Let Dr Michele Koo, MD, FACS, Board Certified Plastic Surgeon, St Louis, Missouri rejuvenate your face by removing wrinkles and frowns in the office in a matter of minutes.
Let’s start with some background on dermal fillers. This market has been growing rapidly, and we expect the growth to accelerate with the introduction of a new entry into the hyaluronic acid segment. Baby Boomers are fueling growth as they more actively fight the aging process. What they’re seeing in the mirror is a loss of volume under their facial skin; that’s a visible sign of aging. The role of dermal fillers is to reduce lines, restore volume, and contour facial folds to restore a more youthful appearance.
The generally accepted signs of aging in the face are the thinning of the dermis layer and the atrophy of fat pads underneath. As a result, there is greater visibility of some unattractive features such as bony areas, blood vessels, wrinkles, and furrows. Because of their placement on either side of the mouth, the nasolabial folds become more prominent and deeply grooved. Some people think of the NLFs as parentheses that call extra attention to the area around the nose and mouth. Others think of them as smile lines. They’re not always welcome, and they can be corrected.
Let’s stop a moment and note that wrinkles can have one of 2 origins. Either they are “dynamic,” meaning they are visibly highlighted when the underlying muscles are in motion. Think of the lines that appear when you smile or frown. Or the wrinkles are classified as “static,” meaning they appear when the face is at rest or not moving. Dermal fillers are used in the treatment of static wrinkles of the face.
In contemporary practice, the physician and patient have a choice of many different types of filler. One of the primary distinguishing features is whether a filler is temporary or semipermanent. Among both varieties of fillers, there is considerable variability in duration. There is a broad spectrum of choice among fillers, with animal, nonanimal, human, and synthetic all available. The physician and patient must weigh a range of risk-benefit scenarios in making a choice, and value must also play a role. Finally, fillers are quite versatile, with products developed that are suitable for many areas of the face: fine lines, deep rhytides, folds, lips, and contouring of the face.
If the ideal filler were ever developed, it would be long-lasting but not permanent, since the skin is a dynamic organ. It would be easy to use and inject. The filler would be considered cost effective by both physicians and patients. It would give a natural-looking and smooth-feeling result. It would be versatile and effective in a variety of facial areas. It could be administered without prior allergy testing. And the filler would result in wrinkle correction with minimal side effects and a quick recovery from treatment.
So now we have JUVÉDERM™ injectable gel, a new product from Allergan. It’s an injectable gel dermal filler with a characteristically smooth consistency. Its indication is for the correction of moderate to severe facial folds and wrinkles. It is a nonanimal-sourced hyaluronic acid, which we’re abbreviating as “HA.” JUVÉDERM™ injectable gel is actually a family of HAs.
There’s room for confusion among dermal fillers, so let’s clarify what JUVÉDERM™ injectable gel is not. JUVÉDERM™ injectable gel is not collagen; it is hyaluronic acid or HA. And that’s a naturally occurring substance. JUVÉDERM™ injectable gel is not animal-sourced. It’s cultivated from bacteria, and that means it’s pure and free from any potential animal contaminants, whether bovine or human.
So, how does JUVÉDERM™ injectable gel work? It’s injected below facial wrinkles and folds, filling the area just below the surface of the wrinkle, and lifting it. JUVÉDERM™ injectable gel is cross-linked, which is the established way to prolong duration in HA. Cross-linking is a chemical step in processing HA that physically binds strands of polymers to each other. More cross-linking means more resistance to enzymatic degradation. Without cross-linking, HA would be absorbed into the body in just a few days.
JUVÉDERM™ injectable gel is a family of HA products. Two formulations are available at launch: JUVÉDERM™ Ultra, a versatile formulation that will probably do the lion’s share of the work. And JUVÉDERM™ Ultra Plus injectable gel, a robust formulation for deeper folds and wrinkles. A key difference in formulation is the higher degree of cross-linking in JUVÉDERM™ Ultra Plus, which results in 20% higher viscosity. This increased viscosity creates a more robust product well suited for deeper facial folds.
So, if JUVÉDERM™ injectable gel isn’t the first HA dermal filler, what makes JUVÉDERM™ different? What makes it the first of the next generation of dermal fillers? JUVÉDERM™ injectable gel is the first smooth-consistency gel HA dermal filler. It has a smooth formulation. A smooth natural look. A smooth feel going into the wrinkle. And leaves a smooth and natural look and feel for the patient. Here we have 2 unretouched photos of new JUVÉDERM™ injectable gel and a widely available HA dermal filler. You can actually see a difference at 9-times magnification.
JUVÉDERM™ injectable gel is actually made with proprietary HYLACROSS™ technology. And that results in a high concentration of HA—24 mg per mL— and a high amount of cross-linked HA per mL.
In terms of the actual JUVÉDERM™ injectable gel treatment, Dr Michele Koo, Board Certified Plastic Surgeon, St Louis, Missouri performs this anti-aging wrinkle removal liquid facelift as an in-office procedure in a matter of minutes. There can be some discomfort injecting into facial folds, but pain management is fairly routine with either a nerve block, local anesthetic, or application of ice just before injection. Dr Michele Koo, Board Certified Plastic Surgeon, performs all of the filler injections to remove wrinkles and creases herself, you will not be injected by a non medical spa personnel. Dr Koo will give you her expertise and advice as to the best procedure for your face for removing the creases and wrinkles. She always performs all of the procedures herself so that you are ensured the highest medical safety and expertise.
