Practical use of Juvéderm: early experience

This article is intended to provide practical information on the use of Juvéderm Ultra and Juvéderm Ultra Plus injectable gel fillers and to highlight differences between the injection techniques and uses of these fillers and those of gel-particle suspensions. The author's purpose was to provide early information to clinicians who perform aesthetic surgery.

The author discusses the properties of the Juvéderm family of products, compares these with particulate gel fillers, and makes recommendations for achieving optimal outcomes with Juvéderm as well as dermal fillers in general.

When correcting relatively fine and superficial lines, or for first-time treatment of the lips, Juvéderm Ultra is preferred. Juvéderm Ultra Plus is useful for correction of deeper wrinkles and folds. Cohesive, homogenous gel fillers such as Juvéderm require gentle, gradual injection, which facilitates very accurate delivery to the site while minimizing the risk of disengagement of the needle from the Luer lock hub of the syringe. These fillers appear to remain in the desired location and do not flow away from the injection point into unintended areas, so that a somewhat smaller amount of filler is required for a given degree of correction. Both the Juvéderm preparations tend to blend in with the treated area in a shorter period of time compared with gel-particle suspensions. Finally, cohesive gels appear to be associated with a lesser degree of swelling in the 24-hour period after the procedure, particularly in the lips.

Juvéderm Ultra and Juvéderm Ultra Plus are new-generation hyaluronic acid fillers used to treat superficial lines and deeper folds, respectively. They require administration by gentle, gradual, and precise injection.