JUVÉDERM® Ultra Plus XC

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Aging is an organic process that signifies the delicate progression of life and endows us with gains such as wisdom and experience, but it is also one in which we have a lot of losses. In terms of our appearance, we lose elasticity, collagen, volume, subcutaneous fat; and therefore we lose our confidence. Along with aging, exposure to environmental elements such as the sun, poor health, smoking, medications, and other factors make our skin age as well. The building blocks that supported our beautiful and youthful skin begin to deteriorate, but luckily there are treatments that can be done to repair and restore those blocks. Injectable filler treatments such as JUVÉDERM® Ultra Plus XC will help us gain back what we have lost.

WHAT IS JUVÉDERM® ULTRA PLUS XC?

JUVÉDERM® Ultra Plus XC (familiarly known as Juvederm or Ultra Plus) is an injectable dermal filler that restores facial harmony and youthful glow in the lower part of the face. As a member of the distinguished JUVÉDERM family of fillers, Ultra Plus is backed by years of clinical trials and millions of clients that have been able to successfully smooth or plump moderate to severe facial wrinkles and folds in the lower part of their face. Best of all, they were able to regain their confidence.

Juvederm is made of hyaluronic acid (HA) which is a a naturally occurring sugar found in the body, predominantly in the skin, between the joints, and in the eyes. The modified form of HA used in Juvederm made via Hylacross™ technology (which makes the material smooth versus granular) resembles a fluid and clear gel. HA works by absorbing water (which helps skin retain softness and suppleness), delivering nutrients, and acting as a volumizing agent (whether adding volume to skin or cushion around joints).

HOW DOES JUVEDERM WORK?

Juvederm works by relying on the main ingredient, the HA, to add volume and fullness to injected areas (as the name”filler” suggests). It acts like a sponge of sorts, taking in moisture and expanding to physically fill out lines and hollows. The material is administered via fine needle injections to areas of interest, and is able to mimic natural facial fullness by binding to water and offering hydration and volume in return. Further, the injected HA induces your own collagen production which would further plump the skin. The improvement will be so subtle that everyone will notice, but nobody will know.

WHAT AREAS CAN YOU TREAT WITH JUVEDERM?

Juvederm is designed for correcting moderate to severe facial wrinkles and folds around the nose and mouth, and for plumping the lips. Therefore, the most common uses for Ultra Plus include enhancing lips, shaping lips, smoothing nasolabial folds (laugh lines, those that go from the nose to the corner of the mouth), correcting marionette lines (those that go from the corner of your mouth to your chin), filling in depressed areas (areas with fat/volume loss) in the lower face, and other creative uses. The consistency of HA in Juvederm is only recommended for particular uses depending on client skin and goals, so it is best to consult with one of our knowledgeable providers here at Lavande to see if Juvederm is the best option for your needs.

WHAT ARE THE CREDENTIALS OF JUVEDERM?

The first instance of JUVÉDERM that was approved by the FDA (Food and Drug Administration) for the temporary correction of moderate to severe facial wrinkles and folds penetrating the mid to deep dermis was in June 2006, but this HA filler did not contain the additional lidocaine ingredient. This product was the foundation for the later FDA approval of JUVÉDERM® Ultra XC and JUVÉDERM® Ultra Plus XC in January 2010, both HA fillers with lidocaine added for injection comfort. Both are indicated for the same injection in the mid to deep dermis to correct moderate to severe facial wrinkles and folds (namely, nasolabial folds). The Ultra Plus is a slightly thicker and more viscous gel as compared to the Ultra, which is why we here at Lavande have chosen this filler product over the other. In October of 2015, these products become FDA approved for the augmentation of lips as well.

WHAT SHOULD I EXPECT FROM JUVEDERM TREATMENT?

It is comforting to know what to expect with a treatment that includes needles in the face, so we have detailed pre- and post- treatment instructions below so our clients can come into their appointments confident and ready.

