I have had multiple Juverderm fillers for tear troughs but they don't seem to last more than a month to 6 weeks. Why?

Question

I have one full syringe of juverderm so half under each tear trough and 2 top ups over the last 4 months. The results look amazing after the last topup which was about 3weeks ago and my tear troughs seemed to have gone back to how they were before. I have a very slim face. I use a well known reputable surgeon that works in London and has very good reviews. Is it something I am doing? The filler just seems to keep moving/disappearing. Please see pictures.

Joseph J. Castellano, MD · Answer

Because everyone's body reacts a bit differently to specific injectables, it's always hard to predict exactly what type of results a client will see or how long they'll last. Given that you've seen only short-term results from JUVÉDERM® up till now, you might want to check with your surgeon about a different product that your body responds to better for the next round.

Daniel Ezra, MD, FRCS · Answer

Its not really possible to make an assessment based on the photos. However, I would say that several aspect of the history do sound a little worrying. Firstly, Juvederm is completely the wrong filler to use in this area. In addition, the volumes you have described are also very large and generally this amount should not be injected. Both of these aspects would indicate that the injector is not experienced in injecting this area, or up to date. I would get a second op and see where you go from there. I would DEFINITELY NOT continue putting more filler in.

Best of luck

Best of luck

Munir Somji, BSc, MBBS · Answer

Many thanks for your question. I do sometimes see this in a few patients and generally my advice is to under go fat transfer (micro and nanofat) in the tear trough area. When performed correctly it gives great results and also has greater longevity. Generally I'm not a fan of using Juvederm in the tear trough region. 99% of my patients using Teosyal Redensity II do not have problems with longevity.

Marek Kacki, MD · Answer

It is very difficult to predict the longevity of any filler in any given individual. Whatever duration is claimed by the manufacturer does not relate to every single person. Although Juvederm may not be the best for this area there are many other fillers that may last longer.  In UK you have more options. One of the filler you could use is Stylage XL or even XXL, a hyaluronic acid mixed with Mannitol. Other fillers, if available in your area are Elanse, Restylane Left or Allofill. Allofill is quite amazing for many applications; it is derived from  human fat tissue and has a potential to last for years. Good luck!

I have had multiple Juverderm fillers for tear troughs but they don't seem to last more than a month to 6 weeks. Why?

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