Injectable Filler
Posted January 22, 2010 7:23 PM in Injectable Fillers
Question:
What is Juvederm and what is it used to treat?
Answer:
Juvederm is an injectable filler. It is made of hyaluronic acid which is a substance that is found naturally in our bodies. Unlike collagen, which may require allergy testing, Juvederm does not require allergy testing. We use Juvederm to add volume to specific areas of the face depending upon what the patient's concerns are and what they would benefit most from. For example, the smile lines, also called the nasolabial folds, may become deeper over time. Juvederm is an excellent option for filling these lines and providing a more youthful appearance.
Another use for Juvederm is lip augmentation. Thin lips may result with time or may be due to hereditary causes. In either case, I use Juvederm to add volume to the lips. However, this volume is very natural in appearance. I do not inject too much volume into the lips, therefore I am able to achieve very natural results with natural volume and a natural appearance for the patient. Furthermore, we use a dental block so that the lip augmentation is virtually painless. Another area that I use Juvederm is for deep frown lines. While Botox can help minimize the frowning muscles and thus limit the depth of the line, if the line is very deep Botox alone will not treat this line effectively. Therefore, I use a combination of Botox and Juvederm to provide complete treatment of the frown lines.
I also use Juvederm for the hollowness beneath the lower eyelids. Over time we develop fullness in the lower eyelid region due to bulging of fat in the lower eyelid. At the same time, the cheek tissues descend and lose volume. Juxtaposed in between the fullness of the lower lid and the descent of the cheek is a hollowness that is sometimes called the tear trough deformity, nasojugal groove or infraorbital hollow. While I perform lower eyelid surgery for some patients to transpose or reposition the lower eyelid fat into the area of hollowness, some patients prefer a non-surgical option. In this case, I use Juvederm to fill the infraorbital hollows to provide a more youthful contour between the lower eyelid and the cheek.
While the FDA studies have shown Juvederm lasts approximately 12 months, I see in my patients a variety of lengths of duration for Juvederm. Some of this depends upon the location of augmentation. For example, in and around the areas of the mouth where there is a lot of muscle movement, Juvederm may last approximately four to six months. However, in the lower eyelids where there is less muscle movement, Juvederm may last approximately 12 to 18 months. Juvederm is not a permanent filler and if a patient develops a significant lump, Juvederm can be reversible with the use of an enzyme called hyaluronidase.
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Injectable Fillers
Posted January 15, 2010 3:32 PM in Injectable Fillers
Question:
What is best injectable for improving marionette lines and how long can I expect the results to last?
Answer:
I prefer to use a hyaluronic acid filler for the marionette lines. One can also use calcium hydroxylapatite (Radiesse) to fill in deeper marionette lines. However, I find great success and very pleasing results aesthetically with the use of hyaluronic acid fillers for the marionette lines. The hyaluronic acids include Juvederm, Restylane and Perlane. I tend to prefer Juvederm because of its smoother application. Furthermore, Juvederm came out with a new product that mixes numbing medicine with it. Using this new product, filling the marionette lines can be done in a relatively painless fashion. Any lumpy or bumpy contour irregularities following injection can be massaged. Any persistent contour irregularities can be treated with an enzyme called hyaluronidase which will diminish these bumps or lumps after 24 to 48 hours. Though I inform patients that Juvederm in and around the mouth/lips tend to last approximately 4-6 months, many of our patients experience the benefits of Juvederm lasting nearly 12 months.
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Injectable Fillers
Posted January 12, 2010 10:43 AM in Injectable Fillers
Question:
Over the past year I have had a few injections of Juvederm. The results have always been good until the last injection. I now have small lumps under the skin that are visible. What can I do about this? Will it clear up and when?
Answer:
Juvederm is made of hyaluronic acid. Hyaluronic acid is a biological product with its origins from substances found in our body. It is not a permanent filler. I use Juvederm to fill fine lines and wrinkles throughout the facial area as well as add volume to certain areas, such as in lip augmentation or non-surgical lower eyelid procedures. Juvederm lasts approximately 12 months. However, I believe this is dependent upon the area injected. For example, if Juvederm is injected in and around the mouth area it may last approximately four to six months. Some of our patients report benefits from Juvederm injections in the lips for greater than that. However, when we inject Juvederm in and around the lower eyelids where there is very little muscle movement, Juvederm can last greater than 12 months. Following the injection of Juvederm, one may experience some swelling. Contour irregularities are rare following injection. If they occur, the lumps or bumps can be managed with massage. If the lumps or bumps are persistent, however, one can have these areas injected with an enzyme called hyaluronidase which will dissolve the lump or bump if it is a collection of Juvederm within 24 to 48 hours.
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