means that unlike other fillers which are hydrophilic (attract and absorb water), Evolence does not rely on the unpredictable effects of water in your skin to get the clinical results desired. This fact has also been shown to reduce the swelling and bruising seen after the injections are completed.
Evolence has also been shown to have excellent and stable duration. Clinical studies have shown that at 6 months after their injections, 91% of patients report that their results were "better" or "much better" than before.
Evolence is contraindicated for any patients who have a known hypersensitivity to collagen products or a history of anaphylactic reactions/recurrent serious allergies.
During the certification process I was very pleased with how easily Evolence injected and the immediate clinical results obtained. I am excited and looking forward to adding this great, new option to my armamentarium in the battle against wrinkles.

Kamran Jafri, MD
New York Facial Plastic Surgeon

Evolence is made of protein from pig collagen. Restylane...

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Evolence is made of protein from pig collagen. Restylane and Juvederm are laboratory synthesized hyaluronic acids which are found in the normal skin's infrastructure. There may be more bruising with the hyaluronic acids than Evolence.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Evolence Collagen Filler

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Evolence is a new dermal filler made of natural collagen, that has been naturally cross-linked to mimic the natural structure of the body’s own collagen. As a result, Evolence is able to integrate and support existing collagen by adding structure, strength, and volume for a natural appearing, long lasting result. Evolence is indicated in patients with moderate to deep facial wrinkles and folds, such as nasolabial folds, along with areas that require lifting such as the corners of the mouth and lateral eyebrows. Evolence effectively works as a “thread-lift” by building three-dimensional structure and support, effectively lifting areas to a more youthful position. Injections are very comfortable, with immediate results, and last through 12 months.

Difference between Evolence and Restylane or Juvederm

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Your question has been expertly answered by the previous doctors so well. Down to the biochemical physiologic levels. But the real difference is the company has 'pulled' it from the market. This was stated due to poor sales. I think it was a total failure from its' marketing to its name choice. So why would you use a product taken off the market and not available? I would not. That is the real difference.

PS: Artefill is now back on the market. Lasts 5 to 7 years. Only a few doctors will be offering this product in each city. It also looks expensive but if you compare costs per treatment it turns out to be much less expensive.

How Evolence differ from the other fillers

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Evolence is a porcine (pig) collagen-based filler. Unlike the first generation collagen fillers, Zyplast and Zyderm which are bovine (cow) derived, skin test is not required. There tends to be less swelling associated with Evolence, as compared to some of the hyaluronic acid fillers Restylane and Juvederm. Therefore, the correction one gets with Evolence is typically exactly the same as immediately post-injection- what you see is what you get.

Unlike the the hyaluronic acid based fillers, Evolence is not a filler that should be injected in the lips or the tear troughs due to the potential of lumps and nodules to form. Evolence also lasts longer than the hyaluronic acid based fillers- up to one year

Ritu Saini, MD - Account Suspended
New York Dermatologic Surgeon

Evolence is collagen, restylane/juvederm are hyaluronic acid

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Unlike Restylane and Juvederm which are made from hyaluronic acid, Evolence is made from collagen and that collagen is derived from pigs. Pig (porcine) collagen has been used for many, many years as an injectable filler as the collagen found in pigs is very similar to that of humans. That said, some people prefer not to use an animal based product for religious (muslim or jewish) or ideological (vegetarian or animal-rights) reasons.

The advantage to Evolence is that the price may be lower and that injection related bruising and swelling are reportedly less than with other fillers. The main disadvantage is that if you get a lump with Evolence, it can take months to dissipate.

Restylane and Juvederm are more costly but if you do get a lump or unevenness, it can be corrected with an enzyme called hyaluronidase with smoothes out or dissolves the hyaluronic acid filler.

I do use all of the above mentioned fillers in my practice, but much less Evolence than Restylane or Juvederm.

Jonathan Hoenig, MD
Beverly Hills Oculoplastic Surgeon

Caution with Evolence in the Lips

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Evolence is a porcine collagen-derived filler initially released in Europe and Canada. It has a relative called Evolence Breeze which is a different version of the same substance (which has "a more finely textured consistency" according to the manufacturer, but they do not clearly describe how this is achieved).

A recently published case report from an experienced Canadian injector revealed a high incidence of nodules lasting over one year after injection. Therefore, its use in lips has been discouraged (see reference).

Restylane and Juvederm will remain the most popular lip fillers for now.


Brett S. Kotlus, MD, MS
New York Oculoplastic Surgeon
5.0 out of 5 stars 63 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.