What is Juvederm®?

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 in 2006 by Allergan, headquartered in California. Juvéderm® was first approved by the US Food and Drug Administration (FDA) in 2006. Bacteria (Streptococcus equi) are used in the production of Juvéderm®. BDDE (1,4-butanediol diglycidyl ether) is used to crosslink the hyaluronic acid chains. Allergan distinguishes three types of cross-linking of the hyaluronic acid chains: the Vycross Technologie™, the Hylacross Technologie™ and the 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 a greater cohesion than the Vycross gels (Micheels P, et al., 2016, J Drugs Dermatol). The ability to bind water is greater in the hylacross gels than in the 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 hyaluron gels contain the local anaesthetic lidocaine (three milligrams per millilitre). The Allergan company has been working with the Brazilian plastic surgeon De Maio since 2015 to offer courses in hyaluronic injections.

 

Juvéderm® Volbella™

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

Fields of application:

  • Injection of crow's feet
  • Filling of tear ducts ("nasojugal groove", "tear trough deformity")
  • Injection into wrinkles around the mouth
  • Lip Injection
  • Injection of smoking wrinkles
  • Modelling of the lip edges (naturally well-formed, curved lip arch)
  • Correction of forehead wrinkles
  • redressing frown lines
  • Treatment of horizontal wrinkles on the neck
  • Treatment of wrinkles of the earlobes
  • Lip Filling
  • Lip contouring

Important parameters:

  • Concentration (milligram per milliliter): 15
  • Duration of effect (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 (microns): 403+/- 193 (Cho S.Y. et al., 2018, J Cosmet Dermatol)
  • Water binding (millilitres 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 water-binding capacity is comparable to Juvéderm® Volbella™. The higher concentration of hyaluronic acid makes the preparation more suitable for medium-depth wrinkles and for volume build-up.

Fields of application:

  • Forehead contouring
  • Injecting under forehead wrinkles
  • Raising the eyebrows
  • Filling empty upper eyelids
  • Correction of hollow temples
  • Injecting under cheek wrinkles
  • Flattening of deep nasolabial folds (nose-mouth wrinkles)
  • Modeling the bridge of the nose
  • Contouring the nostrils
  • Correction of the tip of the nose
  • Injecting the puppet wrinkles
  • Enlarge the red of the lips
  • Modelling of the channel between nose and upper lip (Philtrum)

Important parameters:

  • Concentration (milligram per milliliter): 17.5
  • Duration of effect (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 binding (millilitres per gram): 4 (Edsman K.L.M., et al., 2018, Dermatol Surg)

Juvéderm® Voluma™

The Hyaluron Juvéderm® Voluma™ has been approved in Europe since 2008 and in the USA since 2013. The hyaluronic gel is manufactured using the Vycross process. The product binds little water, so that the treatment results can be seen early on. The concentration of the gel is the highest in comparison with the other Vycross products. To increase volume and correct deep wrinkles, the hyaluronic acid is injected medium-deep to deep.

Fields of application:

  • Filling flabby cheeks
  • Treatment of acne scars
  • Rejuvenation of sunken temples
  • Correction of a receding chin
  • Modeling of the eyebrows
  • Filling empty cheeks
  • Emphasis on the jaw line
  • Modelling the jaw angle
  • Correction of the bridge of the nose
  • Lifting the tip of the nose
  • Injecting nasolabial folds and puppet wrinkles
  • Filling of a retraction at the edge of the lower jaw in the case of drooping jaws (Prejowl sulcus)
  • Chin contouring

Important parameters:

  • Concentration (milligram per milliliter): 20
  • Duration of effect (months): 24
  • 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 (millilitres per gram): 2.8 (La Gatta A., et al., 2019, PLoS One. 2019)

Juvéderm® Volux™

The hyaluronic acid is produced with the Vycross technology and is CE certified. There are no manufacturer's specifications for important characteristic values. The hyaluron gel has a high strength (modulus of elasticity) and viscosity (modulus of viscosity) (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
  • Lamination of hanging cheeks
  • Contouring of the jaw line
  • Injecting the chin crease

Important parameters:

  • Concentration (milligram per milliliter): 25
  • Duration of effect (months): 12

Juvéderm® Volite™

The hyaluronic acid is cross-linked with the Vycross technology. The gel contains a low concentration of hyaluronic acid and is CE certified. There are no manufacturer's specifications regarding the degree of crosslinking, flow properties or water retention capacity of Juvéderm® Volite™.

Fields of application:

  • Improving skin texture
  • Treatment of fine facial wrinkles
  • Increase of skin moisture
  • Reduces skin spots and improves the complexion
  • Against skin imperfections
  • Treatment of skin irregularities

Important parameters:

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

Surgiderm® 18

The hyaluronic acid is produced using the 3D matrix method and has been CE certified since 2005. The hyaluronic acid injections are used for the treatment of fine wrinkles. There are no manufacturer's specifications regarding the flow properties.

Fields of application:

  • Injection of crow's feet
  • Filling the forehead wrinkles
  • Spraying away rabbit wrinkles (bunny wrinkles)
  • Correcting frown lines
  • Optimizing laughter lines
  • Optimizing laughter lines

Important parameters:

  • Duration of effect (months): 6
  • Concentration (milligram 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 ready-to-use syringes are approved for the treatment of medium deep wrinkles. The XP products have a greater lifting capacity. The XP range differs in the degree of cross-linking of the hyaluronic acid.

