Juvederm didn't work. What are my options to fix these lines? (Photo)

The dr I saw about 5 years ago warned me that Juvederm would not work with these folds due to the way my face comes together and said that I was too young for a facelift (I was 33). What are my options to fix these lines? Juvederm didn't work, is my only other option a facelift? Are there other, newer fillers out there that could fix these? Thank you Lisa

Doctor Answers 7

Options for facial aging


In your photos, you appear to have a fairly thin face.  One of the few down sides of being thin and fit in some individuals is that the face may appear especially thin.  This results in increased prominence of lines, folds, and wrinkles.  Although it is true that Juvederm will likely be inadequate in addressing your concerns completely, it would certainly improve the prominence of your lines and wrinkles.  However, because you are quite deficient in overall facial volume, you will likely need to be supplemented with some additional volumizers such as Voluma.  As I'm sure you are aware, HA fillers are eventually metabolized and broken down by the body, and so repeat treatments become necessary.

An alternative solution would be to harvest fat from your own body and carefully place it in the areas of volume deficiency.  You are correct however that results of the fat grafting would be maximized if the loose and redundant tissue were lifted as well.  So yes, you would also benefit from a facelift. 

Discussion with a plastic surgeon who specializes in facial rejuvenation would be greatly beneficial.  I've attached a link on fat injection, but I would encourage you to explore the pages on facelift and fillers as well.

Good luck!

Salt Lake City Facial Plastic Surgeon
4.9 out of 5 stars 107 reviews

Juvederm didn't work - what next

Thank you for asking about your Juvederm.

  • Your photos suggest that you have very little facial fat and sun damaged skin.
  • correcting your skin will not fill out your face but will improve your appearance - prescription creams of tretinion, gycolic and sun block are the basis of it.
  • For your face, one syringe of filler would not be effective - because you need a great deal of facial fill.
  • You might consider a face lift combined with extensive fat injections.
  • Or you can consider only fat or other long-lasting injections, of which my preferences are Voluma and Radiesse.
Always see a Board Certified Plastic Surgeon
Hope you found this answer helpful. Best wishes.

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

Juvederm didn't work. What are my options to fix these lines?

If one treatment of Juvederm UPXC® doesn't fill a specific line, multiple sessions over time may help, since Juvederm UPXC® is known to enhance a person's own collagen growth.

Manjula Jegasothy, MD
Miami Dermatologist
5.0 out of 5 stars 9 reviews

Facial Lipoatrophy and Treatment

you have very severe facial volume loss and it should be replaced with fat (if you have it) or must sustainable fillers like sculptra, bellafill, radiesse, voluma.   I suggest seeing a facial rejuvenation expert.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 191 reviews

Replacing Lost Volume

Thank you for providing the photographs.  You are an excellent candidate for a facial filler.  However, I would use Juvederm Voluma into the cheek areas.  It would give your face the volume that you need and an instant lift.  Just filling in the lines about the face with Juvederm would not be the correct fix for you.  Please consult a board certified dermatologist with a great deal of experience with facial injections such as Voluma for the best cosmetic results.

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 75 reviews

Filling deep lines

These deeper nasolabial folds can be filled locally to some degree with a filler right into them, but I would also do fillers in the cheek bones to lift the skin up higher. A thicker or firmer filler like Voluma or Radiesse or Perlane in the cheek bones should work very nicely for you. Make sure you have an expert injector such as  a dermatologist to optimize the results and safety.

Benjamin Barankin, MD, FRCPC
Toronto Dermatologic Surgeon
4.8 out of 5 stars 50 reviews

Replace volume in face AND fill lines

Part of the reason your nasolabial folds appear prominent is that you don't have much volume in your cheeks.  To best reduce your nasolabial folds, you would have to fill your cheeks and temples to pull the skin back, and then directly fill your nasolabial folds.  Restylane or Juvederm should work to directly fill your nasolabial folds.  Sculptra, Radiesse, and / or Voluma would be good choices to re-volumize your cheeks and temples.

Lawrence Osman, MD
Los Angeles Dermatologic Surgeon
5.0 out of 5 stars 5 reviews

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.