Juvederm Injections for Sunken Smile Lines. Concerns About Further Stretching?

I'm 40 years old. Even though I have avoided the sun and have nice skin; I began developing the dreaded sunken smile lines. I've had annual injections of Juvederm over the past 3 years. I'm concerned with further stretching the skin causing an increased need for fillers, which are already beyond my budget. My doctor claims it could/does not happen but I'm hesitant to believe since he is making a large sum of money from my visits. Do you think my concern is valid? Have you ever seen this occur?

Doctor Answers 3

Does Juvederm cause permanent stretching of the skin?

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As long as you are not "overfilling" or over stretching the skin to begin with, you should not have to worry about making things worse. In fact, there have been some studies that suggest the stretching of the fibroblasts during injections can actually stimulate collagen and elastin growth in your own tissue.

Facial fillers do not cause significant skin stretching

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While I can understand your concern, the amount of skin stretching that occurs due to facial fillers is minimal--certainly not enough to cause anything permanent.  The skin stretches slightly to accomodate the facial filler but there is no evidence that the skin becomes permanently "stretched" requiring you to continue to use the filler.  Skin loses elasticity with age and other factors such as sun exposure, but not secondary to the use of facial fillers.

Better treatments than Juvederm for smile lines

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No, there is really no risk of stretching the skin from filler injections. However, if by smile lines you are referring to the nasolabial folds, you should consider Radiesse injections instead of Juvederm. Radiesse has been proven to be much more effective than hyaluronic acid fillers like Juvederm for treatment of the nasolabial folds. This is because of the difference between "stimulatory" fillers and "wrinkle" fillers.  Radiesse is injected more deeply beneath the skin and will generate more volume to create a much better lifting effect with a much more natural look. It works by stimulating your skin to produce more collagen, which is why it is so effective, and gives longer-lasting results too. I find one syringe of Radiesse does what two syringes of Juvederm will do so it is more economical for many reasons.

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.