Juvederm® is an FDA approved hyaluronic acid filler. Hyaluronic acid is found throughout the body and is a normal component of skin. It is an integral part of the connective tissue of our skin and provides cushioning and lubrication. Juvederm improves appearance of wrinkles and folds by adding volume and lifting the folds and lines within the skin.
The smooth Juvederm gel is injected into the dermis of the skin, the part of the skin that contains collagen, vessels, sweat glands, and oil glands and nerves. Juvederm can last six to nine months before the body naturally starts to decompose and absorb it. Allergic reactions to Juvederm are extremely rare since it is made of a substance that is found naturally in the body.
The Juvederm® collection of fillers includes:
- JUVEDERM® VOLUMA™ XC for treatment of cheeks, midface, and chin
- JUVEDERM® VOLLURE™ XC for treatment of moderate to severe facial wrinkles and folds
- JUVEDERM® XC for treatment of moderate to severe facial wrinkles and folds
- JUVEDERM® Ultra XC is for the treatment of the perioral area and lip augmentation
- JUVEDERM® VOLBELLA™ XC for treatment of perioral lines (“smoker’s lines”) and lip augmentation
Although each type of Juvederm® filler has its own FDA indication, it is very common for physicians to use the dermal fillers for a variety of off-label indications.
Expected Results after Juvederm Injections
- Forehead horizontal lines/crevices: Diminished appearance of forehead lines
- Frown lines/”eleven” between the eyebrows: Diminished appearance of frown lines
- Temple hollowness/”pinched” appearing head: Added volume to the temples to create more facial width to the upper portion of the face
- Under eye hollowness/tear troughs: Improved appearance of under eye circles and hollowness
- Smile lines/nasolabial folds: Softening of the nasolabial folds, or the deep lines that run from the nose to the corners of the mouth
- Cheeks: Increased volume and lifted appearance of the cheeks
- Non-surgical rhinoplasty/liquid nose job: Straighten nasal humps, increase nasal bridge height, “slim” the appearance of the nose and reshape the nasal tip
- Oral commisures lines/Marionette lines: Diminished appearance of the lines that runs from the outer corners of the lips towards the chin
- Lips: Plump, pouty lips, correction of lip asymmetries or subtle lip augmentation
- Deflated and sagging earlobes: More youthful and fuller earlobes.
- Chin augmentation: Creation of a more protruding chin to create a more oval shaped face, or a wider more chiseled masculine appearing chin.
- Jawline contouring/jowls: More defined jaw line for younger individuals, and softened appearance of jowls for aging individuals.
- Liquid facelift: this procedure involves a combination of injected areas to lift the face, plump where volume has been lost and create an overall more youthful and rejuvenated appearance
Ideal Candidates for Juvederm® Injection
Good candidates for Juvederm® injections
- Seek to increase volume in various parts of the face such as lips, cheeks, or temples.
- Want to diminish the appearance of facial fine lines, wrinkles, and deep folds.
- Desire to have a nose job, but do not want to undergo surgery.
- Want more facial definition, higher cheekbones, contoured jaw line, and/or chiseled chin.
- Want to correct facial asymmetries.
- Want to achieve facial rejuvenation, but do not want the downtime, expense, and risks that come with surgical correction.
- Have realistic expectations of what improvements can be made with fillers.
- Are not on medications that can prolong bleeding.
Injection Techniques with Juvederm®
Dermal filler injection results depend on both the type of filler used as well as the injection technique of the experienced provider. The same syringe of filler in two different hands will have two different results, there is both a science as well as an art to performing filler injections. At The Naderi Center, we only allow plastic surgeons or dermatologist to perform filler injections.
