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Juvéderm® for wrinkle treatment & facial rejuvenation

What is Juvéderm®?

Juvéderm® pre-filled syringes contain hyaluronic acid for wrinkle treatment and facial rejuvenation. Juvéderm® and Surgiderm® were developed by the French company Corneal Group. Juvéderm® hyaluronic acid was approved in Europe in 2003. The company was acquired by Allergan, headquartered in California, in 2006. Juvéderm® was first approved by the US Food and Drug Administration (FDA) in 2006.

Bacteria are used in the production of Juvéderm® (Streptococcus equi). BDDE (1,4-butanediol diglycidyl ether) is used to crosslink the hyaluronic acid chains. Allergan differentiates between three types of cross-linking of the hyaluronic acid chains: Vycross Technology™, Hylacross Technology™ and 3D Matrix Technology.

The Vycross process cross-links short-chain hyaluronic acid with long-chain hyaluronic acid. The Hylacross process cross-links long hyaluronic acid chains with each other. In 3D matrix linking, many long chains are strongly cross-linked with a few short chains of hyaluronic acid. This structure gives the 3D matrix gels greater cohesion than the Vycross gels (Micheels P, et al., 2016, J Drugs Dermatol).

The ability to bind water is greater with Hylacross gels than with Vycross hyaluronic acid gels (Goodman GJ, et al. 2015 Plast Reconstr Surg). The Hylacross gels are characterized by their viscosity and durability (Fallacara A., et al., 2017, Facial Plast Surg). All Allergan hyaluronic gels contain the local anesthetic lidocaine (three milligrams per milliliter). Allergan has been working with the Brazilian plastic surgeon De Maio since 2015 to offer courses in hyaluronic acid injections.

Juvéderm® Volbella™

The hyaluronic acid gel was approved in Europe in 2011 and by the U.S. Food and Drug Administration (FDA) in 2016. The hyaluronic acid is cross-linked using the Vycross process. Hyaluronic acid is relatively soft and spreads well in the tissue. The hyaluronic preparation is suitable for correcting fine lines and medium-deep wrinkles.

Areas of application:

Injections for crow’s feet
Filling of tear troughs (“nasojugal groove”, “tear trough deformity”)
Injection into wrinkles around the mouth
Lip injections
Injection of smoker’s wrinkles
Sculpting the edges of the lips (naturally well-formed, curved lip arch)
Correction of forehead wrinkles
Removal of frown lines
Treatment of horizontal wrinkles on the neck
Treatment of earlobe wrinkles
Lip filling
Lip contouring

Important characteristic values:

Concentration (milligrams per milliliter): 15
Duration of action (months): 12 (Narins R.S., et al., 2011, Dermatol Surg)
Modulus of elasticity (G’ in Pascal, at 25°Celsius and 0.1 Hertz): 159 (Fagien S., et al., 2019, Plast Reconstr Surg)
Viscosity modulus (G” in Pascal, at 25°Celsius and 0.1 Hertz): 21 (Fagien S., et al., 2019, Plast Reconstr Surg)
Quotient of viscosity and elasticity (Tan Delta value): 0.13
Particle size (micrometers): 403+/- 193 (Cho S.Y. et al., 2018, J Cosmet Dermatol)
Water retention (milliliters per gram): 3.8 (Fagien S., et al., 2019, Plast Reconstr Surg)

Juvéderm® Volift™

This hyaluronic acid is cross-linked using the Vycross process. The stability of the gel (Tan value) and the water-binding capacity are comparable to Juvéderm® Volbella™. Due to the higher concentration of hyaluronic acid, the preparation is better suited for medium-deep wrinkles and for building up volume.

Areas of application:

Contouring the forehead
Injection of forehead wrinkles
Lifting the eyebrows
Filling empty upper eyelids
Correction of hollow temples
Injection of cheek wrinkles
Leveling of deep nasolabial folds (nose-mouth wrinkles)
Modeling the bridge of the nose
Contouring the wings of the nose
Correction of the tip of the nose
Injection of the marionette lines
Enlarging the red of the lips
Modeling of the groove between the nose and upper lip (philtrum)

Important characteristic values:

Concentration (milligrams per milliliter): 17.5
Duration of action (months): 18
Modulus of elasticity (G’ in Pascal): 340 (Pierre S., et al., 2015, Dermatol Surg)
Viscosity modulus (G” in Pascal): 46 (Pierre S., et al., 2015, Dermatol Surg)
Quotient of viscosity and elasticity (Tan Delta value): 0.14
Water retention (milliliters per gram): 4 (Edsman K.L.M., et al., 2018, Dermatol Surg)

Juvéderm® Voluma™

Hyaluron Juvéderm® Voluma™ has been approved in Europe since 2008 and in the USA since 2013. The hyaluronic gel is produced using the Vycross process. The product binds little water so that the treatment results can be seen at an early stage. The concentration of the gel is the highest compared to the other Vycross products. Hyaluronic acid is injected at medium to deep depths to increase volume and correct deep wrinkles.

