In the 1930s, researchers discovered a natural substance in the body that they named
hyaluronic acid. They found that it plays a key role in numerous areas of the body
including the maintenance of skin volume and hydration, eye volume and shape, as
well as joint lubrication and cushioning.
In the decades since, numerous therapeutic and aesthetic uses have been developed
for hyaluronic acids. In 2003,
the U.S. Food and Drug Administration (FDA) approved the first hyaluronic acid dermal
filler for the correction of facial wrinkles and folds, such as nasolabial folds
(the folds running from the sides of the bottom of the nose to the outer corners
of the mouth).
Hyaluronic acid retains water -- absorbing more than 1,000 times its weight -- and
adds volume to the skin's surface. In addition, hyaluronic acid binds with collagen
and elastin and transports essential nutrients to these fibers. The triple combination
of collagen, elastin and hyaluronic acid provides structure, elasticity and volume
to the skin and contributes to its overall appearance. The hyaluronic acid
in Juvederm® is called non-animal stabilized hyaluronic acid (NASHA)
because it is not derived from animal sources.
Juvederm® Ultra (also called Juvederm®) is a next-generation,
cross-linked hyaluronic acid dermal filler approved by the FDA in June 2006 for
treatment of nasolabial folds. Juvederm® Ultra (also known as Juvederm®)
adds volume to the face and smoothes
moderate to severe facial
wrinkles and folds. With advanced injection techniques, Juvederm®
can also be used to lift and contour facial features.
Cross-linking refers to a process in which the individual chains of hyaluronic acid
are bound or ‘cross-linked' together, transforming the liquid hyaluronic acid
into a soft gel. The firmness of the gel depends on the degree of cross-linking
of the individual hyaluronic acid chains. The body metabolizes cross-linked hyaluronic
acid more slowly, resulting in a longer duration of effect.
As an advanced, cross-linked hyaluronic acid, the results of a Juvederm®
treatment will typically last up to a year or more. Results will vary depending
upon injector technique, the facial area in which it is applied, and upon the individual's
muscle movement, skin and health characteristics. For example, in areas of
the face where there is less exaggerated muscle movement, Juvederm®
will often last longer. Regular BOTOX® treatments in conjunction
with Juvederm® may help extend the duration of Juvederm®.
Juvederm® Ultra Plus (also known as Juvederm® Plus)
is even more cross-linked than Juvederm® Ultra. Juvederm®
Ultra Plus is used by physicians
to treat deeper wrinkles
and folds. Physicians also use Juvederm® Ultra Plus in liquid
face lift procedures where more bulking or more defined sculpting is desirable.
It provides more volume than Juvederm® Ultra and some other dermal
fillers.

The most common side effects of Juvederm® Ultra and Juvederm®
Ultra Plus include temporary redness, swelling, bumps and bruising. Consult your physician for a complete list of JUVEDERM® side effects and to determine if JUVEDERM® is right for you.
(Related topics: Wrinkle Correction -
Facial Contouring -
How to Extend Results - Physician Selection
Tips - Find a Physician -
What are the Risks - Get Answers)
Contributing Physicians:
W. Grant Stevens MD FACS, Marina Del Rey, CA ~ Richard Fleming MD FACS, Beverly Hills, CA
Kimberly J. Butterwick MD, San Diego, CA ~ Cynthia Elliott M.D., Clearwater, FL
Wm. Stephen Martin M.D., Mobile, AL ~ Deason Dunagan M.D., Huntsville, AL
Lydia Parker M.D., Willoughby, OH ~ Paul M. Friedman MD, New York, NY
Lydia Parker M.D., Beachwood, OH ~ Paul M. Friedman MD, Houston, TX
Juvéderm® and BOTOX® are registered trademarks
of Allergan, Inc.