Reuse Juvederm Syringe for Future Injections?

Typically an experienced injector can estimate how much filler you will need for any given area before beginning the procedure. If you know you only need half of a syringe to start, you can just buy a smaller volume to begin with. Then if you need more you can come back and buy more. The product is sterile until it is opened. One it is opened and used, it is no longer technically sterile. I personally would not save a syringe for 6 months. I do think it is reasonable to keep the product around for a couple weeks if you have some left over and may do a touch-up on the followup visit. If that is done, to avoid potential contamination, I recommend removing the needle used, recapping the syringe, and using a new needle on the second injection. It is also important to keep that syringe clearly marked with the patient name. Regarding the lumpy and irregular appearance, that is related to your injector's judegement and technique. First, the treatment needs to be appropriate to solve the problem. For example, Botox is typically used to soften horizontal forehead lines. Really deep lines may not be fully corrected and may be addressed with filler. If filler is chosen, it much be injected with proper technique to be successful, and avoid irregularities like those you describe. The bottom line is choose your injector carefully!

It’s not unusual for patients to ask their physician to save
a partially used syringe of Juvederm. Unfortunately, there’s no way to insure the sterility of this material
once it’s been opened and used. For this
reason, we don’t save partially used syringes of filler.Although
both patients and doctors are motivated to save money, the consequences of soft
tissue infection can be significant. It’s therefore appropriate to start each new procedure with a fresh
syringes of Juvederm.

6 months is questionable and the stability of the product may be compromised if stored for this long.You should perhaps ask the MD how they are preserving the half syringe.

Here are 3 separate studies showing the safety of re-injecting unused filler in the same patient. The science says it is safe.Bellew SG, Carroll KC, Weiss MA, Weiss RA. Sterility of stored nonanimal, stabilized hyaluronic acid gel syringes after patient injection. J Am Acad Dermatol. 2005;52:988–90.Davis K, Bottone EJ, Lucas D, Lebwohl M. Sterility of refrigerated injectable collagen syringes after injection of patient. J Am Acad Dermatol. 1992;27:959–61. Culligan PJ, Koduri S, Heit MH, Rackley R, Thomson RB, Schwabe L, et al. The safety of reusing injectable collagen: A multicenter microbiological study. Int Urogynecol J Pelvic Floor Dysfunct. 2002;13:232–4. 

It is not recommended to reuse syringes secondary to risk of contamination. It is recommended and most sterile to use the products in one treatment. This should provide more filling and a more complete treatment.

First and most important question, should someone be using Juvederm in the forehead.  I think that this is generally a poor choice.  While there may be some exceptions, there are better products to use in the forehead such as Botox and even surgery (brow lift).  As you now know, with a few exceptions, Juvederm is not good in the forehead.  Usually storing Juvederm is not even an issue because it's easy to find places the product will make a difference and you can easily use the full syringe.  When doing just a small little touch up, I have stored the product in a refrigerator for up to 6 months.  I know this is in contradiction to what the company recommends and most of the authors on realself answering this question.  However, I have done this at least 20 times and never had problems.  I think the patient should be allowed to make thier own decision on this, but have the option to keep it for 6 months.

The product label of Juvederm actually states that it is a single use syringe and should only be used as such.  As for the risk of infection, I have never seen this but that doesn't mean it can't happen.  

Always ask for a fresh syringe!

I hope this helps!

Warmest regards,

Gregory A. Buford, MD FACS

Because of the high risk of bacterial invasion, it is not a good idea to store an opened syringe for future use. Doing so would risk an infection.

Unlike many of the other opinions here I feel it is very safe to save a partial syringe as long as it is done carefuly, FOR THE SAME PATIENT and for a limited time.  A recent study showed complete safety with no bacterial contamination when partially used syringes of hyaluronic acid (Juvederm, Restylane) were capped off and saved for up to three months.

As long as the contents of the syringe are kept sterile and only used on the same patient, I see no reason not to give patients the benefit of using the remainder of a syringe that they could not finish on their previous visit.

The manufacturers, such as Allergan, do not recommend saving partially used syringes but they also make many other recommendations for FDA approval purposes that physicians do not have to follow, such as diluting Botox with a type of saline that stings more and so most of us do not use it.

Because Juvederm (as is true with all cosmetic dermal fillers) is a sterile product, it is very poor practice to store unused product for future use six months later. Not only is this discouraged by the manufacturer, it is generally considered unnacceptable to ever store product even for a short time. Doing so for up to 2 weeks is understandable for specific situations; however, this should be far and few in between.
In an effort to avoid wasting a very expensive product, most patients will always benefit from using the remaining amount somewhere else. Also, when very little product is needed or wanted, reaching for a 1/2 syringe of Restylane (Medicis) will avoid unused amounts.
With regards to the lumps in the forehead - this is generally related to poor technique during and after the treatment. Permanent lines/wrinkles that cannot be resolved with Botox often respond well to fillers. We suggest you contact your physician to discuss resolving the lumps of product with hyaluronidase.