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Juvederm
 

One of the newest, most popular trends worldwide in plastic and cosmetic surgery is facial injectables. Leading the pack during the past three years is the wrinkle remover Botox, which saw 3.9 million injections delivered in 2006.

Surgeons and consumers quickly discovered the convenience of visiting a doctor during a lunch hour and leaving immediately afterwards while enjoying a refreshed, more youthful look. However, Botox is only indicated for removing wrinkles around the eyes, the forehead and the mouth.

But the message was clear: Cosmetic, plastic and dermatological surgeons noted that patients wanted quicker procedures. So they started offering various facial injectable filler substances like collagen which could be infused just under the skin.

But there is a downside to facial injectables: the body absorbs almost all fillers within six months to a year.

The newest and most popular dermal fillers are now Restylane and Juvederm which are chemically very closely related. Both are made from hyaluronic acid, a substance found naturally in the body. Among other functions, hyaluronic acid functions to maintain skin volume; the substance can also absorb up to 1000 times its weight in water and has been safely used in medicine for six decades.

Many surgeons report that Juvederm gel is easier to inject than Restylane, less costly and lasts somewhat longer.
Juvederm Photo Gallery
Juvederm Video Gallery
 
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What are some of the most common benefits of this surgery?
Juvederm plumps up deep lines in the face, fills out scars, and augments lips, providing results that are not much different than surgery. But, unlike surgery, patients do not have take time away from their busy lives, jobs and schedules to allow for healing. Because no incision is involved, a patient can usually immediately leave the surgeon’s office and return to her usual routines and activities.
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What will happen at the initial consultation?
Your doctor will take an extensive medical history because some patients with some conditions can not tolerate Juvederm. The physician will also examine your face to make sure you are an appropriate candidate for Juvederm. At this time, you will be able to ask any questions you may have, like how often the surgeon gives Juvederm. Physicians are fond of saying that facial injectable procedures are highly “provider dependent.” This statement means that a great deal of skill and experience is required to plump up facial folds and wrinkles, or to augment the lip with injectables. Physicians who have seen many patients are usually the most skilled.
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How are Juvederm injections performed?
When you and your surgeon have decided that Juvederm is an appropriate treatment for you, the doctor will place a topical numbing medication on the injection area and let it take effect. For very sensitive areas, some physicians may place a dental block into the area of the face receiving the Juvederm. Many are adept at delivering other fillers like Perlane into the very deep structures of the face and then placing Juvederm atop that substance. Sometimes, ice is also used to numb the treatment area. Almost all plastic, cosmetic and dermatological surgeons use the tiniest needle available, one about as thin as four or five human hairs. Once numb, you’ll receive a series of small injections where required to provide more volume under the skin. Experienced doctors often say that Juvederm is somewhat smoother than Restylane and goes into and under the skin slightly easier.
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How long do the injections take?
You should be able to leave the doctor’s office about 20 minutes after the numbing cream takes effect.
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Will I need to stay in a hospital?
No.
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What can I expect afterwards?
The doctor may tenderly massage the injection area for a minute or two. A few patients may have some reddening spots or bruising at the injection sites. Some physicians recommend continuing the ice application for the rest of the day. You’ll notice a smoothing of the treatment area almost immediately.
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What is the recovery period like?
The recovery period is very short, typically taking just an afternoon. The most common side effects include temporary injection site reactions like redness, pain and tenderness, swelling and lumps and bumps. Exposure of the treated area to strong sunlight or extremely cold weather should be held to a minimum until any redness or swelling has gone away. You should not have a laser treatment or a chemical peel or any other procedure that causes an active response in the skin. Try to avoid any active infections at the injection site, and do not have the treatment if you already have an infection.
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What is the long-term outcome like for most people?
Most patients enjoy the facial enhancements until the Juvederm is absorbed; the refreshed look lasts six months to a year, depending on the patient, the practitioner and the exact dose received. Many return to their physicians to maintain the enhanced look with additional injections.
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Ideal candidate:
