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Happy New Year! Whether or not you are ready to admit it, I am sure that “to look better naked” is included on quite a few New Years’ Resolution lists.
As someone who helps people “Look Better Naked” for a living, I can share with you that a new favorite procedure is injectable filler.
In last month’s column, I highlighted this process, and during the month of January I will offer a four-part series on the various types of fillers currently available.
As injectable fillers go, there are a few “household names” such as Juvederm, Collagen and Restylane. A few of the unsung heroes of injectable fillers include Radiesse, Perlane, ArteFill, Sculptra or Silicone Oil.
My goal is to share some information, dispel some myths and help you become a more informed consumer.
There are other fillers out there but these are the main players in the U.S. This week I will focus on Juvederm Ultra and Ultra-Plus.
Week 1: Juvederm Ultra and Ultra-Plus
Juvederm Ultra and Ultra-Plus, made by Allergan, are clear hyaluronic acid gels, formulated with innovative Hylacross technology, resulting in smooth-consistency gel that flows easily into the skin.
Ultra is a bit thinner, used for threading finer wrinkles or in areas where you do not want as much hydration effect.
Ultra-Plus is a bit thicker, used for areas that need more support.
Both are FDA approved to last up to a year with initial treatment. A syringe of Juvederm contains 0.8cc of gel (whereas Restylane contains 1.0cc) but because of the Hylacross technology they claim that it has the same amount of effect as 1.0cc of any other hyaluronic acid filler.
Juvederm now has an “XC” at the end of the name representing infusion with 0.3% lidocaine powder. Lidocaine, as you may know, is an anesthetic – used commonly for minor surgical procedures such as skin biopsies or dental work. For fillers that do not come with lidocaine already, we mix it with lidocaine before injection because it greatly increases patient comfort.
Hyaluronic acid (also called Hyaluronan) is a glycosaminoglycan (you can look this one up on Wikipedia) is a major natural component of skin, connective tissue and joint fluid. It is known as a “goo” carbohydrate, adding thickness, resilience, hydration and lubrication to various tissues and is very important for tissue repair, especially in the skin.
A person weighing 154 pounds has roughly 15 grams of hyaluronan in the body, one-third of which is turned over (degraded and re-synthesized) every day.
Juvederm Ultra costs $350 to $500 and Ultra Plus $350 to $550 per syringe.
For correction of naso-labial folds on most faces, you will need at least one if not two syringes. For smaller areas such as under the eyes, between the brows, lips (all off-label uses), small vertical lip lines and marionette lines, one or just part of one syringe will be enough. Men usually require slightly more filler than women due to thicker skin and deeper folds.
When you buy the syringe, part of what you are paying for is the injection fee of the doctor. In most practices, since this fee is paid, you are not charged to finish off any filler that you have banked – you’ve already paid the bill once.
Darren A. Farnesi, M.D., APC, offers his sound advice and personal knowledge of the industry as a successful doctor with Medical Age Management Inc. He can be reached at (619) 299-0700 or online at his website.