Can Juvederm Ultra be used in the midface for volume and cheekbone enhancement?

Question

I am 45 years old and got filler for the first time two weeks ago. I assumed the doctor was using Voluma or Lyft. After it was done said she didn't like the cross-linked HAs because they occasionally caused nodules and she used Juvederm Ultra. I have never heard of Ulta being used in the mid-face. After nearly 2 weeks I can still feel it as hard threads under my skin, and I didn't get the effect I wanted. I'm not sure what to do -- get more Ultra? Get it removed and then get Voluma?

Alexander Rivkin, MD · Answer

Hi and thanks for your question. I assume that by mid face, you mean cheeks. In that case, I would not choose Juvederm Ultra as a filler. Ultra is a great filler for fine lines and lips. It is soft and flows well, which is why it is good for those areas. In the the midface, you need a filler that is structural. It needs to hold its shape against tissue pressure. You need a filler that is more firm and hearty than Ultra. Voluma is an excellent volumizing filler that is safe and effective for augmenting the cheeks. It lasts for a long time and nodules or lumps are extremely rare if it is injected correctly by an experienced practitioner. You will probably need to get the Ultra dissolved and replaced with a filler like Voluma (other fillers like Lyft, Radiesse or Defyne work as well). I would suggest that you make sure to find a very experienced injector and ask to see their before and after gallery. Hope that helps.

Jonathan Kulbersh, MD · Answer

This is difficult to answer without photos. If you're unhappy with your final results, additional filler may give improvement. I recommend following up with your injector. Hope this helps.

Ramandeep Sidhu, MD · Answer

There are variety of fillers that can be used in mid face to enhance the volume. Juvederm has different products indicated for different parts of the face. Best is to have a consultation to discuss the needs.

Jason Emer, MD · Answer

Yes, Juvederm Ultra can be used in these areas. If you're unhappy with your final results, you can have it reversed with hyaluronidase and try a different technique next time. See an expert. Best, Dr. Emer

Monika Soni, MD · Answer

Thank you for your question! Juvederm Ultra is one of the first and most basic fillers ever designed. It can be used as a filler absolutely anywhere on the face and body. The only issue with the product is that it will not last as long as voluma or other product. Best of luck!

Jonathan Berman, MD · Answer

Juvederm Ultra is typically used to plump the lips, decrease the prominent laugh lines, not add volume to the midface. While it’s not necessarily dangerous to have Juvederm Ultra placed in the midface, it is not surprising that you may not have received the most satisfying results. If you don’t want to wait for the formula to dissolve naturally, an experienced injector or plastic surgeon can have it dissolved and replaced with a better suited formula such as Juvederm Voluma or Restylane Lyft.  Sculptra also is a good filler for restoring volume in the midface.   Fat transfers to the face are an excellent alternative to the “peel and place” fillers.  It is my opinion that your own fat is the best filler available.  The fat will usually last longer than any “peel and place.”  The fat transfer procedure will be more expensive, but as always, you get what you pay for.  :)

Peter J. Jenkin, MD, FAAD · Answer

Thanks for that question.  There are a variety of fillers which can be used for midface volume.  As long as you have been experienced injector, preferably a board-certified dermatologist there are a lot of options for fillers which can all give great results.  The main difference will be the amount of filling or lift you will get per syringe of filler and the duration of effect.  For cheek augmentation for example,  it would take a lot more Juvederm ultra to get the same amount of lift as a much smaller amount of Voluma.  In addition, Juvederm Ultra would be expected to last 6-12 months whereas the Voluma should last 12-24 months.  Side effects such as nodules have very little to do with which hyaluronic acid filler is used and is much more closely related to the injection technique.  Hope this helps.  Best.

Leonard Grossman, MD · Answer

Juvederm Ultra is one of the first and most basic fillers ever designed. It can be used as a filler absolutely anywhere on the face and body. The only issue with the product is that it will not last as long as voluma or other product. Good luck from New York City

Gerald Wittenberg, MSc, DMD (retired) · Answer

The 'type' of filler is important as it relates to the duration and location and depth of placement of the material. 'Nodules' potentially relate to the way it was placed, how much was placed in one area rather than 'blending' it; and the patient's own tissue type/thickness/fullness. The use of Ultra is fine but its duration in some areas is less ideal - it can be used alongside Voluma/xlinked material to 'layer' the material for the best look. Technique and anatomic knowledge are critical to a natural look

Can Juvederm Ultra be used in the midface for volume and cheekbone enhancement?

Answers (9)

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