This is my first experience with fillers and I have nothing but good things to say. I asked the derm about the nasolabial folds and we discussed the pros and cons of the different fillers. He recommended Juvederm for my skin and warned me I might bruise a bit. I did but I bruise when I bump against a door so I am not surprised. Slight bruising lasted 2-3 days. I had both topical and injected anesthetic so no pain. He only used half a syringe and I'll use the other half within 6 months. The results were subtle but instant: I look less pinched, if you know what I mean. My derm explained that we don't really know about longevity since it's new on the market but that I could reasonably expect 6 months.
Updated September 6, 2009
I first wrote a review in August 2007, when I had my first injections. At the time I used 1/2 syringe in my NL folds and around the mouth (done properly, it lifts up the corners). I returned 6 mos later for the second 1/2 of the syringe and have kept up with the injections so have now had 3 syringes in all. With repeat use, I have to say it really does last longer. My doctor was the one to point this out but I absolutely agree.
Some thoughts based on my experience:
-- Cosmetic dermatology is both a science and an art. You need a doctor who is skilled at both. I would never, ever (never!) get this procedure done at a medi-spa. In a best-case scenario, you find a doctor who is treating people with skin cancer and doing cosmetic work on the side.
-- My face is small so others made need more of the product but my derm errs on the side of caution, which is absolutely what you want. More can always be added. I once saw a woman come out with complete trout-pout but she was clearly pleased. I saw her around town a few weeks later and this is just her aesthetic. This confirms that you should find a derm who listens and works to give you the effect that you want.
-- Now I have the injections in my folds, around my mouth, under the eyes, and a bit above the center of the eyebrows. I branched out a bit because I actually wasn't using the whole syringe on my folds and it would have gone to waste otherwise. As it turns out, the slight bit under my eyes has made a tremendous difference.
-- I have learned how to manage the bruising. The key is ice, ice, baby. The derm assistant fills a small plastic bag with ice and I use it until it all melts. I know it makes a difference because I somehow missed a spot this week and this is the one spot I have a bruise. I also use arnica both topically and orally.
-- Sometimes it hurts more than others. I actually think the pain is greater before and during the menstrual cycle, for what it's worth. This last time was almost painless, even under the eyes, where I didn't have any topical anesthetic. I think one's sensitivity to pain varies and is not always predictable.
-- You shouldn't sleep on your side until it's "set." I'd say give it 2 days at minimum.
-- My derm says "take it easy for the rest of the day" so I go as late as possible and then spend the evening watching movies or reading. If you're swollen, ice. If you're sore, ice. Regardless, ice.
-- You won't really know what it looks like for 3-4 days.