Want your face to look younger instantly?
You should know about Juvéderm®

Even if you feel as young as you did 20 years ago, is the face in the mirror betraying your age? Have you started to notice:

• Deepening of the “parentheses” between your nose and the corners of your mouth?
• Thinning lips?
• Vertical lines between your eyebrows?
• “Smoker's lines” around your lips?

If you'd like to smooth out these lines and wrinkles instantly—without surgery—you should know about Juvéderm.

What is Juvéderm?

Juvéderm is an injectable hyaluronic acid gel that helps add volume and restore moisture to your skin. This state-of-the-art facial filler works on people of all skin tones, and is the first FDA-approved hyaluronic acid dermal filler proven safe and effective for people of color.

What is hyaluronic acid?

Hyaluronic acid is a naturally occurring substance in the skin—a complex sugar found in all living cells. It provides a framework for the skin by holding collagen and elastin together.

Hyaluronic acid adds moisture to the skin by retaining water like a sponge, absorbing more than 1,000 times its weight. Result: Your skin's volume and density increase, giving you a more youthful appearance.

How is Juvéderm used?

Dr. Rappaport uses Juvéderm to:

• Smooth out the nasolabial folds
• Add fullness to thin lips
• Diminish vertical lip lines (smoker's lines)
• Fill in lines in the glabella—the area between the eyebrows

How long do Juvéderm treatments last?

The FDA has approved a label extension of Juvéderm to provide smooth, natural-looking results lasting up to one year with a single treatment. The FDA approval was based on 2007 clinical data showing that Juvéderm's effects may last for up to 12 months, which is longer than reported in clinical studies supporting FDA approval of other hyaluronic acid facial fillers.

Does Juvéderm have any side-effects?

Juvéderm's manufacturer, Allergan, Inc., reports that Juvéderm's side-effects were usually mild to moderate, lasting seven days or less, and included temporary injection site reactions like redness, pain, firmness, swelling and bumps. As with all skin injection procedures, there is a risk of infection.

Who should not use Juvéderm?

You should not be treated with Juvéderm if you have:

• Severe allergies marked by a history of anaphylaxis
• Multiple severe allergies
• Allergies to gram-positive bacterial proteins

Dr. Rappaport answers questions
about Juvéderm

How do you determine which type of facial filler to recommend for a patient?

“Juvéderm can be used anywhere on the face. However, I like to use a semi-permanent filler such as Radiesse in areas where I know the patient will be happy with the long-term effect.

“If the patient has any concerns about whether he or she will like the results, I will go with a less-permanent filler such as Juvéderm in those areas.”

Are there areas where Juvéderm
is always a better choice?

“I prefer to use Juvéderm for lip enhancement, and avoid using Radiesse in the lips because it is thicker. I may also add some Botox to calm down the muscles around the mouth, because muscle activity tends to make any facial filler go away quicker.”

What is your approach to lip enhancement?

“Less is more. What I try to do is outline the white roll of the lip—the puffy area right above where you put your lipstick. If you desire more lip enhancement, I may add some filler from the red border of the lip, where you put your lipstick, up to the junction of the moist mucosa.

“In patients over 40 who have wrinkles around their lips, I may extend the use of the filler underneath the skin surrounding the lip to smooth out those wrinkles.”

What determines how long a facial filler will last?

“The length of time an injectable material lasts depends not only on the product, but on the amount of muscle activity in the area. While there are guidelines, they're not absolute. If you inject Juvéderm in the nasolabial folds, it will last longer than if you inject it in the lips, simply because there's less muscle motion in the nasolabial folds.”

Do you consider Juvéderm a lunchtime treatment?

“Yes. Many patients are able to return to work or their normal activities after a Juvéderm treatment. However, you might have some temporary bruising and swelling with any injectable filler. While a Juvéderm treatment is not a long procedure, the effect of the injection will result in some swelling greater than the final result.

“It's a good idea to have injectable treatments well before any special events, not at the last minute, in case you experience bruising or swelling.”

What can cause bruising and swelling?

“Part of it has to do with the size of the needle and how fast the material is injected. I use the smallest-gauge needle I can, but that also depends on the thickness of the material—I have to be able to get it through the needle. Juvéderm is not as thick as Radiesse, so I can use a finer-gauge needle.”

Do you numb the area before a Juvéderm treatment?

“Yes. The anesthetic I use depends on the area I'm treating. Before treating the lips with Juvéderm, I use a topical anesthetic and a regional anesthetic block to numb the area. For the nasolabial folds, I normally use just a topical anesthetic.”

Have you noticed a change in what patients want
from injectable treatments?

“Yes. There is an ebb and flow of appearances that people want to emulate. When actresses with fuller lips were popular, patients wanted big lips. Now patients are looking for more subtle changes. That's why we start with a modest lip enhancement and add more only if the patient desires it.”