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Juvederm is a family of five hyaluronic acid fillers. The original products were Ultra and Ultra Plus. The main protein in skin is collagen and the main nonprotein in skin is hyaluronic acid. We are familiar with this product and so it is well tolerated in the body. As an added benefit there is an enzyme which breaks down the hyaluronic acid so in the event you do not like the result (which is rare) the product can be dissolved. Allergan has added Voluma, Vollure and Volbella to the product line. These hyaluronic acids are crossed linked, using the Vycross technology, which means they last longer because it takes us longer to break them down. The 3 cross linked fillers have different lifting properties. Voluma provides the greatest lift and is used in areas such as the cheeks and jawline. Vollure is intermediate in its lifting ability and works nicely in the nasolabial folds and marionette region. Volbella is ideal in the lower lids and in accentuating the architecture of the lips. Dr. Kessler prefers Ultra Plus XC to enhance the volume of the lips.
There are seven fat pads in each cheek. The three which frame the mouth and form the nasolabial fold, the marionette lines and the jowl maintain there volume throughout life. The four fat pads which are located below the eye and the cheek bones lose their volume as we age and the skin doesn’t retract or tighten. This leads to the impression that the face has fallen forward and down. A youthful face is perceived as having smooth curves with the fullest part of the face being at the cheek bones and gradually tapering at the chin. As we age volume loss breaks these curves and we see areas of fullness adjacent to areas of hollow. A youthful face is more triangular whereas an aged face is more square.
When fillers are used appropriately and artistically, these youthful curves are restored. This rejuvenation makes you look like did when you were younger. Fillers should not alter your natural beauty. Although fillers can be used to fill the face to minimize lax skin this can create a characteristically odd appearance. Often when skin is lose a balance between volume and skin tightening is needed to achieve the best results.
Voluma is a deep facial filler that is FDA approved for improving submalar or mid-face volume when a deficiency in the fat pads of the cheeks occurs. Dr. Kessler also places Voluma in the angle of the mandible, prejowl sulcus and chin for better jawline definition in both men and woman. Facial volume loss occurs at and below the cheekbones while volume is maintained in the lower third of the face. Women and men between the ages of 30 and 40 and in good physical health are typically the best candidates for the procedure.
Vollure is wonderful at softening the nasolabial fold and the marionette region below the corners of the mouth.
Volbella is used to blend the transition from the lower lid to the cheek and restore the youthful architecture of the lips.
Ultra Plus is great for volumizing the lips and for restoring fullness to the temples and tail of the eyebrow.
Video: Injectable filler treatment to pre-jowls & marionettes
by Dr. Rob Kessler
How Juvederm is Used
Filler injections are performed in the office setting. The length of the procedure is about 20 minutes. Anesthesia is not necessary for the non-invasive procedure since the local anesthetic lidocaine is included in the mixture. A fine cannula injects the filler into the deep layers of the facial tissue in order to provide the most natural-looking lift. Dr. Kessler uses advanced techniques to make the procedure as comfortable as possible for his patients.
Your Juvederm will be performed in Dr. Robert Kessler's surgery center located in Corona Del Mar.
Results are seen immediately after injection. Minor swelling may be noticeable by the patient for the first 48 hours after the procedure. Despite mild side effects, patients can return to work immediately afterwards. Exercise and laborious activity should be avoided for 24 hours but may then be resumed.
The cross linked fillers are long lasting and have been reported to last about 18 months, with some patients experiencing continued natural-looking rejuvenation of the cheeks for up to 2 years.
Other potential complications associated with fillers are bruising and contour irregularities in the treatment site. Exceedingly rare instances of skin sloughing and blindness have been reported with fillers but Dr Kessler is familiar with techniques to minimize and if necessary treat this occurrence. As mentioned the filler can be dissolved to attempt to correct the problem. Bruising is temporary and will resolve.
I am extremely pleased to have found Dr Kessler and his staff. He is very caring , knowledgeable and great in giving injectables. Just love this office.
By (Self-verified patient of Dr. Robert W Kessler)