4 Factors that Affect Dermal Filler Results
- Type of Filler
- Number of Syringes
- Injected Area
- Injection Technique: fanning, micro-droplet, cone, cannula, fern, threading, crosshatch, depot, etc
Type of Filler: Cross-linking
Type of dermal filler selected for a particular patient is a unique and multifactorial decision that your provider must know how to make. Not only is general filler knowledge important, but your medical provider should exam the anatomy of your bone structure, skin type, and texture, as well as the type of look that you desire to achieve in order to select an appropriate filler. For example, whether a patient wants a subtle lip augmentation or a very pouty full lip will impact which filler should be used.
All Juvéderm® products are made of hyaluronic acid (HA) molecules, a natural component within our skin. What makes one product different from the other is the science of cross-linking, a process which links or bonds one HA molecule to another HA molecule. The stronger and tighter this cross-linking the greater the concentration of HA molecules will be suspended per mL of water. Stronger cross-linked HA fillers form a thicker gel and tend to spread less.
Hylacross™ vs. Vycross™ technology
The older forms of Juvéderm® (Juvaderm® Ultra, Juvaderm® Ultra Plus) use Hylacross technology where they cross-link same size HA molecules.
Newer Juvederm® products use Vycross™ technology, (Voluma®, Volbella® and Vollure®) which have HA-molecules that are of different weights and cross-link together.
Number of Syringes and “Full Correction”
Volume or number of syringes of dermal filler injected makes a difference in terms of whether a subtle result or a more dramatic result is achieved. Additionally, the more filler that is injected the longer the results will last and the less frequently the injections need to be repeated. Our physicians will always advise you on the number of syringes they recommend in order to achieve a “full correction” dose. “FULL CORRECTION” is an important concept in determining the longevity of the filler results. Full correction refers to fully correcting the problem with the necessary amount of filler. However, at The Naderi Center we also realize that patients for a variety of reasons, including limited budget or concerns about too drastic of change too fast, may not want to achieve “full correction”. Regardless of whether a full correction is achieved, our doctors will always want you to leave with a noticeable improvement.
Today the variety of facial corrections that can be safely achieved with dermal fillers is way beyond their original FDA indications. However, the provider should know the risks and potential complications that are associated with certain facial anatomical regions. These same injection providers should be experienced and knowledgeable in treating potential complications that can arise from filler injections. Many people do not know that one of the most common complications of filler injections, is a vascular occlusions. This is when a small amount of the filler is injected into a superficial vessel and it can potentially lead to death of the surrounding tissue. Vascular occlusions must be quickly identified and treated by melting the filler. Many people are comfortable with going to a medspa for Botox injections, but when it comes to fillers they want to make sure they are in experienced and well trained hands.
Juvederm® Injection Before and After Photos
Juvederm® Injection Pricing
Preparing for Juvederm® Injections
At The Naderi Center, we prepare our patients prior to their injection treatment in order to decrease their downtime and risks for bruising and swelling. Prior to your appointment it is important to be off of certain supplements and medications as well as to minimize consumption of certain foods that are high in Omega-3 and Omega 6. All of our patients are advised to view our list of “Things to Avoid” prior to injections or surgery.
2 Weeks Before Injections
Follow our dietary restrictions.
- For 2 weeks before your appointment avoid nuts, seeds, fish, fish oil, NSAIDs, supplements, and anything that prolongs bleeding. This will significantly help minimize bruising, bleeding, and swelling after your injections. Read our Guidelines on Foods and Medications to Avoid Prior to Injections.
- You can start Arnica supplements a week prior to injection to help with post injection bruises. Arnica helps to speed up the fading away of bruises. Arnica supplements can be found in most health supplement isles at your local Whole Foods, GMC or CVS, as well as purchased from The Naderi Center.
Stopping Medications and Supplements
- Talk to your primary care doctor or physician specialist. If you are on blood thinners you may need to stop these a few days to weeks prior to your injection treatment. Speak to your prescribing physician regarding if it is safe to stop these medications as well as to obtain instructions about when to stop and restart the medication. We do not recommend patients that are on life saving medications stop their medications in order to have any cosmetic procedures performed.