The ideal candidates for Juvederm injections include people who desire facial enhancements din the following areas:
  • Forehead lines
  • The glabellar lines (the deep folds between the eyebrows)
  • Nasal furrows
  • Cheek wrinkles
  • The “marionette” lines at the corners of the mouth
  • Lips
  • Scar correction
  • Troughs under the eyes
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    Alternatives:
    Older injectables like Cosmoderm and Cosmoplast, substances derived from animal tissues, can still be found at the offices of some physicians. Hylaform removes wrinkles and restores fullness to the skin while Sculptra stimulates the body’s collage production to fill in sunken facials areas. (Ask your doctor about permanent facial fillers like Artecoll and Artefill if you dislike returning for maintenance injections.)
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    Other potential complications include:
    Juvederm has not been tested on pregnant patients, those who may be breast feeding, or on patients younger than 18. The safety and effectiveness of Juvederm for treating areas other than facial wrinkles and folds -- like the lips -- have not been studied. Also, testing of Juvederm has not been done on patients who have a medical history of hypertropic scarring or keloid formations. Your doctor will tell you more about potential complications that might affect you.
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    Costs:
    According to the American Society of Plastic Surgeons, the average Juvederm cost in the United States in 2007 was $598. Prices vary depending on the area of the nation in which you live.
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    Questions to ask your doctor:
    Be sure and ask how many syringes of Juvederm your enhancement will require and how many patients he or she has administered Juverderm to The following questions should help you to select your doctor, and better understand the procedure.
    1. Are the desired results I described realistic?
    2. How should I prepare my skin for the treatment
    3. Where is the procedure performed? How long will it take?
    4. Are there other procedures that I should consider to enhance the affects of Juvederm?
    5. How much will the procedure cost?
    6. What is your experience in performing this procedure? (How long has he/she performed this procedure, and how many he/she has performed in the past year?)
    7. How long has your practice offered Juvederm injections?
    8. What percentages of patients have had significant complications? (The physician should disclose this information to you.)
    9. When should I start noticing the results of the Juvederm procedure?
    10. Will you repeat or correct the procedure if it does not meet agreed upon goals? And if the procedure must be repeated or corrected, will I be charged again? (The physician should provide you with his/her policy on this issue.)
    11. May I see "before and after" photos of recent patients? (The physician should provide many photos of recent patients.)
    12. May I have the names and contact information for several recent Juvederm patients? (Follow up to get first-hand information on the procedure and the physician.)
    13. Could I observe the exact procedure I am considering before I decide to have the procedure? (Either on videotape or live.)
    14. What should I expect post-operatively in terms of soreness, what to watch for, medication, bathing, and level of activity? (Ask if your doctor has a list of activities that you should avoid.)
    15. Who will be assisting during the procedure? What are their qualifications? (Does the physician perform the entire procedure?)
    16. Have you ever had your malpractice insurance coverage denied, revoked, suspended?
    17. Do you offer patient financing?
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    Be sure to:
    Get a written quote and thoroughly check your doctor’s credentials and training beforehand. The best way to screen out undesirable doctors is to check on the doctor’s hospital privileges. Hospitals will not extend operating privileges to physicians who cause problems or perform lackluster surgery.
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    How do I finance this procedure?
    Did you know that 29% of all Americans have considered having an elective procedure? Of those, 60% would schedule a procedure immediately if financing was available. With iEnhance's patient financing options, money no longer has to be the barrier between you and your new image. By filling out our on-line application you can qualify for a loan in as little as 30 seconds.
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    Related Articles
    Chasing Botox: Juvederm

    Coming Soon: New Facial Injectables!

    Wikipedia’s Entry on Juvederm
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    Facts:

    *Top 5 Surgical Cosmetic Procedures in 2008:

    1. Breast Augmentation: 356,000
    2. Liposuction: 341,000
    3. Blepharoplasty: 195,000
    4. Rhinoplasty: 152,000
    5. Abdominoplasty: 147,000

    *Top 5 Non-Surgical Cosmetic Procedures in 2008:

    1. Botox: 2,464,000
    2. Laser Hair Removal: 1,281,000
    3. Juvederm/Restylane: 1,263,000
    4. Chemical Peel: 592,000
    5. Laser Skin Resurfacing: 571,000

    * Data collected from the American Society of Plastic Surgeons (ASPS)
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