Why is Juvederm only lasting two weeks in marionette lines?

Juvederm typically works quite well in marionette lines in the far majority of patients. It usually lasts 9-12 months, sometimes longer. I would really like to know if the marionette lines are visibly gone immediately after your Juvederm injections. If so, then I am confused as to why the result doesn't last for more than a couple of weeks.If your marionette lines are not improved immediately after the injection, but rather they get better in the first hour or two after the injections, then you are just seeing the effects of the swelling, and that will go away within 2 weeks. By the way, most 59 year olds need 2-3 syringes of Juvederm just to get rid of the marionette lines. If you have been getting less than that, then your injector is most likely not treating the lines aggressively enough.I'd discuss your concerns with your injector, or consider seeing another for a second opinion.Andrew Campbell, M.D.Facial Plastic SpecialistQuintessa Aesthetic Centers

Often this area requires a more robust filler like Radiesse or bellafill or even fat injections.  HA fillers like juvederm sometimes have an afinity to dissolve in these areas, you may need to try a more particulate filler like lyft.  I suggest seeing an expert.  Best, Dr. Emer.

It is possible that you are not noticing much improvement because the lines are very deep or you may need the product injected in the mid-face to lift it away from these lines. It would be best to post before and after photos as well.  I would consult with an experienced dermatologist who does a lot of facial cosmetic injections.  Best, Dr. Green

Thank you for asking an important question.  While many people notice and wish to correct the nasolabial folds (line from corner of nose to corner of mouth), your physician needs to address the underlying cause of these lines on you.  Aging is a three dimensional process involving bone loss, muscle loss, fat compartment loss, and skin changes.  Most often, the etiology of nasolabial folds (NLF)is not "volume loss" of the NLF.  Typically, the temples and mid face need to be addressed to minimize the nasolabial folds.  In my practice, I use a variety of options including Voluma, Volift, Restylane Lyft, Sculptra, Radiesse, lasers, microneedling, and radiofrequency to individualize treatment for a patient.  I often see results that last several years.  It is not the filler (product used); it is the Filler (meaning the physician injector) that produces amazing results.  Please revisit your board certified dermatologist or plastic surgeon to see if you actually need upper face or mid face correction rather than simply injecting your nasolabial folds.  Best of luck,Suneel Chilukuri, M.D.Houston, TX

Hi thereJuvederm should be lasting longer than 2 weeks.  Its possible you are seeing the effects of swelling initially, and then as the swelling goes down it does not look as impressive.  It may be that you need more filler.  You might look over filled for a week or two, but once the swelling goes down it  should settle out.  Another suggestion would be to try another product.  Try restyalane next time.  Your body may just chew up the juvederm more quickly, and another product might not have the same effect.  Another option is fat grafting.  Fat will be much longer lasting but is more invasive since it needs to be harvested from somewhere.  Good Luck