Prevention of Cold Stores
- Patients prone to cold sores will need to start a prophylaxis dose of an anti-viral medication prior to their injection treatment. Your physician provider will prescribe this medication prior to your treatment.
Familiarize yourself with Risks and Benefits
- Read our filler consent prior to your visit to familiarize yourself with risks and benefits of filler injections.
Day of Injection
Eat and drink before your treatment
- it is not uncommon for patients to “pass-out” or get “vasovagal” during their injection. Most people are not fond of needles. Having a good blood sugar and being hydrated will make it less likely that you will feel queasy during your treatment.
Minimize make up and lotions
- Please minimize make-up, especially in and around areas where you would like to get injections performed. Our medical assistants will have to remove your make-up prior to the procedure. You can bring make up with you and apply it immediately after your treatment
Come in 30 minutes prior to appointment time for numbing
- We recommend numbing cream application prior to dermal filler injections. The numbing cream needs a good 20 – 30 minutes to exert its full effect, hence we ask all our filler injection patients to come a little earlier to allow for the numbing time.
Reserve your next appointment
- We love our loyal patients and making sure that we can see you when you need your next injection is important to us. Most of our physicians book out 3 – 4 months and we prefer to never double book patients. We always recommend that you schedule your next appointment before leaving.
Recovery after Juvederm® Injections
After your filler injection, it is normal to have some swelling, pinpoint bleeding, and bruising. If numbing cream was applied for your procedure you will still feel numb for another 1-2 hours after your procedure. Please be sure to follow our post procedure instructions in order to minimize swelling, bruising, and decrease downtime.
Ice, Ice, Ice
- Use a small bag of frozen peas in a sandwich bag or crushed ice to gently ice the area. No heavy ice bags. Ice for 20 minutes on and 20 minutes off. Continue the icing for 48 hours if possible.
Minimize Strenuous Exercise
- We recommend no strenuous exercise for 48 hours in order to reduce swelling and bruising.
Do not manipulate, massage, rub, or poke the area.
- Unless specifically advised by your physician, do not massage or manipulate your face. For one week, avoid facials or rough scrubbing of the face. You can wash your face gently.
Use make-up and concealer to cover up bruises.
- You can use makeup and concealer the day of your injections to cover up any bruising.
Non-surgical rhinoplasty patients should avoid glasses if they “dig into” the injection region
- Bring your glasses to your appointment to show Dr. Shervin Naderi if they would be appropriate to wear after non-surgical rhinoplasty. Additionally, if you are an avid swimmer mention the use of swim goggles during your consultation.
Take Arnica supplements
- Arnica supplements can quickly help reduce appearance of bruises.
Eat pineapples and drink pineapple juice
- Pineapples have natural anti-inflammatory properties to them that help to minimize swelling after injections.
Do not over-evaluate your face the first two weeks
- The first two weeks after injections is normal to have bruises, swelling, and be asymmetric. We recommend waiting two weeks for swelling and bruising to be completely gone before you can appreciate your final results.
Take Tylenol for Pain
It is normal to experience some pain and sensitivity in the area of the injection. Most patients find that Tylenol can help relieve this post-injection pain. Avoid NSAIDs such as Motrin and ibuprofen as these can make swelling and bruising worse.
Risks, Safety, and Potential Complications after Juvederm® Injections
Common and expected side effects of Juvederm® filler injections include the following:
- May last 1-2 weeks but bad bruises can last up to 4 weeks. This is normal. Bruises can show up several days after the treatment.
- Bruising can be covered with a full coverage concealer such as Neostrata, which we sell in the office, or Cover Fx brand from Sephora.
- Tear troughs and lips are more likely to bruise because these areas are more vascular than other parts of the face.
- May not always be even from side to side depending on pre-existing facial asymmetry and volume of injection and bleeding at each injection site.
- Initial swelling takes 2 weeks to settle.
- Sleeping propped up and icing can minimize this side effect.
- Avoid exercise first 48 hours or longer as swelling increases when working out.
