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Juvéderm® for wrinkle treatment & facial rejuvenation

What is Juvéderm®?

Juvéderm® prefilled syringes contain hyaluron 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 in 2006 by Allergan, headquartered in California. 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 distinguishes between three types of cross-linking of 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 3D Matrix gels greater cohesion than Vycross gels (Micheels P, et al., 2016, J Drugs Dermatol).

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

Juvéderm® Volbella™

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

Fields of application:

  • Injection of crow’s feet
  • Filling of tear troughs (“nasojugal groove”, “tear trough deformity”)
  • Injection into wrinkles around the mouth
  • Lip injections with filler
  • Injection of smoker wrinkles
  • Modeling of the lip edges (naturally well-formed, curved lip bow)
  • Correction of forehead wrinkles
  • Correction 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).
  • Modulus of viscosity (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 (microns): 403+/- 193 (Cho S.Y. et al., 2018, J Cosmet Dermatol).
  • Water binding (milliliters per gram): 3.8 (Fagien S., et al., 2019, Plast Reconstr Surg).

Juvéderm® Volift™

The cross-linking of this hyaluronic acid is done with the Vycross process. The stability of the gel (Tan value) and the water-binding capacity is comparable to Juvéderm® Volbella™. Due to the higher concentration of hyaluronic acid, the preparation is more suitable for medium-deep wrinkles and for volume building.

Fields of application:

  • Contouring the forehead
  • Injecting forehead wrinkles
  • Lifting the eyebrows
  • Filling empty upper eyelids
  • Correction of hollow temples
  • Injection of wrinkles on the cheeks
  • 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
  • Injecting the marionette wrinkles
  • Enlarge the red of the lips
  • Modeling 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).
  • Modulus of viscosity (G” in Pascal): 46 (Pierre S., et al., 2015, Dermatol Surg).
  • Quotient of viscosity and elasticity (tan delta value): 0.14
  • Water binding (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 hyaluron gel is produced using the Vycross process. The product binds little water, so that the treatment results can be seen early. The concentration of the gel is the highest compared to the other Vycross products. For volume building and correction of deep wrinkles, hyaluronic acid is injected medium to deep.

Fields of application:

  • Filling sagging cheeks
  • Acne scar treatment
  • Rejuvenation of sunken temples
  • Correction of a receding chin
  • Modeling eyebrows
  • Filling empty cheeks
  • Emphasis on the jaw line
  • Modeling the angle of the jaw
  • Correction of the bridge of the nose
  • Lifting the tip of the nose
  • Injection of nasolabial folds and marionette wrinkles
  • Filling of a contraction at the lower jaw margin in 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).
  • Modulus of viscosity (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 hyaluron gel is produced with the Hylacros technology. The hyaluron is particularly suitable for the beautification of the lips. Juvéderm® Ultra Smile and Juvéderm® Ultra 3 have similar indications. The gels differ in their degree of crosslinking and ability to bind water.

Fields of application:

  • Structure of the lips
  • Shape lips
  • Filling the wrinkles around the lips
  • Emphasize natural lip contours (lip heart)
  • Lift drooping corners of the mouth
  • Lip modeling
  • Contour philtrum and cupid’s bow

Important characteristic values:

  • Concentration (milligrams per milliliter): 24

Juvéderm® Ultra 2

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

Fields of application:

  • Beautification and enlargement of the lips.
  • Volume building of the cheeks
  • Injection of nasolabial folds (wrinkles between the nose and mouth)
  • Treatment of marionette wrinkles (wrinkles between the corner of the mouth and chin)
  • Correction of sagging cheeks by filling depressions on the lower jaw (prejowl sulcus)
  • Modeling the corners of the mouth
  • Lip augmentation
  • Lip beautification
  • 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).
  • Modulus of viscosity (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 binding (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). In the USA, the hyaluronic injections have been approved under the name Juvéderm® Ultra Plus XC since 2008. Hyaluronic acid is produced according to the Hylacross process. The hyaluron gel is elastic and binds a lot of water. Therefore, the result may change in the first days after a treatment. The hyaluronic gel is suitable for the treatment of medium deep and deep wrinkles and lips.

