Juvederm Ultra Injection to NasoLabial Folds (laugh lines) by Reston Virginia Cosmetic Surgeon
Board Certified Facial Plastic Surgeon, Dr. Naderi, discusses options for reducing smile lines / laugh lines (nasolabial folds) and marionette lines. Surgical options such as midface lift, fat injection and subcision are discussed as well as filler injections such as Juvederm, Restylane, Perlane, Radiesse, Artefill, Evolence. Juvederm Ultra injection technique is demonstrated in Herndon, Virginia. Dr. Shervin Naderi is a Board Certified Facial Plastic Surgeon. He has practices outside of Washington DC in Reston-Herndon Virginia and Chevy Chase Maryland in the Barlow Building. He is a “Rhinoplasty specialist” as well as a master injector and a clinical instructor for Botox, Dysport and dermal filler injections. He is also an examiner for the American Board of Facial Plastics & Reconstructive Surgery.
We all look at ourselves and pick out things we don’t like…and if you need it go for it…fined a well known,educated ..doctor and those who do,nothing wrong with it!!!!! I do it and the best thing ever….its worth every penny…i have friends who disagree and i am doing it for me…NO ONE ELSE..
I am 30 and my skin is pretty much like your model’s. I was debating whether to go with radiesse or juvederm. After seeing your video I will go with juvederm. It looks like you only used 1 syringe, does your model also have botox and lip augmentation? what does she do about large pores?
@beatrizemo
For skincare we start our patients on medical grade cosmeceuticals like Obagi, SkinMedica, NeoCutis or Image products. Retin-A is often a part of it. Microdermabrasion and light chemical peels help with skin texture, tone, color and pores.
We also start people on Botox or Dysport in their 20′s-30′s to PREVENT getting lines and wrinkles.
How long does Juvederm typically last? How much does it hurt to receive injections into the nasolabial folds?
@TheMinnesotaMom
Typically it lasts 6 months or so. Most patients do this twice a year. Juvederm now comes in a mixture with Lidocaine (numbing solution) so its not that bad at all. Gentleness of injection technique is also important.
This is one of the better videos on Juvederm I’ve seen. I’m just starting to get some laugh lines and really don’t think that they suit me at all. Also, on my right side, there is one very, very deep wrinkle that I have hated. When i was in my teens, it would come and go. Now it’s there and won’t go away.
Would Juvederm also fill out a small, very deep wrinkle that runs with my laugh lines? Also, does Juvederm (if used consistently) prevent more severe laugh lines from forming? Thank you.
@td241
Thank you. The reason laugh lines form is trifold: Loss of skin elasticity, continual “folding” of the area by movement or pressure (laughing or sleeping on your face), as well as descent of the cheek pads. Juvederm and Restylane can help. The injection technique is VERY important. Bad injection can make the lines worse. There are various techniques for different types of lines.
I’m curious, after the effects of the injections wear off do the lines then look deeper because they had been filled in? In other words, does the filler (once gone) end up making deeper lines? Also, do you get the stiff “can’t smile” look with this filler?
Thanks
@itfelldown
Good question. Actually the injections stimulate your own collagen production so theoretically the area should look slightly more filled in that if you had never gotten an injection. But, at the same time, theoretically you will have aged so the lines may be deeper regardless. But the injections wont make the lines deeper if you stop. The “stiff, cant smile” look is a matter of volume and injection technique and should not occur in good hands.
How many cc for the 1st , 2nd and 3rd injections?
Do you give local?
Do you do skin allergic test?
@tllktc
No allergy testing is necessary with the FDA approved products I use: Perlane, Juvederm, Restylane or Radiesse. Typically I do 1-2cc on the first injection and 1-2cc injections subsequently. Some patients only need 1cc and others need 4-6cc. Just depends on the patient. Most of the products have lidocaine in them and pain is very minimal.
I am really impressed by your prompt reply and most of all your injection technique!
I also understand you have done thousands of injections to obtain your level of competency and experience.Have you come across any severe allergic skin reaction that leads to scarring? Is it frequent? Is it fast ? I mean does it come with rashes first or delayed?