- Do not manipulate or massage area as this can aggravate swelling.
- Asymmetry can be related to swelling. Wait 2 weeks before deciding whether asymmetry is from filler differences or swelling.
- Please keep in mind that once you start to analyze your face, it is not rare to start to “notice” new asymmetries that have been there your entire life.
Lumps and Bumps
- The filler is going to feel firmer than your own tissue. Do not massage or manipulate the area.
- The feeling of lumps and bumps usually improves within 2 weeks as swelling resolves.
- 1 syringe of filler is the equivalent of 1/5th of a teaspoon in volume. After swelling subsides there may be a need for additional filler injections if you desire increased volume.
- Our doctors are very conservative and do not over inject patients. Our physicians prefer to add volume slowly, giving time to achieve the patient’s desired look.
- The first time getting injections the results tend to go away faster. With repeat treatments, results last longer as you build your own collagen around the injection sites.
- Lips will also be more dry post injections. Ice the areas and keep lips lubricated with Vaseline or Aquaphor. No more than 20 minutes of ice at a time.
Possible complications after dermal filler injections
- Hypersensitivity or allergic reactions
- Cold sore or herpes simplex virus outbreak
- Acne breakout
- Skin necrosis
- Intra-vascular injection leading to skin necrosis and even blindness
- Sterile abscess
Please notify our office immediately if you feel that you may be experiencing any of the above possible complications after your filler injections.
RealSelf Most Loved Injector Awards: 2017 Winners Announced, according to patients.
Juvederm® Injection Specialists at The Naderi Center for Plastic Surgery and Dermatology
Dr. Naderi is a board certified facial plastic surgeon and a National Clinical Trainer for Allergan and Medicis. He teaches other doctors how to inject Juvederm® properly. Other doctors from all over the world refer to Dr. Naderi’s instructional videos on YouTube to fine tune and improve their own filler injection techniques.
Dr. Kulak is a facial plastic surgeon with a gentle, artistic female touch and her patient’s love her nearly-pain-free techniques. She focuses on facial rejuvenation with advanced, minimally invasive techniques as well as more invasive face lift and eyelid lift surgeries.
Dr. Alexandra Snodgrass is a board certified dermatologist who trained with Dr. Shervin Naderi prior to joining The Naderi Center. Dr. Snodgrass is expert on a variety of filler types and injection area techniques. Dr. Snodgrass’ dermal filler injections create a noticeable yet natural rejuvenation of the face.
Dr. Erica Anderson, board certified plastic surgeon, performs facial filler injections as well as injections on the body. Dr. Erica Anderson is known for her Sculptra® Brazillian Butt Lift. Patient’s desiring to enhance non-facial areas of the body would seek the expert opinion and guidance of Dr. Anderson.
Dr. Shervin Naderi was just named “Top 25 Injector” by the 10 million member community of RealSelf. Out of 2000 nominees, Dr. Naderi was chosen as Top 25! This is a huge honor being recognized by the national and international community of RealSelf, the most trusted and authoritative site for all unbiased plastic surgery research.
Dr. Naderi is one of only 4 winners in the South East region of the United States. His patients who regularly fly and drive to The Naderi Center from all over the country have already known how great he is for his unique style of Botox and filler injections. Doctors all over the world who regularly use his online tutorial videos to learn and enhance their own technique have always respected Dr. Naderi’s injection skills.
Schedule your Juvederm® Consultation
Contact us to schedule your Juvederm® injection consultation with one of our specialists at The Naderi Center. We are located in the greater Washington DC area with two locations, Chevy Chase, Maryland, 301-222-2020 or Reston, Virginia, 703-481-0002. For out of town patients we offer virtual consultation prior to your visit which can be arranged by filling out our contact us form.
If you live in the states of Virginia or Maryland, The Naderi Center for Plastic Surgery and Dermatology offers Juvederm® among its services. For a full list of services, please visit our Locations page.
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