Restylane vs Juvederm

What should I ask my doctor before getting a Restylane or Juvederm injection? I don't want to look lumpy or unnatural. It's for naso-labial folds and my eye area.

Doctor Answers 51

Restylane, Juvederm, and Other Fillers for Nasolabial Folds and Eyes

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I would only inject Restylane under the eyes. This is also the general consensus from the various cosmetic seminars from the March 2016 American Academy of Dermatology Annual Meeting. Juvederm is too hydrophilic and can cause excessive swelling under the eyes, and it is also more likely to cause a Tyndall effect (bluish discoloration) under the eye. Other HA fillers such as Restylane Silk and Belotero do not cause a Tyndall effect, but Restylane Silk also tends to cause more temporary swelling than Restylane and Belotero does not last as long as Restylane.

There are many different fillers, Restylane, Restylane Lyft (formerly Perlane), Juvederm Ultra and Ultra Plus, and Radiesse that can be injected into the nasolabial folds. However, a global assessment of the face is necessary before injecting the nasolabial folds, as loss of cheek volume which results in cheek sagging will often accentuate the depth of the nasolabial folds, in which case injecting filler to replace cheek volume will dramatically reduce the appearance of the nasolabial folds, as well as rejuvenate the face.

I agree with previous comments that the experience of the injector is as important as the filler being used. Make sure they are board certified in dermatology, plastic surgery, or ENT.

New York Dermatologist

Juvederm vs. Restylane

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There is very little difference between the two products as far as longevity is concerned — clinical studies led to the labeling with the products.  Restylane was the first to market and did a six month clinical trial – it worked and it became the label.  With the right injector, Restylane lasts longer than six months.  They next did a trial where they did two injections at 4 month intervals and showed that they could get results up to 18 months – so not bad.  Juvederm's clinical trial was 9 months – extended out to one year.  It worked. The most important thing is to find a skilled injector who knows the subtle differences in flow characteristics of the products and is comfortable with each of them.

Michael Gold, MD
Nashville Dermatologic Surgeon
3.9 out of 5 stars 17 reviews

Experience with either Restylane or Juvederm is essential

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Juvederm and Restylane are very similar products, both of which are hyaluronic acid-based fillers. Both are manufactured in Europe. The manufacturing process is slightly different between the two products. I find that Juvederm goes in a little smoother and has a silkier texture as compared to Restylane.

The critical factor when injecting these products is having someone, preferably a board certified Plastic Surgeon or Dermatologist do the procedure. I find that that injecting the lower eyelid area the most difficult - conservative injection is critical. If one is over-zealous with this area excessive puffiness may result. It is important also that your physician has a sense of aesthetics, and that you do not get an unnatural "weird" look. The physician should also feel comfortable treating the potential risks of the procedure such as lumpiness or excessive augmentation

Wilfred Brown, MD
New York Plastic Surgeon

Choosing the right filler - Restylane versus Juvederm

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This is a common question asked by many patients everyday. Which filler is the best for me?  Most of the fillers on the market are made of hyaluronic acid, a carbohydrate polymer that is found extensively in joints, neural tissue and especially the skin. When hyaluronic acid is injected it can be used to correct facial hollows, minimize wrinkles, and augment desirable features such as the cheeks and the lips.

The choice of a hyaluronic acid filler, such as Restylane of Juvederm, depends on the area to be injected and the specific needs of the patient. Differences in the manufacturing process affect the properties of each filler - how much water they bind, their cohesiveness, their relative 'hardness'', the forced needed to inject them, their durability and how they reflect light from the skin.  I prefer Restylane for the under eye hollow because the product is less likely to imbibe too much water and cause puffiness. Around the mouth area I like the "water loving" nature of Juvederm and its relative smoothness. 

Ultimately the choice of a filler comes down to the preference and experience of your provider.

Brock Ridenour, MD
Saint Louis Facial Plastic Surgeon
5.0 out of 5 stars 126 reviews

The choice you make will depend on how you look for the next 6 months

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Does your doctor perform the injections himself? Is he even interested in performing the injections? Many otherwise fine surgeons view fillers as a nuisance, or delegate this task for business reasons.

Others are cavalier and will inject anything new, whether it is legal in this country or not, whether or not it has been proven safe (and no, that doesn't just mean FDA approval, as the many reports of granuloma formation for FDA approved substances shows).

Where and how fillers are injected will directly impact how you look the next 6 months of your life. And if you are receiving ill advised injections such as silicone, for the rest of your life.

Once you have screened for credentials (i.e. board certification), you should have confidence that your doctor has your best interest in mind. You should feel confident that he has a plan based on carefully listening to your needs. You should feel confident that he is safe. You should feel confident that he is aware of the risks and benefits of fillers, not only by themselves but as a plan for your overall rejuvenation over time.

Many patients have expressed dissatisfaction with their fillers in the blogs. When you look more carefully, there are 60+ women who would benefit from skillful plastic surgery but instead have placed all their hopes in a few syringes of Restylane, an unrealistic and ill-informed plan destines to produce dissatisfaction when the results don't deliver. Apparently nobody ever told them that their skin was sagging and that is why the $2000 they just spent for Restylane did not fix their problem.

