Getting Juvederm Plus, is it okay when you have regular Juvederm in your cheeks?
Doctor Answers 14
You can have different thicknesses of fillers at the same time, but keep in mind thicker fillers should be placed deeper
Thank you for your question. You state you had 6 syringes of Juvederm placed for acne scars, and you’re going back for a touchup. I believe you were offered Juvederm Plus or Juvederm Ultra Plus, and ask if it’s okay to have 2 different types of fillers, or if it’s better to stick with the one you started with.
I can give you some guidance on this, even in the absence of a photo. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon practicing in Manhattan and Long Island for over 20 years. I use a lot of fillers in my practice and treat a lot of acne scarring. The application of this whole spectrum of fillers includes not only fillers in the Juvederm family, but also Restylane. We also treat acne scars with regenerative medical technology like platelet-rich plasma (PRP) and platelet-rich fibrin matrix (PRFM), as well as fat grafting, so I am very familiar with this type of question.
To begin with, it is very good to hear you are satisfied with the result. The challenge with acne scarring is diagnosing the type of scar, and using the right strategy to maximize the outcome. Chances are with 6 syringes of Juvederm prior, you were getting a lot of injections intradermally within the scar, and probably some subdermal under the skin. The difference between the 2 products has to do with the relative thickness and viscosity. There is basically a direct correlation - the thicker the product, the longer it lasts., but thicker fillers are meant to be placed deeper.
When treatment is more superficial, setting aside acne scars using an example like lips or fine lines or wrinkles. If you use a thicker product, it doesn’t fit very well and can create an elevation that’s undesirable. When you place the material deeper, it can really work out very well. We actually do a procedure called structural volumizing where we routinely use Juvederm Ultra Plus to augment and enhance the cheekbone, the jawline, the chin. We place it deep at the bone level, under the muscles and it lasts a long time and it provides correction for a longer period.
I think the reason your doctor is considering Juvederm Ultra Plus may be based on the response of certain areas of the acne scarring which didn’t hold up well with the Juvederm Ultra. The natural thinking for a physician is if something less thick didn’t provide correction, maybe something thicker will. The coexistence of the product is no problem at all as they are all in the family of hyaluronic acid. As I mentioned earlier, it is routine for us in acne scarring to combine hyaluronic acid with platelet-rich plasma (PRP). Every doctor approaches acne scarring from the lens of their experience and their experience using certain products and strategies.
I think it’s perfectly fine to get more clarification. Speak to your doctor about why the choice was made to go to Juvederm Ultra Plus. I suspect it’s not about the longevity, but rather about the ability to maintain its shape in certain areas where it might be of greater benefit. I hope that was helpful, I wish you the best of luck, and thank you for your question.
Thank you for your excellent question. The various Juvederm products differ in their thickness and longevity. They are commonly used together, depending on the areas being treated. Please be sure to see an expert injector for an in-person consultation to fully discuss your goals and expectations in order to determine the best treatment plan. Hope this helps and best wishes!
Juvederm Ultra and Ultra Plus
The two Juvederms are often used together. Juvederm Ultra Plus is longer lasting and is typically used for deeper injection. It may or may not be the right filler for the acne scars that are left. Your dermatologist can make that determination. If you have superficial depressions left it is possible that you need a little more Juvederm Ultra.
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