Areas of application:

Filling sagging cheeks
Treatment of acne scars
Rejuvenation of sunken temples
Correction of a receding chin
Modeling the eyebrows
Filling empty cheeks
Emphasizing the jawline
Modeling the jaw angle
Correction of the bridge of the nose
Lifting the tip of the nose
Injection of nasolabial folds and marionette lines
Filling of an indentation at the lower jaw edge in the case of sagging jaws (prejowl sulcus)
Contouring the chin

Important characteristic values:

Concentration (milligrams per milliliter): 20
Duration of action (months): 18 (Smith S.R., et al., 2010, Arch Dermatol Res)
Modulus of elasticity (G’ in Pascal, at 30°Celsius and 0.7 Hertz): 270 (Sundaram H., et al., 2013, Plast Reconstr Surg)
Viscosity modulus (G” in Pascal, at 30°Celsius and 0.7 Hertz): 28 (Sundaram H., et al., 2013, Plast Reconstr Surg)
Quotient of viscosity and elasticity (Tan Delta value): 0.1
Water binding (milliliters per gram): 2.8 (La Gatta A., et al., 2019, PLoS One. 2019)

Juvéderm® Ultra Smile

The hyaluronic acid preparation has been CE certified since 2011. The hyaluronic gel is produced using Hylacros technology. Hyaluron is particularly suitable for beautifying the lips. Juvéderm® Ultra Smile and Juvéderm® Ultra 3 have similar areas of application. The gels differ in their degree of cross-linking and ability to bind water.

Areas of application:

Structure of the lips
Shaping lips
Filling in wrinkles around the lips
Emphasize natural lip contours (lip heart)
Raise drooping corners of the mouth
Lip modeling
Contouring the philtrum and cupid’s bow

Important characteristic values:

Concentration (milligrams per milliliter): 24

Juvéderm® Ultra 2

The hyaluronic acid is cross-linked using the Hylacross process. Juvéderm® Ultra 2, which is available in Europe, corresponds to Juvéderm® Ultra XC, which has been available in the USA since 2006. The gel is elastic and binds plenty of water. Juvéderm® Ultra 2 is used for the correction of fine and medium-deep skin wrinkles and for the treatment of lips.

Areas of application:

Beautification and enlargement of the lips.
Volume build-up of the cheeks
Injection of nasolabial folds (wrinkles between the nose and mouth)
Treatment of marionette lines (wrinkles between the corner of the mouth and chin)
Correction of sagging cheeks by filling depressions in the lower jaw (prejowl sulcus)
Sculpting the corners of the mouth
Lip augmentation
Lip enhancement
Chin correction

Important characteristic values:

Concentration (milligrams per milliliter): 24
Modulus of elasticity (G’ in Pascal, at 25°Celsius and 0.1 Hertz): 76 (Fagien S., et al., 2019, Plast Reconstr Surg)
Viscosity modulus (G” in Pascal, at 25°Celsius and 0.1 Hertz): 18 (Fagien S., et al., 2019, Plast Reconstr Surg)
Quotient of viscosity and elasticity (Tan Delta value): 0.23
Cross-linking (percent): 6
Water retention (milliliters per gram): 8.2 (Edsman K.L.M., et al., 2018, Dermatol Surg)

Juvéderm® Ultra 3

Juvéderm® Ultra 3 was approved in Europe in 2007 (CE certified). Hyaluronic acid injections have been approved in the USA under the name Juvéderm® Ultra Plus XC since 2008. Hyaluronic acid is produced using the Hylacross process. The hyaluronic gel is elastic and binds a lot of water. The result may therefore change in the first few days after treatment. The hyaluronic gel is suitable for treating medium and deep wrinkles as well as the lips.

Areas of application:

Beautification and enlargement of the lips.
Rejuvenation of the back of the hand
Volume build-up of the cheeks
Correction of nasolabial folds
Smoothing marionette lines
Raising the corners of the mouth
Lip augmentation
Correction of sagging cheeks
Injection of dimples in the chin

Important characteristic values:

Duration of action (months): 12 (Day D.J., et al., 2004, Am J Clin Dermatol)
Concentration (milligrams per milliliter): 24
Modulus of elasticity (G’ in Pascal, at 37°Celsius and 0.1 Hertz): 173 (Santoro S., et al., 2011, J Appl Biomater Biomech)
Viscosity modulus (G” in Pascal, at 37°Celsius and 0.1 Hertz): 37 (Santoro S., et al., 2011, J Appl Biomater Biomech)
Quotient of viscosity and elasticity (Tan Delta value): 0.21
Cross-linking (percent): 8
Water retention (milliliters per gram): 9.5 (Edsman K.L.M., et al., 2018, Dermatol Surg)

Juvéderm® Ultra 4

Juvéderm® Ultra 4 is manufactured using the Hylacross process. The firmness of the gel is low. Juvéderm® Ultra 4 probably differs in that it has a higher degree of cross-linking and longer hyaluronic acid chains. Hyaluron is suitable for increasing volume and treating deep wrinkles. The hyaluronic acid is a smooth gel (high tan delta value).