Your doctor should discuss all the options with you, not just pump fillers.

If you don't get a definite yes on all these counts, you should move on. It's that important.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 195 reviews

Juvederm for the Lips or Tear Troughs, Everywhere Else it Doesn't Really Matter

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Juvederm Ultra is slightly smoother to inject and slightly less likely to form a bump, compared to Restylane. For "unforgiving" areas, like the lips and tear troughs, I think Juvederm is a better product because it has a smoother consistency. For "forgiving" areas, like the nasolabial folds, marionette lines, frown lines, etc..., I think Juvederm or Restylane are fairly comparable, lasting about 6-8 months on average.
If cost is a consideration (and both cost about the same per syringe), I often recommend Restylane. The reason is that Juvederm has 0.8cc in a syringe, while Restylane has 1.2cc in a syringe. Therefore, you have more material to use with one syringe of Restylane, enabling more folds and wrinkles to be improved. Unfortunately, Juvederm doesn't come in any other size, while Restylane also has a 0.4cc syringe (which is cheaper because it is 1/3 the amount of a 1.2cc syringe).
Similary, if a person needs more than one syringe of product for correction, it takes 3 syringes of Juvederm (2.4cc) to equal the amount of product in 2 syringes of Restylane (total 2.4cc). This means you have to spend money to purchase an extra syringe of Juvederm.
I think the decision of which to use between these two fillers should be a mutual one between you and your treating physician. Treatment goals, area to be treated, cost, and amount of product required are all key factors.

Anurag Agarwal, MD
Naples Facial Plastic Surgeon

Restylane, Juvederm, Radiesse and Fat

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Different Strokes for different folks.

Fine lines around the mouth- Juvederm or Restylane (juvederm is smoother and lasts longer)

Nasolabial Folds - If the folds are deep without fine wrinkles use Radiesse, Juvederm or Fat. Both synthetic fillere are long lasting. Juvederm is easier to inject and less painful. Fat will last the longest and is all-natural.

Nasojugal Gooves - The creases below your eyes are best treated with Fat,Restylane or Juvederm. Both synthetic fillers do well although it is easier for the surgeon to apply Juvederm and shape it to the deformity. The best way to treat this area by far is fat injections. The volume necessary to adequately correct these depressions may sometimes be up to 4cc per cheek. That is only available at a reasonable cost when injecting your own fat.

Larger Lips - Juvederm or Restylane, although both will not last as long as if they are injected into other areas of the face.Fat is still great in the lips. It will last for a long time and the volume necessary is not a limitation.

Robert M. Freund, MD
New York Plastic Surgeon
4.8 out of 5 stars 34 reviews

What to Ask Before Having Fillers

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Hi Kerry,

There is a saying, "It's filler, not the filler" that determines your results. In other words, choose your injecting physician carefully. Ask if they are board certified in one of the cosmetic specialties (plastic surgery, facial plastic surgery, ENT, dermatology, oculoplastics), and ask how they received their training. Ask them what kind of side effects or complications that they have seen.

Restylane and Juviderm are both very good fillers. They can both be reversed with hyaluronidase if too much is placed. I have never needed to reverse Restylane while I have had two experiences with Juviderm where there was excessive persistent swelling. Therefore I do not use Juviderm under the eyes. So if you were my patient having both the eyes and nasolabial folds treated, I would recommend Restylane for you. Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

Top 6 Are Questions to ask about Facial Fillers: Juvederm and Restylane

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Facial fillers are one of the most common non-invasive treatments around the world. In the United States, Juvederm and Restylane have become the two most popular hyaluronic acid type fillers. Important questions to ask your physician:

How much experience have you had with facial fillers in the lips, tear trough area, or nasolabial folds?
Have you experienced any complications with fillers in the lips, tear trough area, or nasolabial folds?
How would you treat the complications (nodules, bumps, overcorrection, undercorrection) if I developed any?
Can you show me before and after pictures of the fillers?
What options do I have for anesthetic before the procedure?
Can you go over my post-procedural instructions before treatment?

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Juvederm or Restylane for Lip Augmentation

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The answer is to first choose the right doctor, then be sure your doctor is using the right material. I use Hyaluronic acid products, including Juvederm Ultra, Juvederm Ultra Plus, Restylane, Perlane and Prevelle. For permamnet lip augmentation I use autologous fat injections.

In my plastic surgery practice, patients seeking natural looking lip enhancement should ask the following questions:

  1. How much experience does the surgeon have with soft tissue augmentation by injection?
  2. Does the surgeon numb the area prior to injecting the lip? It is easier to get a perfect result if the patient is comfortable.
  3. Have other options been discussed? Fat grafting is a permanent method of filling lines and enhancing lips. Individuals requiring more than one syringe of Restylane for the result they desire may want to explore fat grafting, a safe and permanent alternative to Restylane.
  4. Does the physician have patient photos to share with you and patients to speak to about their experience with lip augmentation? Amost all plastic surgeons have performed lip injections on many staff members. You should be able to see their work in person on both front office staff, medical professionals and aestheticians.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 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.