Fields of application:

  • Reduction of forehead wrinkles
  • Reduce frown lines
  • Spray wrinkles around the mouth away
  • Injection of the corner of the mouth wrinkles
  • Lip Injection

Important parameters:

  • Duration of effect (months): 9
  • Concentration (milligram per milliliter): 24

Surgiderm® 30

The hyaluronic acid from the 3D-Matrix series is suitable for the treatment of deep skin wrinkles. It was approved in Europe in 2005.

Fields of application:

  • Reduction of frown lines
  • Injection of nasolabial folds
  • Forms of the mouth
  • Lifting the corners of the mouth
  • Lip augmentation

Important parameters:

  • Duration of effect (months): 9
  • Concentration (milligram per milliliter): 24

Surgiderm® 30 XP

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

Fields of application:

  • Injection of glabella wrinkles (frown lines)
  • nasolabial fold removal
  • Treatment of skin folds around the mouth
  • Embellishing the corners of the mouth
  • Accentuation of the lips
  • Lip augmentation
  • Eliminating forehead wrinkles
  • Embellishment of the lip contours
  • Upholstery of the cheeks

Important parameters:

  • Duration of effect (months): 12
  • Concentration (milligram 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® Ultra Smile

The hyaluronic acid preparation is CE certified since 2011. The hyaluron gel is produced with the hylacross technology. The hyaluron is especially suitable for the beautification of the lips. Juvéderm® Ultra Smile and Juvéderm® Ultra 3 have similar applications. The gels differ in their degree of cross-linking and ability to bind water.

Fields of application:

  • Structure of the lips
  • lip-shape
  • Filling wrinkles around the lips
  • Highlight natural lip contours (lip heart)
  • Raise hanging corners of the mouth
  • Lip Modelling
  • Contour philtrum and cupid bow

Important characteristic value:

  • Concentration (milligram per milliliter): 24

Juvéderm® Ultra 2

The hyaluronic acid is cross-linked by the Hylacross process. The Juvéderm® Ultra 2 available in Europe is equivalent to the Juvéderm® Ultra XC available in the USA since 2006. The gel is elastic and binds plenty of water. Juvéderm® Ultra 2 is used to correct fine and medium-deep skin wrinkles and to treat lips.

Fields of application:

  • Embellishment and enlargement of the lips.
  • Cheek volume enhancement
  • Injecting nasolabial folds (wrinkles between nose and mouth)
  • Treatment of puppet wrinkles (wrinkles between the corner of the mouth and chin)
  • Correction of drooping cheeks by filling in depressions in the lower jaw (Prejowl sulcus)
  • Modelling the corners of the mouth
  • Lip augmentation
  • lip enhancement
  • Chin correction

Important parameters:

  • Concentration (milligram 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 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 syringes have been approved in 2008 under the name Juvéderm® Ultra Plus XC. The hyaluronic acid is manufactured using the Hylacross process. The hyaluronic acid gel is elastic and binds a lot of water. The result may therefore change in the first few days after treatment. The hyaluron gel is suitable for the treatment of medium and deep wrinkles as well as lips.

Fields of application:

  • Embellishment and enlargement of the lips
  • Rejuvenation of the back of the hand
  • Volume increase of the cheeks
  • Correction of nasolabial folds
  • Smoothing puppet wrinkles
  • Lifting the corners of the mouth
  • Lip structure
  • Correction of drooping cheeks
  • injection of chin dimples

Important parameters:

  • duration of action (months): 12 (Day D.J., et al., 2004, Am J Clin Dermatol)
  • Concentration (milligram 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 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 in a higher degree of cross-linking and longer hyaluronic acid chains. Hyaluronic acid is suitable for building volume and treating deep wrinkles. Hyaluronic acid is a smooth gel (high Tan Delta value).

Fields of application:

  • Embellishment and enlargement of the lips.
  • Volume increase of the cheekbones
  • Volume treatment of empty temples
  • Restoration of the facial volume
  • Chin contouring
  • Scar treatment
  • Manual rejuvenation

Important parameters:

  • duration of action (months): 12 (Day D.J., et al., 2004, Am J Clin Dermatol)
  • Concentration (milligram 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® Hydrate

Hyaluronic acid is used to treat the superficial layers of the skin and has been approved in Europe since 2008. The ready-to-use syringes contain non-crosslinked hyaluronic acid. Juvéderm® Hydrate also contains nine milligrams per milliliter of mannitol. This natural alcohol sugar provides additional moisture and acts as a free radical scavenger (André P., et al., 2017, Int J Cosmet Sci). The hyaluron gel can store a lot of water.

Fields of application:

  • Improvement of moisture and elasticity of the skin.
  • Rejuvenation of the back of the hand
  • Stimulates the formation of collagen
  • Improvement of colour defects, also called pigmentation marks, in the décolleté
  • Improvement of the skin appearance on the neck
  • Refines the complexion of the face

Important parameters:

  • Duration of effect (months): 6 to 9
  • Concentration (milligram per milliliter): 13.5

Author's statement

Author: Stéphane Stahl, MD, PhD. There are no financial relationships with the pharmaceutical or medical device industries that could have influenced the above text. Any reproduction, even partial, is permitted for personal use only. All texts used on this website are protected by copyright.

 

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