ArTIcLe | beST prAcTIce |
Figure 1 The anatomic foundation of facial ageing6
.
(A) Young face with midface fat; (B) older face with sagging fat
enhancement and fine wrinkles, although some
patients, including men, may achieve a more satisfactory result with the somewhat more viscous Juvéderm ULTrA 3 (Juvéderm ULTrA pLUS in the US)12
. Additionally, the
products can be combined to augment volume and restore and define the vermilion border depending on individual patient presentation. In general, the more viscous products are best suited for deeper defects, while the less viscous products can be layered over more viscous products. This combination of attributes, including the high degree of cross-linking with a relatively low amount of soluble HA, provides clinicians and patients with a long-lasting outcome that is smooth and natural in feel and appearance.
Juvéderm VOLUMA: properties and performance Juvéderm VOLUMA was designed to be more viscous and robust than other products in the Juvéderm family. It is therefore highly suitable for deep injection and volumising, but not for more superficial uses. In applications where an HA is used for volumising, a high lift capacity is essential. This property is a function of cohesivity and viscosity, as well as gel hardness, and can be achieved using different manufacturing methods. One approach is to increase gel hardness at the expense of cohesivity, a characteristic offered by the restylane family of products. An altogether different way is to combine lower gel hardness with a high degree of cohesivity; a characteristic typified by the Juvéderm family of products. by design, Juvéderm VOLUMA also demonstrates
Figure 2 The triangle of beauty: HeArt of Face™4. Illustration of a 57-year-old female treated with 20 U
BOTOX® Cosmetic in the glabella, Juvéderm™ VOLUMA™ 1 cc in the midface area, and 0.4 cc of Juvéderm® ULTRA 2 in the upper lip contour plus 0.4 cc of Juvéderm® ULTRA 3 in each nasolabial fold. (A) before treatment, (B) 3 months after treatment, (C) after 2 years, and (D) after 5 years
18 ❚ November/December 2011 |
prime-journal.com
maximum lift capacity and retains its gel shape and structure as a result of its high cohesivity. Unlike the other Juvéderm products, however, Juvéderm VOLUMA is composed primarily of low-molecular-weight (LMW) hyaluronic acid, which results in increased thickness and viscosity when it is crosslinked. As the cross-linking is very efficient with LMW hyaluronic acid, the final
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