Patrick K. Sullivan, MD, FACS
Double Board Certified Providence, Rhode Island Plastic Surgeon
One of “America’s Top Doctors” & “The Best Doctors in America”
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Before & After Pictures
- Test Patient: Test Patient 1
- fp-fr-00001-1209: Facial Rejuvenation Including Croton Oil Peel (female)
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Juvederm
Our goal is to help people who want to look their best and appear healthy and well rested. Contouring and sculpting with Juvederm is a treatment that helps people fight the deflation that comes with aging without the recovery time of surgery. The facial fillers such as Juvederm can be and often are used in combination with Botox to delay surgery. We treat patients as optimally as we can with the combination of non-invasive treatments including lasers, peels and microdermabrasion and then have them come back for surgery whenever they think that they are ready for a surgical procedure.
Juvederm Ultra injectable gel is a colorless, hyaluronic gel that is injected into the facial tissue to smooth wrinkles and folds and fill in areas where soft tissue has been lost. Because this is a completely natural occurring substance in everyone's body, there is no need for a skin test to determine an allergy.
Overall, the studies have shown Juvederm results last for about six months. The side effects are usually of short duration and last a week or less. Most commonly people go right back to work again after they have had this treatment. Carole who is part of our team, for example, went right back to performing skin treatments in our office after she was injected.
We have found the results to be very technique dependent with Juvederm. Juvederm is a highly concentrated agent. It is a hydrophilic substance that binds with water. This causes an expansion of the places where it has been placed and if not used correctly can lead to overexpansion and an abnormal appearance. Because the duration of this is at least six months, it can be quite a long time to put up with a bad result. So it is important to have it injected by a highly experienced person who has artistic skills.
What is Juvederm?
This hyaluronic substance is a naturally occurring sugar found in the human body. Its role in the skin is to deliver nutrients, hydrate the skin by holding in water and to act as a cushioning agent.
Juvederm binds to water and draws water into it, up to 1000 times its weight. That is why we have to be particularly careful when injecting it into the lip area because it continues to expand over the course of hours. That is why the manner and technique used for injecting Hyaluronic gel is so critical.
Thus, what Juvederm gel does is temporarily add volume to facial tissue and restores a smoother appearance to the face.
Juvederm Side Effects
The side effects that we have seen in our series of patients include swelling and on occasion some bruising in the injection site. Other side effects that have been reported include redness in the areas of injection, pain/tenderness, firmness, itching, and discoloration. As with any skin injection, there is a risk of infection, though we have not seen infections with any of our injections and we have performed hundreds of them. This experience includes Botox, Juvederm, Restylane and other injectable agents we have used. We ask our patients if they have any allergies. We also want to make sure they are not taking any substances that can produce bleeding or cause excessive bruising.
We would not use Juvederm at the same time as we would be doing a laser treatment, chemical peeling, or any procedure that would cause an active dermal response, as there is a possible risk of an inflammatory reaction at the treatment site. We have not seen this, but it has been reported so we are very cautious. We would also be cautious in using this on a patient who is on immunosuppressive therapy, as it may increase the risk of infection.
Juvederm's Longevity
The reason I like Juvederm the most is because it has given me the smoothest, most natural results that I have seen with synthetic agents. I am continuing to study its longevity. The patient's own fat is still the gold standard, works the best, and lasts the longest. Because of the large amount of experience we have with facial sculpting using the patient's own fat and using other synthetic agents combined with Botox in many instances, the company came to us requesting we help them with their longevity trials. We were delighted to do so, as it afforded our patients the use of this substance that had already been approved by the FDA, but was not yet available to physicians through purchase. It has been a wonderful experience and we are so happy we can share it with you.
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