Of all the available fillers, the Juvederm family of products are easily the most recognized by our patients. Juvederm products that includes Juvederm Voluma and Juvederm XC Ultra Plus are produced and distributed by Allergan Inc®. Allergan has developed and maintained a strong direct to consumer (i.e., patient) marketing campaign including television advertisements, magazine and newspaper print, and a strong internet campaign. Juvederm XC Ultra Plus, like Restylane, is a hyaluronic acid dermal filler. It is based on a naturally occurring substance found in the cell walls of our skin, hair, and mucus membranes.
Juvederm XC Ultra, like Restylane-L, does have lidocaine inside of its gel carrier, which improves patient comfort during the procedure. Juvederm XC Ultra Plus is the same parent molecule of Juvederm XC Ultra, but it has a greater degree of “molecular cross-linking”. Juvederm XC Ultra has 6% concentration of cross-linking, while Juvederm XC Ultra Plus has 8% concentration of cross linking. This increased cross-linking allows Juvederm to be much more durable. This durability translates into longer lasting results in our experience. Juvederm is the undisputed heavyweight champion of all dermal fillers in its ability to absorb water and provide effacement of moderate and deep wrinkles.
Pound for pound, Juvederm has the greatest degree of hydrophilic activity, or the ability to absorb water, as compared to Restylane, Radiesse, Belotero, etc. Juvederm is a very safe, very reliable filler that offers patients the opportunity to markedly volumize their face. Juvederm also serves a secondary role in that, because of its ability to absorb water, it serves over time to maintain moisturization of the deep dermis for months after injection.
While the company cannot scientifically say that this product improves skin water volume, most master injectors agree that Juvederm does offer the skin excellent long-term secondary moisturization, especially in patients that use the product on a regular basis.
While Juvederm XC Ultra Plus is the undisputed champion at water absorption, it also has the distinction of offering next to zero tissue lift.
In other words, unlike other fillers like a Restylane and Radiesse, the Juvederm XC family cannot provide a lifting effect to the soft tissue it treats. It has a very low g’ value, with poor overall cohesivity and viscosity. As such, it cannot latch onto tissue and pull it up. However, it can act as an internal “water beacon”, and draw hydration into the deep dermis and subcutaneous planes, offering outstanding skin rejuvenation. For Juvederm XC Ultra Plus is incredibly useful in aesthetic plastic surgery of the face. We use it routinely in the following situations:
Long term skin quality investment. For patients who want the ABSOLUTE BEST in dermal filler therapy, and who are willing to spend for it, we will commonly put 0.05ml aliquots of Juvederm into the moderate subcutaneous plane to provide long-term, 24-7 moisturization to the skin. Basically, in this instance, we use Juvederm as an internally injected moisturizer. For example, in patients that can afford the best plastic surgery available, we will commonly do our cheek injections with Radiesse Plus or Voluma, fill the tear trough’s with Restylane-L, and provide any other interventions indicated. Once complete, I will take 2-3 tubes of Juvederm XC Ultra, and microinject it into the moderate subcutaneous plane in a volume small enough so that it is not seen or felt. This small aliquot, however, will serve as a continuous internal moisturizer for the skin.
This is also a fantastic adjunct for patients undergoing laser therapies to the face. In those patients, 1-2 weeks after laser, we will then provide full face Juvederm microinjections throughout the entire face. No question that this approach is expensive, but the long-term results are absolutely fabulous. We also commonly complex this approach with Rejuvapen microneedling. By combining internal moisturization with laser resurfacing or microneedling, we are able to produce a renewal effect to the skin on multiple levels without any significant increase in downtime. While there is no stopping Father Time, full facial microinjections of Juvederm to the face sure do slow down his effects on the facial skin.
It can be used throughout the face. However, there are a number of areas where this filler should not be used:
At Ocean Drive Plastic Surgery in Vero Beach, Dr. Alan Durkin, Dr. Jimmy Chim and their team of providers deliver incredible results tailored to your needs in a relaxing and uplifting atmosphere. Learn more about the Ocean Drive difference by scheduling your one-on-one diagnostic consultation with Dr. Durkin or Dr. Chim today.