Rhinoplasty
New versions of Juvederm and Restylane
There have been new additions to the two families of relatively safe Hyaluronic Acid fillers recently.
Allergan has introduced the long awaited formulation of Juvederm with lidocaine for added patient comfort. Juvederm is now available in Ultra, Ultra Plus and XC variations.
Medicis also released Restylane with Lidocaine as well as a 2.2cc syringe of Restylane.
These safer HA fillers, now with lidocaine allow for more patient comfort during injections.
For lip injections, patients can now try without dental block numbing. However, patients who still choose to undergo dental blocks for total lip numbness should probably stick with the older, less expensive Juvederm or Restylane formulation without added lidocaine as there is no point spending extra money on the cost of the new formulation if a dental block is to be done prior to the injections anyway.
The larger syringe of Restylane allows for a more cost effective volume restoration of the laugh lines or facial wrinkles and sagging cheeks. While some doctors may simply charge twice the amount of a 1cc syringe, we have chosen to offer the 2.2cc syringe at asignificant discount to help patients achieve their desired and needed volume restoration without worrying about cost.
These added versions of Restylane and Juvederm have been long awaited. While no medical substance or drug is 100% safe, Restylane and Juvederm have had very good track records in the US over the last few years.
Hello Dr Naderi
I am curious as to why you pick out Hydrelle of all fillers to highlight patient problems .
You recommend Juvederm to your patients.
I did a quick search for Juvederm in Maude reports from FDA web site.
You can do this yourself.
Google – Maude FDA- and enter Juvederm for brand name.
I got 42 adverse reports on Juvederm to FDA in 2009.
Should you be concerned about Juvederm as well?
Thank you.
Louis
Comment by Louis — February 22, 2010 @ 9:50 am
Dear Louis,
Great question.
There are many fillers in Europe and Canada that have been responsible for significant problems. Luckily the FDA has been a fairly decent gate keeper and has kept us fairly safe over the years.
While no filler or product or device is 100% safe, there are relative risks that must be taken into consideration. The safest thing is to do nothing and stay at home. But if a patient wants to rejuvenate their face and wrinkles and lips then choosing the relatively safest substance is the best chance at achieving success.
While Juvederm and Restylane have had problems (1 in 3000 – 1 in 10000 depending what studies you read), they have had the longest safety record. You can argue that 42 Adverse reports for a substance as widely and frequently used as Juvederm is not “that bad.” Restylane also had problems and reports have been filed. But the issue is relative safety. I, (as well as many other doctors), can tell you that after many years and many thousands of injections with Juvederm or Restylane, have not personally seen an issue with these fillers whereas after only a few short weeks and a handful of patients with Hydrelle, we have seen significant problems. The other reason I started to blog on this topic was the complete denial of any problems by the company for many months. I found that unacceptable and dangerous and since I had initially been excited about Hydrelle and written about my positive INITIAL experience with the substance, I felt obligated to high light its short comings when it was clearly evident that an unacceptable high portion of patients were developing problems 4-6 weeks after the injection.
I have also pointed out that there are many patients that do not have any problems with Hydrelle. Its just that the numbers that do, are too high for comfort. Thats all. With that said, there are plenty of patients who choose to inject even Silicone in their faces. To each their own…….
Comment by Dr. Naderi — February 24, 2010 @ 3:19 pm