It is still a major concern for patient who is thinking of undergoing fillers injection.
I know even lotion can leads to scarring if allergic set in
@tllktc
Thank you. I have seen patients who had questionable fillers by other doctors from outside of the United States who ended up with serious infections and scarring. As long as a relatively safe filler is used by an experienced doctor then the risks are minimal – not zero but close to it. For example, the risk of allergic reaction to Restylane is anywhere from 1 in 3000 to 1 in 10000. The actual filler and the technique are important.
Hi There,
I had restylane injections for Naso. Folds over 1 year ago and I still have bruising in the left side of the injection area not to dark of a bruise but it is still dark enough to have to use makeup to cover? The spa said sometimes that happens Is this Permenant? How do I fix it
@Solayg
I highly doubt its a bruise. Bruises don’t last this long. You could have had the injection too superficially creating whats known as a Tyndall Effect or you may have had tattooing of the area especially if they marked the injection areas first with a marker and then injected you. However, without seeing and examining you, I cannot tell you what it is or what the solution would be. You need to see a good local plastic surgeon and not just trust the spa’s answer. Good luck.
you mention that the kind of product to choose should depend on the type and severity of the lines. I have very deep naso folds that I have had all my life, of course with age they are very deep. Not at all like the model in the video. Is there a product that is better for deeper lines?
@chezwickgee
I prefer Perlane or Radiesse for very deep nasolabial folds. However, I have seen plenty of patients who barely have any lines who think they have very deep lines. I try to talk these patients out of fillers or recommended a very conservative amount of juvederm ultra xc. It just depends. It also depends on the state of the cheeks and midface. If all of the cheek fat pad has dropped down creating deep nasolabial folds then that should be addressed first.
@DrNaderi you are very kind to reply so quickly and thoroughly. I am just beginning to explore this idea. I know what you mean about perception. But I have been told about my lines since I was very young (I am 48). they are a genetic component of my face, and I have avoided any thoughts of change. In fact, I worry that they are so deep and actually creased, they might not respond to a filler, or worse look strange and puffy. I d like to opt for something extremely minor.thank you so much.
I had one syringe each of Restylane for the naso folds, they werent too deep but my cheek area has lost alot of volume so it makes my face look flat. I can still see the naso fold lines and wondering if I should have used two syringes for each side instead of the one? Or perhaps it was the injector, shes a certified nurse and has done injectons for more than 7 yrs. and im also wondering if I should try Perlane instead? your work looks awesome, wish you werent so far away!!!
@KrissyKful
Thank you. Completely getting rid of the nasolabial folds is unrealistic and if over injected it can make the face look puffy and snout-like. I love injecting the midface and cheek area to give it fullness and volume which are signs of youth and beauty. I cannot tell you what is best for you since I have not seen or examined you. See a few doctors and get a few different perspectives. Always stay with “safer” Hyaluronic acids for your first time (Perlane, Restylane, Juvederm)
hi, how much does it typically cost. just an estimate, thanks
@madiha610
Hi. It just depends on the filler you need and the volume you require. For example one syringe of Restylane may be $600. If you require more volume then you pay for additional syringes. Some times doctors may discount the 2nd or 3rd syringe so you can get the volume you require without hesitating too much about the price. Other fillers have different prices. The cost of the syringe is one consideration but the skill of the doctor injecting you is more important.
@DrNaderi thanks for the quick reply and thorough information. i’ll keep it in mind.
cost that much to last only 4 to 18(not clear) month, better to save for plastic segery instead. Looks very painful when nidle goes again in the same area, which is bleading…
@russiuka38
First of all its not that painful. I have never had a single patient ask me to stop because the pain was too much. But much more importantly, there is no “Plastic Surgery” to correct the smile lines in a young patient like this. Facelift do not correct the smile lines and she does not even need a facelift. Therefore she does not need surgery no matter what the cost. And even surgery results do not last forever. Injection of fat or fillers are the most common approach to this