If you are looking for a well-established, highly adaptable filler treatment that is suitable for treating facial wrinkles and folds, look no further than Juvederm Ultra Plus XC. Manufactured by Allergan, this implantable dermal filler is a sterile, biodegradable, nonpyrogenic, viscoelastic, clear, colourless, homogeneous gel implant that is manufactured using proprietary Hyalacross Technology that utilises high-molecular weight hyaluronic acid chains that are highly cross-linked. This product is a malleable, smooth gel that flows easily and consistently into the skin and provides a predictable result, unlike other hyaluronic acid fillers that have a gel consistency that is granular. Juvederm Ultra Plus XC is formulated with 0.3% preservative-free lidocaine for the management of pain during the procedure.
Juvederm Ultra Plus XC is used for correcting moderate to severe skin depressions such as wrinkles and folds. Parentheses lines, also known as nasolabial folds, are natural facial features; however, particularly deep or pronounced nasolabial folds can age the face and become a cause for concern for many patients. Other facial wrinkles that are results of age-related volume loss can also be treated with this cosmetic filler.
This cosmetic filler is implanted into the dermis where it acts to physically plump tissue, thus smoothing over any wrinkles. Juvederm Ultra Plus XC is formulated to be a thicker gel that is more robust than other formulations, making it suitable to treat moderate to severe skin depressions. The gel is manufactured using Hyalacross Technology that results in a smoother consistency compared to other dermal filler brands. This formulation contains a higher proportion of cross-linked hyaluronic acid than Juvederm Ultra XC, making it more appropriate for volume creation and correcting deeper facial skin depressions.
As with all procedures involving dermal fillers, administration of Juvederm Ultra Plus XC should only be carried out by a suitably qualified medical practitioner who has received prior training in the injection techniques for filling wrinkles. Health-care professionals are encouraged to inform their patients of the potential risks of soft tissue injections before treatment and ensure that patients are aware of signs and symptoms of potential complications. This dermal filler is implanted into the mid to deep dermis, using a 27G needle. Injection techniques that can be employed to administer this filler include serial puncture and tunneling. This product is known to slightly expand after injection as it absorbs water. Thus, you may want to undercorrect in order to allow for this expansion to occur without tarnishing the desired effects.
In the first 24 hours after receiving treatment, your patient should refrain from strenuous exercise, sun or heat exposure, and alcoholic beverages. Patients who are using products that can prolong bleeding (such as aspirin, nonsteroidal anti-inflammatory drugs, and warfarin) may experience increased bruising or bleeding at treatment sites. Also, if procedures based on active dermal response such as if laser treatment or chemical peel is considered after treatment, or if the product is administered before the skin has healed completely, there is a possible risk of an inflammatory reaction at the treatment site.
With optimal treatment, the effects of Juvederm Ultra Plus XC can last for 1 year. Variation of duration of effects may occur and must be taken into consideration; these may be caused by factors such as patient’s age, skin type, lifestyle, as well as area of treatment.
Juvederm Ultra Plus XC is FDA-approved for the indications of treating moderate to severe facial wrinkles and folds, such as nasolabial folds, since 2010. Before that, a non-lidocaine version was approved in 2006. Since then, the product has been widely used worldwide. In clinical trials, as well as in real-world use, incidences of adverse events have been reported to be mild to moderate in severity, lasting 14 days or less. FDA approval was granted based on the results of a multicentre, double-blinded, randomised study that compared the safety and effectiveness of Juvederm fillers versus cross-linked bovine collagen filler, which showed that Juvederm dermal fillers presented longer lasting clinical corrections than collagen fillers and required less volume.
Safety and effectiveness in the following specific populations have not been established: pregnant and/or breastfeeding women, patients under 18 years, and individuals who are susceptible to hypertrophic scarring, keloid formation, and pigmentation disorders. Exercise caution when administering this filler to patients who are on immunosuppressive therapy.
Do not use this injectable in patients with multiple severe allergies or a history of anaphylaxis or history or patients with known hypersensitivity to any of the fillers components. Also, product use at specific sites in which an active inflammatory concern (skin eruptions such as cysts, pimples, hives, or rashes) or infection is present should be postponed until the underlying process is resolved.
Juvederm Ultra Plus XC, like other dermal fillers can produce reaction that are unintended.
Many patients who received this treatment experienced expected injection-related reactions that are localized to the site of treatment.
Rarer but more serious adverse effects associated with Juvederm Ultra Plus XC. Follow standard precautions associated with injectable materials to minimize the risk of infection. Patients should receive prompt medical attention and, possibly, evaluation by an appropriate health-care specialist should an intravascular injection occur as it can cause complications.
Stop the injection immediately if a patient experiences any signs of stroke, changes in vision, blanching, or unusual pain.
Juvederm Ultra Plus XC is made of highly cross-linked hyaluronic acid that is produced by the Streptococcus species of bacteria. The hyaluronic acid is formulated to a concentration of 24mg/mL in a physiologic buffer. The gel is also supplemented with 0.3% lidocaine.