Is Juvederm making my face too puffy? (Photo)

Without an in-person evaluation, it's difficult to determine the exact cause of the puffiness you're experiencing - whether it's improper technique or prolonged swelling or simply the natural aging process. If you're unhappy with your results, you can have the treatment reversed with hyaluronidase.There is a great deal of precision involved in facial sculpting, and technique is key to getting subtle, natural-looking results that highlight your signature features.For nasolabial folds, I recommend a combination approach to get the most improvement: Fillers like Juvederm, Radiesse, Restylane, and Belotero for the folds themselves and Sculptra to provide anatomical support through collagen building. If needed, lasers and microneedling/PRP can improve texture and tone.I suggest getting a formal evaluation with a board-certified cosmetic dermatologist and facial sculpting expert; our practice is located right here in Los Angeles. Best, Dr. Emer

Thanks for your question! I believe you somewhat answered the question yourself when you mention that your face is undefined and excessively full, and I agree. In the US many sorts of injectors concentrate heavily on the middle face, and over time it can result in the look you have. I would definitely not recommend more filler, but instead on taking some time off from filler or having it dissolved so that your doctor or injector can start with a blank canvas to get you to where you desire. 

Many things can effect the subtle differences over time including age, weight loss or gain, environmental factors, etc. I encourage you to discuss your concerns with your injector so that adjustments can be made to help you achieve the results you are wanting.

Hi
It is difficult to see the results with out seeing full face. When we age volume loss happen from all over face including temples, under eyes cheeks, nasal folds and mouth. So just putting filler in nasal folds on regular basis versus assessing volume all over face may change the appearance of your face. Stop using filler in nasal folds for some time and than comparing your pictures with old ones will help.
Good luck
Dr Mahajan 

OK, lets make some logical decisions.  Firstly you notice a gradual change, not a change within a few days. This means that your injector has done a great job, as changes and puffy face occurred over 2017 to today. It can not be injector error. More information needed with time line pictures. As specialist  we never make subjective assessments, just objective ones based upon history, examination and time line photography. 1. Was there any weight gain that could account for this?2. Hydration status with the before and current photos?3. Any other filler used?4. Filler migration is certainly on the cards, however if the filler was placed deep OR in the appropriate tissue plane this would be unlikely. Your injectors notes will be helpful.5. If it was Juvederm with Vycross, cross reaction antigenic morphing can be considered. The presentation of HA will change with time as its broken down. This is a rare but well known change with Vycross fillers. In most cases it presents as acute swelling- yours is too subtle for this reaction. 6. Your best avenue is to see your injector. He or she will be well versed in all the potential causes of filler reactions, and can start investigating as need be. Dr Davin S. Lim. Brisbane. Australia.