It is highly recommended to consult with one of our aesthetic professionals here at Lavande prior to booking your filler appointment. This is to determine the best course of action for your aesthetic needs, determine which filler is right for you and your skin type, and to prepare you for your filler appointment. In preparation, we ask that you abstain from taking bloodthinners or non-steroidal anti-inflammatory medications (such as alcoholic drinks, Ibuprofen, Aspirin, Advil, Aleve, Fish Oil, Vitamin E, and others) for a couples days before treatment. This will lower the possibility of thinner blood causing bleeding, bruising, and swelling during/following treatment. In addition, we here at Lavande will offer our filler clients complimentary Arnica, which is a natural oral medication that has anti-inflammatory properties and will further prevent the likelihood of bleeding, bruising, and swelling. This should also be taken starting a couple days before treatment.

When you come in for your treatment, if a personal evaluation synthesizing your medical history and aesthetic goals had not been completed before, it will be done at that time. We here at Lavande want to make sure you are a candidate for this treatment as well as confident about your decision to proceed with the injectable gel treatment. The treatment area will be examined by our skilled and knowledgeable practitioner before injection, and private “before” pictures will be taken for comparison purposes and kept in your profile. Once examined the treatment area will be prepared by being cleaned with antiseptics, and a topical BLT (Benzocaine, Lidocaine, Tetracaine) numbing agent will be applied to sit for 30 minutes.

During treatment, our provider will begin by determining the most strategic injection sites that adhere to your aesthetic goals and needs. Using a fine gauge needled syringe, our provider will skillfully and softly begin injecting small amounts over multiple injection sites, while pausing for short intervals of time between injections to allow for the lidocaine numbing agent present in the gel to take effect. Also in between injections, our provider may rub injection sites with their fingers to mold the desired result with the filler and make sure the gel is distributed evenly under the dermis. They will also provide clients with a mirror to watch the smoothing and plumping of their skin take effect in real time, as well as to provide constructive feedback. Finally, an ice pack will be provided to clients to apply until they get home, in order to minimize pain and swelling. In total, the treatment should take about 30-60 minutes, but we will book the full hour in order to assure that all client needs are met and all questions answered.
Recovery time following JUVÉDERM® Ultra Plus XC treatment can be anywhere from a day to a week. Most people can resume daily activities following treatment, although they might have slight swelling immediately following treatment. Some clients develop bruises after about a day, and this can take anywhere from 3 days up to 5 days to subside. For the first 24 hours, it is recommended to avoid exposure to sunlight and high temperatures, and also to abstain from strenuous exercise and drinking alcohol, in order to evade any increase in redness, itching, swelling, and to avoid filler breakdown. Clients are advised to make a follow-up appointment for 1 month after filler treatment in order for our aesthetic professionals to examine treated areas and assure appropriate targeting of problem areas, evenness of treatment areas, and to determine whether more filler would be recommended.

WHEN WILL I SEE MY JUVEDERM RESULTS?

Clients can watch the HA gel work its magic during the treatment, witnessing plumping and smoothing with a mirror provided by our practitioner. Improvement is visible immediately following treatment, however the full result will not be visible until about 4 weeks following treatment. This is because swelling inflates results right after treatment, and it takes time for the HA to absorb moisture and for new collagen to form. It will take about a month for swelling to go down, the material to fully settle, and collagen production to be to successful; only then will the final result be present and touchups can be pursued.

HOW LONG DOES JUVEDERM LAST?

A majority of subjects enjoyed results for up to 1 year in the clinical trials. However, results will vary for clients depending on multiple unique factors including their metabolism (how fast their body naturally breaks down the material), their aesthetic goals, and more. Most people experience the benefits of Juvederm for about 6 months to 1 year, after which they are welcome to get additional injections for maintenance. Due to the long-term benefits of collagen production, future treatments can be less frequent and may require less filler to achieve the same result.

