Both Juvederm and Restylane are FDA approved hyaluronic acid fillers. There are minor technical differences in the two products. Both are proven to provide lasting results. Having said that, I think an experienced physician can do just about anything with just about any product. What is important to the consumer is what happens to a product when it is used by a less experienced physician. This is important because not everyone is going to be treated by the "world's greatest." As a physician with a great deal of experience with these products, I prefer Restylane and Perlane. The "smoothness" of Juvederm is not a clinically meaningful expression. It is a marketing term of art. The marketing people are making lemonade out of lemons. Having said that, when injecting tiny volumes, Juvederm is less likely to form a bump because it readily diffuses in the tissues. This is an advantage for doctors who are not prepared to mold and work with the filler once it is in the tissue. Restylane is more cohesive and tends to stay where it is placed. It needs to be carefully molded once injected. The advantage of this cohesion is that Restylane can be used to build up the face in away that is impossible with Juvederm. This is especially evident in the lower eyelid/tear trough hollow under the eyes. Juvederm injected in this area in enough volume to make a difference can readily drift into the top of the cheek creating unwanted fullness. This does not happen with Restylane. On the other hand, one has to expect lumps with Restylane and actively work to smooth these if they occur. This can easily be done and it is my opinion that the results are worth the effort. Some authors here suggest that Juvederm does not last, and I think the reality is that it does last but it tends to get flattened in the tissue and over time appears less effective. Recognize that some offices push products because the doctors get financial incentives from the companies to do so and these incentives increase based on how much of the company's product the offices uses. For example, Allergan incentivizes plastic surgeons by counting any of the Allergan products, this includes BOTOX, Juvederm, Prevage, as well as Allergan manufactured breast implants. For Allergan, the offices that use enough of their product not only get a significant discount on product, they get favorable placement on the Allergan doctor referral website. Medicis, the company that makes Restylane, has a similar type program, but it only applied to its hyaluronic acid filler products. So be aware of this because it creates a potential bias in what the doctor may recommend. Ultimately it comes down to trust. Do you trust the doctor to make a recommendation that is right for you and not the doctor's wallet?
