August 16 is Juvederm Day!  All you need to know about Fillers

Funny, in my world, this means a lot. But for many of you, maybe not.  So humor me!  First of all what is Juvederm?  And why does it need a day?

What is Juvederm?  Juvederm is the trade name for a group of fillers made by Allergan.  

What are fillers?  Fillers are what we use to plump up the skin to improve lines and grooves in the face.  Most fillers are made of hyaluronic acid, which naturally occurs in the skin, the joints and more.  They are synthetically made.  There are dozens of fillers on the market, made by three main companies, Allergan, Galderma and Revance.  Historically, Restylane, currently marketed by Galderma was the first hyaluronic acid filler available in the US and the one I was initially trained with about 20 years ago now.  Since then, a number of other fillers have come to market.

What is the difference between all the fillers available?  Most of the fillers vary in their structure.  Though all are made with hyaluronic acid, in the laboratory fillers can vary.  Over the past few years, thankfully a number of independent studies have now looked at properties of the fillers and tried to define how they are different independent of drug company claims and marketing.  Currently, there are a number of different variables that make all the fillers different and few tests to determine how those variations impact performance, functional ability and results.  This discussion will specifically focus on hyaluronic acid fillers.

Filler Properties:

Concentration – How many filler particles per a given volume.

Particle Size – As a simplification, those with smaller particle size are placed more superficially and used for more fine lines.

Crosslinking – Refers to how the particles are connected and suspended within the solution.

Water absorption – Some of the fillers naturally draw water to themselves, some much more than others, this can lead to fluctuation of result depending on hydration of the filler once in the skin. 

Filller Tests of Functional Ability:

G Prime (G’) – Also know as the elasticity coefficient, refers to the ability of the filler to maintain shape and structure. For example, Restylane Lyft has the highest G Prime so I use it for marionetter lines where I need to rebuild the structure.

Viscosity, Flexibility or X Strain – Refers to Flexibility and refers to the ability of the filler to move well with your skin and to withstand shearing forces. A high X Strain is important for areas like fine lip lines. 

How does a patient choose which filler to use?   Generally,it is hard for the average consumer to pick which filler to use, so I recommend asking your dermatologist what filler they think would be best for the areas you would like to improve.  Practically, pretty much no one carries all the fillers available on the market.  We carry on average 4-5 different varieties of fillers, plus I usually have a few samples of each of the Juvederm family of products available should a patient request a specific one.  

Which filler does Dr Rosenberger use the most?  I usually prefer Juvederm Ultra as a great well-rounded filler and I often use it for fine lines, and filling more superficial areas and lips.  After many years, I don’t feel there is a huge difference in the longevity of the different hyaluronic acid fillers, so I choose more on the scientific performance than anything else. 

Admittedly, if you talk to a hundred injectors, you will have a hundred different approaches to this.  Some injectors even use multiple syringes of different types of filler on the same patient to achieve more specialized results.  Fact of the matter is, most of my patients can’t afford to use multiple different syringes of filler at a given appointment.  So, I have really been challenged over the years to make one syringe work as much as possible.  I try to always fully correct the area that is of most concern to the patient using the filler that scientifically has been shown to be most likely to meet their desired effect.  

As we celebrate Juvederm Day this week, follow us on social media to watch for special promotions through Alle this week. Alle is Allergan’s reward program.  You can read more about it below.  Make sure you have the app downloaded and you are logged in ahead of time to take advantage of their special offers.

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