Frequently Asked Questions (FAQ)

Recommended amounts of filler vary depending on client personal aesthetic goals, volume loss, skin thickness, and more unique defining factors. Clients with more volume and collagen loss will need more filler to attain desirable results. Clients with thicker skin might be recommended more filler, or a different type of filler that will provide their skin with more support and lift. Certain clients want a natural look, therefore they might be recommended less filler, whereas clients that want dramatic changes will be recommended more filler. There is a delicate balance between type of filler, amount of filler, and clients needs that will need to be addressed by our professional and knowledgeable staff here at Lavande before proceeding with your injectable treatment.

Due to the fact that Juvederm’s main ingredient, HA, is a naturally occurring substance in our bodies, the results of using this material for cosmetic purposes is actually quite natural. The HA will simply provide support in place of lost volume, collagen, and fat, which allows for a youthful and natural result. Further, the soft nature of the gel filler is made to mimic the suppleness of youthful skin (which is why particular fillers with particular thicknesses will be recommended for different areas of concern). People can of course achieve a more dramatic look by request, but a natural look is absolutely within reach.

The second main ingredient present in Juvederm is 0.3% of the anesthetic lidocaine, which serves to make the injection experience more comfortable. Of course, perception of pain is a unique experience for everyone, but most clients will only feel a mild discomfort due to the combined numbing of the topical and injectable anesthetic that accompanies the procedure. Areas with thinner skin, such as around the mouth, will be slightly more sensitive as well. Further, the cooling effect from the ice that will be applied to the area following injections helps reduce any pain at injections sites.

Most side effects will be moderate or mild, and should last no more than a week or two. Side effects such as tenderness, redness, swelling, and bruising at injections sites might be immediately visible, of course only minimally, and can be covered up with makeup. Other common side effects include firmness, lumps/bumps, itching, and discoloration. If you are worried about any side effects, please feel free to make an appointment to meet with one of our professional providers or to give us a call at (760) LAVANDE (528-2633) to discuss your concerns.

There are various other filler options available at Lavande, and we invite clients to discuss these options with our experienced and insightful staff before proceeding with treatment. Most fillers are made with the same natural HA ingredient, but others have different chemical makeups to achieve similar results that are useful for certain circumstances and needs. Even among the HA fillers, there is lots of variation between added compounds, gel consistencies (spectrum of thinner to thicker fillers), designation of depth of injection, and more. Even in a single treatment, different fillers might be recommended for different needs (such as a thicker filler for your cheeks and a thinner filler for your lips), so it really is best to come in for a consultation for full understanding of recommendations first.

The other available fillers include JUVÉDERM Voluma® XC, JUVÉDERM Vollure™ XC, JUVÉDERM Volbella® XC, Restylane®, Restylane® Lyft, Sculptra® Aesthetic, Radiesse®, Belotero Balance®, and others. Certain situations might have recommendations that deviate from filler options.

Filler, as the name suggests, will physically fill out any lines, wrinkles, and hollows you may see. However, Botox as a neuromod is meant to simply relax underlying muscles by blocking nerve impulses and therefore prevent the formation of said lines and wrinkles. Filler is usually made from a natural ingredient that already exists in the body, but Botox is made from a neurotoxic protein. Filler is indicated for injection in the mid and lower parts of the face, and Botox is indicated for injection in the upper part of the face. Filler results will last up to a year, Botox results will last up to 3-4 months. Most clients will get a combination of filler and Botox treatments for optimal results.

Not to fear, there is absolutely a method for dissolving HA filler via injection of the enzyme hyaluronidase. This enzyme is another naturally-occurring substance found in the body (therefore it is safe and effective) that is able to degrade hyaluronic acid (HA) by catalyzing the bodys ability to absorb the material. This option is available per client desire, such as for clients that might be unhappy with their injectable filler injection, and per client need, such as clients that have an adverse reaction to the filler or those that have filler injected in a blood vessel. If HA filler is inadvertently injected in a blood vessel, it can cause negative side effects such as skin ulceration, breakdown, and necrosis, but thankfully hyaluronidase can reverse these effects. It is recommended to get this antidote at the institution that did the injection.