Juvederm Gone in a Week?

Question

I had Juvederm injected in the periorbital lines, nasolabial, chin, upper and lower lips. It has been a week and the swelling is gone and so is the Juvederm. Except for some (uneven) fullness in the upper lips, everyone I know said they don't see any difference. Neither do I. What happened? I went to a very well known dermatologist who is supposd to have a lot of experience.

Gregory A. Buford, MD, FACS · Answer

I would agree with Dr. Weiner in that you had a number of areas treated and so effective treatment would realistically require at least 3-4 syringes. Undertreatment is one of the main causes of suboptimal outcome; simply put, if you don't use product and spread it out too much, you're not going to see very much difference and are really wasting your money. I would talk to your dermatologist and express your concerns.

Raffy Karamanoukian, MD, FACS · Answer

Address your concerns with your dermatologist. Sometimes before and after photos can help determine how much of a difference was actually made. Raffy Karamanoukian Los Angeles

Anil R. Shah, MD · Answer

Juvederm will last for months.  However, if too little is injected around many areas of the face, little to no impact will be seen.

Harold J. Kaplan, MD · Answer

Hi Bery,
We'd like to offer two possibilities. 
The first is that you have too little product injected. For the areas you mentioned, you might easily need 3 syringes and perhaps as many as 5 (1 lips, 2 nasolabial, 2 marionette). So, if you did not have this much injected, you may consider asking your practitioner if more is required.
The second is that you may have some good correction, but might not be able to tell easily without looking at your "before" photos. In either case, your concerns warrant a follow up visit to your practitioner to discuss the procedures. Good luck.

Jeffrey W. Hall, MD · Answer

It depends on the amount of product used. Some people and some areas require more Juvederm than others. Your product is still present at one week, but it may be that you need more product to get the full correction you desire.

Kris M. Reddy, MD, FACS · Answer

The injector may have injected too little for the number of areas to provide you lasting visible results. You may need to augment with additional product to get the results that you desire. It is not unreasonable for an injector to be conservative with the treatment on a new patient. It is easier to add juvederm then remove.

Ben Behnam, MD · Answer

Hello, you mention that "periorbital lines, nasolabial, chin, upper and lower lips" were all injected. These are a lot of areas just to be injected with one syringe. If you were injected with one syringe, then I guarantee that you will not see any results. Depending upon the severity of nasolabial folds, I sometimes inject one full syringe on each side. The lips also vary, it depends on how big the lips are to begin with. I've had patients where their lips were full and big to begin with, so to see any results, I had to inject a syringe and a half just to see some improvement. I'm not sure what you mean by chin but this is an area that can take up a lot of volume. Marionette lines, the corners of mouth, can easily take half a syringe to even a full syringe, depending upon the severity. Unfortunately, a lot of patients just want one syringe, and I always tell my patients that under treatment will cause disappointment down the line. So if a patients wants only one syringe, I would limit the number of areas treated to only one or two. Dr. Behnam.

Steven Hacker, MD · Answer

Juvederm should last in the nasolabial folds anywhere from 6-8 months. It won't last that long in other areas such as the lips and face. Factors that might affect the duration are the volume injected, location and technique.

Hisham Seify, MD, PhD, FACS · Answer

These are many areas. My guess is that a small amount of filler material was used, and it was diluted between all these areas. It also depends on how many lines you had and what technique was used.

Ralph R. Garramone, MD · Answer

The most likely expanation is that you need more. Given all the areas that were treated I would expect that not enough was used to adequately address all areas. The more areas that are treated the more product needs to be used. It is possible that the product was not injected at the correct level, however, if you went to a provider who uses the injectable fillers often he or she shoud be aware of the correct level of placement. I would go back to your physician and see what he has to say.

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