Perlane vs Juvederm Ultra Plus

I had perlane injected in my nasal labial folds 3 years ago and it looked completely natural. I had just a slight loss of volume in my nasal labial region that I wanted filled. I tried juvederm ultra plus a few months ago for the same region and it seems to have changed the shape of the region. Instead of just filling in the loss of volume it is flat looking, different then the surrounding tissue.I need one more syringe can I try to alleviate the issue with using perlane? Why did this happen?

Doctor Answers 12

Radiesse is Usually Best for Nasolabial Folds

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The problem you are describing is most likely due to the use of a superficial "wrinkle filler" in this area instead of a "volume filler". Several years ago a study was done where Radiesse was injected into one nasolabial fold and, in the same patient, fillers containing hyaluronic acid such as Juvederm were injected onto the other nasolabial fold. Most patients picked the Radiesse side as more natural looking. This is because of the difference between "stimulatory" fillers and "wrinkle" fillers.  When treating problems due to volume loss I will almost always use stimulatory fillers such as Radiesse and/or Sculptra. They are injected deeper, beneath the skin, and will generate more volume to create a much better lifting effect for sagging skin. They work by stimulating your skin to produce more collagen, which is why they are so effective, and give longer-lasting results too.


South Burlington Dermatologic Surgeon
4.7 out of 5 stars 12 reviews

Perlane and Juvederm Ultra Plus

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Although Perlane and Juvederm Ultra Plus have slightly different consistences, both can achieve significant improvement in the nasolabial folds.  The variation in results, between the two injection you had, is probably not related to the filler used.  Injection technique, amount of volume injected, aging, and complications such as swelling or bruising can all play a part in the outcome.  However, I do have patients who are loyal to one or the other brands of hyaluronic acid fillers and, therefore, we do keep each of them in stock.

Vincent D. Lepore, MD
San Jose Plastic Surgeon
4.7 out of 5 stars 63 reviews

Perlane vs Juvederm Ultra Plus

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Both fillers are excellent for nasolabial folds.  Perlane tends to be stiffer, Juvederm softer.  It has been 3 years since your last treatment.  Consider that you may now have deeper nasolabial folds due to time, or weight loss.  The injection technique may be different between the 2 treatments, particularly if the treating physician was different (and sometimes even if the physician is the same).


Madeline Krauss, MD
Boston Dermatologic Surgeon

Perlane vs. juvederm

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Superwoman, I think that the result had nothing to do with the product but is more likely related to how injected. Both should give equally good results. You can touch up with either one. Most important is that you let the injector use what they are most comfortable with and you make sure that they understand what you want. 

Jo Herzog, MD
Birmingham Dermatologist
4.8 out of 5 stars 20 reviews

Perlane and Juvederm work for nasolabial folds

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Both Juvederm and Perlane both work very well to improve the nasolabial folds. If you are not as pleased with the results of Juvederm it is most likely due to injection technique. If injected very close to the surface of the skin these fillers (both are hyaluronic acid) can be noticeable. This may be what you are experiencing, but without pictures it is hard to say. I would recommend expressing your concerns with the physician who performed the procedure. Hope this helps.

Jason Lichtenberger, MD
Bellingham Facial Plastic Surgeon
5.0 out of 5 stars 3 reviews

Perlane and Juvederm Ultra Plus Results Quite Similar if Done Correctly

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Although there are small differences between Perlane and Juvedem Ultra Plus, essentially identical results can be obtained with these products, when injected properly.  These products contain Hyaluronic Acid, a normal constituent of the skin, that gradually diminishes over time, with resulting loss of skin plumpness.  It is possible that, three years after your first treatment, you may require additional filler.  Also, treatment is technique-sensitive, meaning that your most recent filler was placed in a slightly different location than your first, yielding slightly different results.  Go back to the doctor who performed the treatment and I am sure that he or she will do everything possible to make you happy.

Sheldon V. Pollack, MD, FRCPC

Toronto Cosmetic Skin Surgery Centre, Inc.

Sheldon Pollack, MD
Toronto Dermatologic Surgeon

What is better Juvederm Ultra Plus or Perlane ?

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In my practice we use both options and get excellent results with both Juvederm or Perlane treatments. Each patient is assessed individually and depending upon a variety of factors, we select either one for any particular patient.

Steven Hacker, MD
West Palm Beach Dermatologic Surgeon

Perlane v Juvederm Ultra Plus

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Since you had a great correction with Perlane in the past and are less pleased with Juvederm Ultra Plus, it may make sense to use Perlane again . First, I would be certain that the injections were done by the same doctor. If not, then it may be a matter of technique rather than product. In my experience Perlane and Juvederm are similar but no where near identical fillers so be sure that you get the results you want and work with your doctor to achieve optimal results.

Shawn Allen, MD
Boulder Dermatologist

The injector is at least as important as the product injected

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Perlane® and Juvéderm Ultra Plus® are both excellent, safe hyaluronic acid [HA] fillers for use in the nasolabial fold area.

Was the second treatment done by a different physician from the first treatment? If so, it could be that you prefer the technique and aesthetic judgement of the first physician. In any event, if I were you I'd go back to the first physician [or the one who injected the Juvéderm®] to sort this problem out. One nice feature of both Perlane® and Juvéderm Ultra Plus® is that they are HA fillers and so can be quickly and easily reversed if desired by small injections of hyaluronidase into the affected areas.

Kevin C. Smith, MD
Niagara Falls Dermatologic Surgeon

Juvederm ultraplus vs perlane

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Both of these products are hyaluronic acids but the G prime of Perlane is much higher than Juvederm Ultra Plus and Perlane can support a heavier load above it at times. Possibly this may improve your outcome the next treatment. If you had the treatment by two different physicians, then it may be technique related.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 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.