In the 1930s, researchers discovered a natural substance in the body that they named hyaluronic acid. They found that it plays a key role in numerous areas of the body including the maintenance of skin volume and hydration, eye volume and shape, as well as joint lubrication and cushioning.
In the decades since, numerous therapeutic and aesthetic uses have been developed for hyaluronic acids. In 2003, the U.S. Food and Drug Administration (FDA) approved the first hyaluronic acid dermal filler for the correction of facial wrinkles and folds, such as nasolabial folds (the folds running from the sides of the bottom of the nose to the outer corners of the mouth).
Hyaluronic acid retains water -- absorbing more than 1,000 times its weight -- and adds volume to the skin's surface. In addition, hyaluronic acid binds with collagen and elastin and transports essential nutrients to these fibers. The triple combination of collagen, elastin and hyaluronic acid provides structure, elasticity and volume to the skin and contributes to its overall appearance. The hyaluronic acid in Juvederm® is called non-animal stabilized hyaluronic acid (NASHA) because it is not derived from animal sources.
Juvederm® Ultra (also called Juvederm®) is a next-generation, cross-linked hyaluronic acid dermal filler approved by the FDA in June 2006 for treatment of nasolabial folds. Juvederm® Ultra (also known as Juvederm®) adds volume to the face and smoothes moderate to severe facial wrinkles and folds. With advanced injection techniques, Juvederm® can also be used to lift and contour facial features.
Cross-linking refers to a process in which the individual chains of hyaluronic acid are bound or 'cross-linked' together, transforming the liquid hyaluronic acid into a soft gel. The firmness of the gel depends on the degree of cross-linking of the individual hyaluronic acid chains. The body metabolizes cross-linked hyaluronic acid more slowly, resulting in a longer duration of effect.
As an advanced, cross-linked hyaluronic acid, the results of a Juvederm® treatment will typically last up to a year or more. Results will vary depending upon injector technique, the facial area in which it is applied, and upon the individual's muscle movement, skin and health characteristics. For example, in areas of the face where there is less exaggerated muscle movement, Juvederm® will often last longer. Regular BOTOX® treatments in conjunction with Juvederm® may help extend the duration of Juvederm®.
Juvederm® Ultra Plus (also known as Juvederm® Plus) is even more cross-linked than Juvederm® Ultra. Juvederm® Ultra Plus is used by physicians to treat deeper wrinkles and folds. Physicians also use Juvederm® Ultra Plus in liquid face lift procedures where more bulking or more defined sculpting is desirable. It provides more volume than Juvederm® Ultra and some other dermal fillers.
In October of 2013, the FDA approved the first and only Hyaluronic Acid filler, Juvederm® VOLUMA™ injectable gel, to instantly add volume to the cheek area. Hyaluronic Acid (HA) is a naturally occurring, hydrating substance found in your skin. As you age, you start to lose HA, which causes the skin to lose structure and volume. VOLUMA™ works to restore contour and a more youthful appearance by providing a subtle lift, for up to two years in patients over 21 years of age. VOLUMA™ is different than any other Juvederm® injectable gel filler product, in that VOLUMA™ is formulated to add volume to the cheek area, whereas other products target moderate to severe wrinkles and folds around the nose and mouth areas.
Juvederm® VOLUMA™ lasts longer than other HA dermal fillers, lasting up to two years! This means fewer injections and less overall downtime.
After 24 hours of treatment with VOLUMA™, you should be able to resume your normal activities. Side effects are moderate and generally last 2 to 4 weeks. Common side effects include temporary reactions at the treatment site such as tenderness, swelling, firmness, lumps/bumps, bruising, pain, redness, discoloration, and itching.
Juvederm® VOLBELLA™ XC is among the most recent additions to the Juvederm® collection. Like the other Juvederm® fillers, Juvederm® VOLBELLA™ XC is a hyaluronic acid-based gel, which combines a lower concentration of HA along with Allergan’s patented VYCROSS™ technology to add subtle volume to the lips, and to soften the appearance of vertical lip lines. This combination of small HA particle size and VYCROSS™ technology makes Juvederm® VOLBELLA™ XC perfectly suited for fine lines in delicate areas around the mouth, and results in a softer, more natural look with reduced swelling compared to other fillers.
In addition to effectively increasing lip fullness and softening the appearance of lines around the mouth (perioral rhytids), Volbella™ XC has also been successful in treating fine lines on the forehead and around the eyes (crow’s feet). The patented technology produces a soft, natural look, with results lasting up to 12 months from a single treatment.
Due to the low HA concentration, and ultra fine needle, side effects are often minimal, and patients can resume their normal activities immediately after treatment. Common side effects include minor swelling and bruising around the treatment area, and generally last 30 days or less. Consult your physician for a complete list of Volbella™ XC side effects, and to determine if Juvederm® VOLBELLA™ XC is right for you.
Over time, skin loses its elasticity, which contributes to moderate to severe parentheses lines around the nose and mouth (the nasolabial folds). Juvederm® VOLLURE™, approved by the FDA in March 2017, is a next-generation hyaluronic acid-based gel filler that adds volume to smooth those lines and folds, providing natural-looking, subtle, and long-lasting results. In clinical trials, patients reported seeing desired outcomes for up to 18 months.
Juvederm® VOLLURE™ is specifically tailored with a balance of gel firmness and low cohesivity, resulting in a versatile formula that adds subtle volume for the correction of moderate to severe nasolabial folds and wrinkles. Juvederm® VOLLURE™ is manufactured using Allergan’s patented VYCROSS™ technology, a unique process that provides a high concentration of cross-linked hyaluronic acid for long-lasting results.
Juvederm® VOLLURE™, like other fillers in the Juvederm® collection, can also be used to subtly enhance and contour lips. Patients may experience some side effects at the site of injection, such as firmness, swelling, lumps, bumps, redness, bruising and itching. Side effects are generally mild and in most cases do not last longer than a week.
The most common side effects of Juvederm® Ultra, Juvederm® Ultra Plus, Juvederm® VOLUMA™, Juvederm® VOLBELLA™, Juvederm® VOLLURE™ include temporary redness, swelling, bumps and bruising. Consult your physician for a complete list of JUVEDERM® side effects and to determine if JUVEDERM® is right for you.
W. Grant Stevens MD FACS, Marina Del Rey, CA
Richard Fleming MD FACS, Beverly Hills, CA
Kimberly J. Butterwick MD, San Diego, CA ~ Susan M. Hughes MD FACS, Cherry Hill, NJ
Cynthia Elliott M.D., Clearwater, FL ~ Deason Dunagan M.D., Huntsville, AL
Wm. Stephen Martin M.D., Mobile, AL ~ Paul M. Friedman MD, New York, NY
Lydia Parker M.D., Willoughby, OH ~ Lydia Parker M.D., Beachwood, OH
Paul M. Friedman MD, Houston, TX