What is Juvederm?

Produced by pharmaceutical company Allergan, JUVEDERM ® is an FDA-approved dermal filler whose primary active ingredient is hyaluronic acid, a naturally occurring substance in the human body that is found in skin and muscle tissue. JUVEDERM ® comes in the form of a gel and is administered by subcutaneous injection beneath areas of the facial skin that are sagging or marked with lines and wrinkles. The presence of the gel increases the skin's volume, smoothing away pronounced folds and wrinkles. Perhaps the most popular use of JUVEDERM ® is to eliminate the deep creases commonly known as "smile lines" that form around the nasolabial folds, the lines that connect the bottom of the nose to the corners of the mouth. JUVEDERM ® is also a popular and effective treatment for plumping up the lips. In some instances, it is used to reduce the appearance of facial scars and other depressions in the skin. JUVEDERM ® is longer-lasting than collagen-based dermal fillers. However, because hyaluronic acid occurs naturally in the human body, it is biodegradable, and the gel breaks down and begins to be absorbed within six months to a year of an application. Thus, the injections must be repeated at regular intervals in order to maintain the desired cosmetic effect. The exact length of time that any particular application of JUVEDERM ® will last depends on many different factors, but typically JUVEDERM ® 's effects on creases in the nasolabial folds last up to a year, while lip augmentation treatments generally need to be repeated within 3 to 6 months of the original application. The effects of collagen-based dermal fillers, on the other hand, can wear off in as little as two months. JUVEDERM ® achieves its relatively long-lasting effect due to a process known as cross-linking. In its natural state, hyaluronic acid is a liquid that is broken down and metabolized by the body within a matter of hours. However, the developers of JUVEDERM ® created a technology that transforms hyaluronic acid from a liquid into a gel by "cross-linking" the chains of the acid. In other words, the ends of the acid's molecular chains are bound together to create a more durable semi-solid gel. In gel form, hyaluronic acid retains its beneficial effects while resisting decomposition for a longer period of time and bestowing an appearance of greater volume to the skin. Hyaluronic acid is not only longer-lasting than collagen in its improvement of the skin's appearance; its cosmetic effects are also, in general, noticeably superior to the results achieved through collagen-based products. In clinical studies, nearly 88 percent of subjects in a JUVEDERM ® trial reported that they preferred the appearance achieved with Juvederm over than achieved with Zyplast, a collagen-based dermal filler. JUVEDERM ® 's superior performance over collagen-based dermal fillers can be attributed to the unique properties of hyaluronic acid. Although JUVEDERM ® , the first hyaluronic-acid based dermal filler to receive FDA approval, was not approved for treatment of deep facial creases until 2006, hyaluronic acid has been used in Europe in facial tissue augmentation procedures since 1996 and has also been used in a number of other medical contexts, including the performance of certain eye surgeries, the alleviation of joint pain, and the treatment of skin wounds. Hyaluronic acid has been especially useful in the plastic surgery setting because it can absorb up to one-thousand times its weight in water. It is this absorption capacity that enables hyaluronic acid to add volume to and smooth out the surface beneath sagging and creased skin. However, hyaluronic acid does much more than simply hydrate the skin and keep it "plumped up" by providing extra volume. It has been discovered that the molecules of hyaluronic acid bind with those of collagen and elastin, elements essential to preserving skin tone and elasticity. In addition, hyaluronic acid blocks the breakdown of existing collagen and stimulates the creation of new collagen in skin cells known as fibroblasts. Thus, hyaluronic acid not only improves the appearance of the skin "artifically" by providing volume under the skin's surface, but it also gives the skin a natural boost through its action upon collagen and collagen-producing cells. JUVEDERM ® comes in three different formulas distinguished primarily by the degree of cross-linking in the molecular chains of the hyaluronic acid contained in the preparation: JUVEDERM ® 24HV, which is formulated to contour and volumize facial folds and wrinkles; JUVEDERM ® 30HV, a stronger formulation for the correction of deep folds and wrinkles; and JUVEDERM ® 30 for correction of more subtle wrinkles and lines in the skin. Most side-effects reported from JUVEDERM ® treatments are minor. They include discomfort at the injection site during the actual treatment and temporary redness, swelling, or bruising at the injection site for a few hours or days following the treatment. The most serious side-effect reported is the development of skin growths known as granulomas which can be difficult to treat and eliminate. Granulomas are the result of especially vigorous immune reactions, and, for that reason, individuals who have experience severe allergic reactions in the past are counseled to forego JUVEDERM ® treatments or at least discuss their past medical symptoms in depth with a physician before proceeding. In any event, those considering JUVEDERM ® treatments, or any cosmetic or medical treatment, should disclose their medical history in full and learn about any possible side-effects before undergoing the procedure.