"There are a number of dermal fillers on the market today that can be used either in conjunction with Botox® or alone to fill permanent wrinkles, grooves, depressions and even correct or improve facial structures. Fillers are widely used today to enhance the lips and cheek bones, lift the corners of the mouth, and eliminate the grooves under the eyes. If the filler is applied correctly to these areas a completely natural and ‘untreated’ appearance may be achieved. As we age a number of factors contribute to how the face and other areas change". Dr Alek Nikolic
Typically the skin loses its elasticity and its ability to 'bounce' back after facial movements, the underlying muscles begin to elongate, and pockets of fat that give definition and youthfulness to our face, begins to thin and drop. These factors can be addressed and treated with volume replacement through the correct placement of fillers that ultimately will provide patients a more youthful appearance. My firm belief is that if a patient does not go "wow" after his or her filler treatment session then the injecting doctor has not addressed the areas of concern correctly.
Of the 70 or so ‘natural fillers’ or non-animal derived hyaluronic acid fillers on the market today only 3 have FDA and CE approval: the Juvederm family, the Restylane family, and the Hydrafill family (marketed in the US as Softline).
My preference is to only use fillers that have FDA approval as the CE Mark Registration number found for fillers is only for the syringe or the device used for the injecting, and not for the product being injected. The FDA approval is for both the device or syringe used, and the product or ingredients (hyuloronic acid) that is being injected. The importance behind this is a well studied safety and complication profile and clinical studies demonstrating longevity or length of duration in the skin (dermal layers).
Juvederm™ General Overview
The JUVÉDERM™ dermal filler family of products, approved by the U.S. Food and Drug Administration in 2006, is the next generation in hyaluronic acid dermal fillers that provide a smooth, long-lasting correction of moderate to severe facial wrinkles and folds.
To provide physicians with the flexibility to tailor each treatment to the specific needs of the patient, there are two formulations of JUVÉDERM™. Product formulations include: JUVÉDERM™ Ultra, a highly cross-linked formulation for more versatility in contouring and volumizing of facial wrinkles and folds; and JUVÉDERM™ Ultra Plus, a more highly cross-linked and thicker gel for volumizing and correction of deeper folds and wrinkles. Ask you doctor if JUVÉDERM™ is right for you.
Important Safety Information
In the United States, JUVÉDERM™ injectable gel is indicated for injection into the mid-to-deep dermis for correction of moderate to severe facial wrinkles and folds (such as nasolabial folds) and is generally well tolerated. The most commonly reported side effects are temporary injection-site redness, swelling, pain/tenderness, firmness, lumps/bumps, and bruising. Exposure of the treated area to excessive sun and extreme cold weather should be minimized until any initial swelling and redness have resolved. If laser treatment, chemical peel, or any other procedure based on active dermal response is considered after treatment with JUVÉDERM™ injectable gel, there is a possible risk of an inflammatory reaction at the treatment site.
Patients who are using substances that can prolong bleeding, such as aspirin or ibuprofen, as with any injection, may experience increased bruising or bleeding at injection site. You should inform your physician before treatment if you are using these types of substances. As with all skin-injection procedures, there is a risk of infection. JUVÉDERM™ injectable gel should be used with caution in patients on immunosuppressive therapy, or therapy used to decrease the body's immune response, as there may be an increased risk of infection. The safety of JUVÉDERM™ injectable gel in patients with a history of excessive scarring (eg, hypertrophic scarring and keloid formations) and pigmentation disorders has not been studied.
JUVÉDERM™ injectable gel should not be used in patients who have severe allergies marked by a history of anaphylaxis or history or presence of multiple severe allergies. JUVÉDERM™ injectable gel should not be used in patients with a history of allergies to Gram-positive bacterial proteins. The safety of JUVÉDERM™ injectable gel for use during pregnancy, in breastfeeding females, or in patients under 18 years has not been established. The safety and effectiveness of JUVÉDERM™ injectable gel for the treatment of areas other than facial wrinkles and folds (such as lips) have not been established in controlled clinical studies.
Other FDA Approved NASHA Fillers: