Juvederm to marionette and nasolabial lines hasn't worked? (Photos)

Juvederm typically takes 10-14 days to see optimal results. If you are unhappy with the results I suggest reversing with hyaluronidase and seeking treatment from an experienced cosmetic dermatologist. There are other options including layering with fat and combination of fillers, or lifting which may need implants or surgery. Please consult with an expert. Best, Dr. Emer 

Thank you for your questions and photographs and I am sorry that your current results have not met your expectations.  At 10 days your results may still improve as the filler material matures and softens but if you feel large lumps I would revisit your injector for an in-person evaluation.  They may ultimately need to dissolve the material if it does not clear on its own.  As far as your results, one consideration you did not mention was how much filler material was used.  These two areas often require more filler volume than people expect and can be supported by filler placement into the cheeks for further improvmeent.  As far as your vertical lip wrinkles you may see better benefit from the use of chemical peels, Botox, and a thin filler such as restylane silk or belotero.  See a board certified plastic surgeon for an in-person evaluation and discussion of treatment options. 

First, make sure you express your concerns to your injector. Juvederm can help improve the appearance of skin folds, but it cannot take the place of a facelift or skin tightening from a laser. Jowling is best treated with a facelift and will help improve the appearance of marionette lines beyond what Juvederm can do. Before and after photos (taken with your face in the same position and the same lighting in each photo) can help you see when/if a difference has occurred so that pertinent adjustments can be made to your treatment plan. It my be as simple as you may need more Juvederm or you may need something more invasive (laser, facelift, etc.). Feel free to discuss these options with your injector.

Thank you for your question. You have deep etched in lines that are best treated with a combination treatment of botox, fillers and laser resurfacing. A face lift will do nothing to address these, unless paired with an aggressive laser or deep chemical peel. When treating the peri-oral lines one must address multiple issues such a over all volume loss in and around the lips to "frame" and "reset" the lips, relax excessive movement and puckering with botox injections, and filling of the individual lines with fillers that are meant for fine line treatment such as restylane silk. Often when lines are deep, filler alone is not sufficient, and a resurfacing laser such as erbium in need not only to soften the lines, but also improve skin quality and thickness that causes lines in the first place. Best of luck!

There are many factors that may influence one's results.  We don't know how many syringes were used.  When injecting multiple areas there is usually a need to use more than one syringe.  The placement of the product is important.Lumps and bumps will lessen in weeks.  Before you consider more Juvederm ask about any other procedure that may benefit you, including facelifting and skin resurfacing.I always recommend returning back to your doctor.