Fields of application:

  • Beautification and enlargement of the lips.
  • Rejuvenation of the back of the hand
  • Volume building of the cheeks
  • Correction of nasolabial folds
  • Smoothing marionette wrinkles
  • Raising the corners of the mouth
  • Lip augmentation
  • Correction of sagging cheeks
  • Injection of chin dimples

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).
  • Modulus of viscosity (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 binding (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 strength of the gel is low. Juvéderm® Ultra 4 probably differs by a higher degree of cross-linking and longer hyaluronic acid chains. The hyaluron is suitable for volume building and treatment of deep wrinkles. The hyaluronic acid is supple gel (high Tan Delta value).

Fields of application:

  • Beautification and enlargement of the lips.
  • Volume building of the cheekbones
  • Volume treatment of empty temples
  • Restore the volume of the face
  • Contouring the chin
  • Minimizing Scars
  • 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).
  • Modulus of viscosity (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 with Vycross technology and is CE certified. There is no manufacturer information on important characteristic values. The hyaluronan gel has high strength (elastic modulus) and viscosity (viscosity modulus) (Ogilvie P, et al, 2019, Dermatol Surg). It is used for volume restoration in the face.

Fields of application:

  • Definition of the chin
  • Chin augmentation
  • Concealing sagging cheeks
  • Contouring the jaw line
  • Injecting the chin crease

Important characteristic values:

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

Juvéderm® Volite™

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

Fields of application:

  • Improvement of the skin texture
  • Treatment of fine facial wrinkles
  • Increase skin hydration
  • Softens skin spots and improves the complexion
  • Against skin imperfections
  • 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 manufactured using the 3D matrix process and has been CE certified since 2005. Hyaluronic injections are used to treat fine wrinkles. There is no manufacturer information on the flow properties.

Fields of application:

  • Injection of the crow’s feet
  • Filling the wrinkles on the forehead
  • Injection of bunny wrinkles (Bunny Wrinkles)
  • Correcting frown lines
  • Optimize smile lines

Important characteristic values:

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

Surgiderm® 24 XP

The hyaluron gel is produced with the 3D-Matrix technology and has been approved in Europe since 2005. The prefilled syringes are approved for the treatment of medium depth wrinkles. The XP products have a greater lifting capacity. The XP series differs in the degree of cross-linking of hyaluronic acid.

Fields of application:

  • Reduce wrinkles on the forehead
  • Reduce frown lines
  • Injection of the wrinkles at the corners of the mouth
  • Lip injections with filler

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 the treatment of deep skin wrinkles. Approval in Europe was granted in 2005.

Fields of application:

  • Reduce frown lines
  • Injection of nasolabial folds
  • Shapes of the mouth
  • 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 large lifting capacity. Hyaluron treats especially deep wrinkles and sunken facial contours.

Fields of application:

  • Injection of glabellar wrinkles (frown lines)
  • Eliminate nasolabial folds
  • Treatment of skin folds around the mouth
  • Beautification of the corners of the mouth
  • Accentuation of the lips
  • Lip augmentation
  • Fix wrinkles on the forehead
  • Beautification of the lip contours
  • Underpadding 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).
  • Modulus of viscosity (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 prefilled syringes contain non-crosslinked hyaluronic acid. In addition, Juvéderm® Hydrate contains nine milligrams per milliliter of mannitol. This natural alcohol sugar additionally moisturizes and serves as a free radical scavenger (André P., et al., 2017, Int J Cosmet Sci). The hyaluronic gel can store a lot of water.

Fields of application:

  • Improve moisture and elasticity of the skin.
  • Rejuvenation of the back of the hand
  • Stimulates the formation of collagen
  • Improvement of color defects, also called pigment spots, in the décolleté
  • Improving the appearance of the skin on the neck
  • Refines the complexion of the face

Important characteristic values:

  • Duration of action (months): 6
  • Concentration (milligrams per milliliter): 13.5

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