It has been a while! I hope everyone had a good summer and that the new school year is off to a good start!
I thought I would do a quick blog on some of the newer HA (hyaluronic acid) dermal fillers that have come on the market. As an injector I have been utilizing Allergan’s offerings with Vycross® technology. These products inject very smoothly, have good malleability and moldability and tend to create less swelling for my patients. (not ZERO swelling, but less) As an injector it makes my job easier and for my patients the treatments are well tolerated. Additionally, the product lasts longer due to Vycross® technology.
The Juvederm® family of products have been available for a number of years. Juvederm Ultra® XC and Juvederm Ultra Plus® XC utilize hylacross technology, the predecessor to the newer line of products. Vycross® technology blends different molecular weights of hyaluronic acid and have enhanced cross linking to increase the duration of the product in the dermis. The newer products, Juvederm Voluma®, Juvederm Vollure™ and Juvederm Volbella® have given injectors and patients more options to choose from.
The products have differences which make them suitable for different areas of the face. Voluma® has 20 mg/ml of Hyaluronic Acid, tends to be very cohesive and is frequently utilized in the mid face to replace lost volume and to create lift. Vollure™ has 17.5 mg/ml of Hyaluronic Acid and tends to be much less cohesive than Voluma® and works well in areas where finer correction or more subtle volume is desired. Volbella® has 15 mg/ml of Hyaluronic Acid and works well in fine lines, such as perioral lines (smoker lines). Volbella® smooths very easily once injected. In general, the less the HA concentration the softer and smoother the product. You and your provider can determine which products to use to achieve your aesthetic goals. It may be that you can benefit from several of the products.
All of the products mentioned have 0.3% lidocaine added to make the injections less painful. I also pretreat with topical numbing and use ice during the treatment. There are also occasions when a 2% lidocaine dental block is helpful. For example, lip injections.
The duration of the products varies patient to patient and the companies literature tends to promise more than it can deliver. BUT, I do find these products are outperforming their predecessors and longevity has improved. All of the HA fillers have a good safety record and have minimal side effects.