Areas of application:

Beautification and enlargement of the lips.
Volume build-up of the cheekbones
Volume treatment of empty temples
Restoring facial volume
Contouring the chin
Scar treatment
Hand rejuvenation

Important characteristic values:

Duration of action (months): 12 (Day D.J., et al., 2004, Am J Clin Dermatol)
Concentration (milligrams per milliliter): 24
Modulus of elasticity (G’ in Pascal, at 37°Celsius and 0.1 Hertz): 102 (Santoro S., et al., 2011, J Appl Biomater Biomech)
Viscosity modulus (G” in Pascal, at 37°Celsius and 0.1 Hertz): 30 (Santoro S., et al., 2011, J Appl Biomater Biomech)
Quotient of viscosity and elasticity (Tan Delta value): 0.29

Juvéderm® Volux™

The hyaluronic acid is produced using Vycross technology and is CE certified. There is no manufacturer’s information on important characteristic values. The hyaluronic acid gel has a high strength (modulus of elasticity) and viscosity (modulus of viscosity) (Ogilvie P, et al., 2019, Dermatol Surg). It is used to restore volume to the face.

Areas of application:

Definition of the chin
Chin augmentation
Concealing sagging cheeks
Contouring the jawline
Injection of the chin crease

Important characteristic values:

Concentration (milligrams per milliliter): 25
Duration of action (months): 12

Juvéderm® Volite™

The hyaluronic acid is cross-linked using Vycross technology. The gel contains a low concentration of hyaluronic acid and is CE certified. There is no manufacturer’s information on the degree of cross-linking, the flow properties or the capacity to bind water of Juvéderm® Volite™.

Areas of application:

Improvement of the skin texture
Treatment of fine facial wrinkles
Increase skin hydration
Softens skin spots and improves the complexion
Against uneven skin
Treatment of skin irregularities

Important characteristic values:

Concentration (milligrams per milliliter): 12
Duration of action (months): 6 (Niforos F., et al., 2019, Clin Cosmet Investig Dermatol. 2019)

Surgiderm® 18

Hyaluronic acid is produced using the 3D matrix process and has been CE certified since 2005. Hyaluronic acid injections are used to treat fine wrinkles. There is no manufacturer’s information on the flow properties.

Areas of application:

Injection of the crow’s feet
Filling the forehead wrinkles
Injection of bunny wrinkles (bunny folds)
Correction of frown lines
Optimizing laugh lines

Important characteristic values:

Duration of action (months): 6
Concentration (milligrams per milliliter): 18

Surgiderm® 24 XP

The hyaluronic gel is produced using 3D matrix technology and has been approved in Europe since 2005. The pre-filled syringes are approved for the treatment of medium-deep wrinkles. The XP products have a greater lifting capacity. The XP series differs in the degree of cross-linking of the hyaluronic acid.

Areas of application:

Reducing forehead wrinkles
Reducing frown lines
Injection of the corners of the mouth
Lip injections

Important characteristic values:

Duration of action (months): 9
Concentration (milligrams per milliliter): 24

Surgiderm® 30

Hyaluronic acid from the 3D-Matrix range is suitable for treating deep skin wrinkles. It was approved in Europe in 2005.

Areas of application:

Reducing frown lines
Injection of nasolabial folds
Shaping the mouth area
Raising the corners of the mouth
Lip augmentation

Important characteristic values:

Duration of action (months): 9
Concentration (milligrams per milliliter): 24

Surgiderm® 30 XP

Surgiderm® 30XP was approved in Europe in 2005. The 3D matrix hyaluronic acid has a high lifting capacity. Hyaluron treats particularly deep wrinkles and sunken facial contours.

Areas of application:

Injection of glabellar wrinkles (frown lines)
Elimination of nasolabial folds
Treatment of skin folds around the mouth
Beautification of the corners of the mouth
Accentuation of the lips
Lip augmentation
Removal of forehead wrinkles
Enhancement of the lip contours
Padding the cheeks

Important characteristic values:

Duration of action (months): 12
Concentration (milligrams per milliliter): 24
Modulus of elasticity (G’ in Pascal, at 25°Celsius and 1 Hertz): 133 (Micheels P, et al., 2018, J Drugs Dermatol)
Viscosity modulus (G” in Pascal, at 25°Celsius and 1 Hertz): 35 (Micheels P, et al., 2018, J Drugs Dermatol)
Quotient of viscosity and elasticity (Tan Delta value): 0.27

Juvéderm® Hydrate

Hyaluronic acid is used to treat the superficial layers of the skin and has been approved in Europe since 2008. The pre-filled syringes contain non-crosslinked hyaluronic acid. This natural alcohol sugar provides additional moisture and serves as a radical scavenger (André P., et al., 2017, Int J Cosmet Sci). The hyaluronic gel can store a lot of water.