Hyaluronic acid gel ( Juvéderm™) preparations in the treatment of facial wrinkles and folds

Soft tissue augmentation with temporary dermal fillers is a continuously growing field, supported by the ongoing development and advances in technology and biocompatibility of the products marketed. The longer lasting, less immunogenic and thus more convenient hyaluronic acid (HA) fillers are encompassing by far the biggest share of the temporary dermal filler market. Since the approval of the first HA filler, Restylane, there are at least 10 HA fillers that have been approved by the FDA. Not all of the approved HA fillers are available on the market, and many more are coming. The Juvéderm product line (Allergan, Irvine, CA), consisting of Juvéderm Plus and Juvéderm Ultra Plus, was approved by the FDA in 2006. Juvéderm is a bacterium-derived nonanimal stabilized HA. Juvéderm Ultra and Ultra Plus are smooth, malleable gels with a homologous consistency that use a new technology called "Hylacross technology". They have a high concentration of cross-linked HAs, which accounts for its longevity. Juvéderm Ultra Plus is used for volumizing and correcting deeper folds, whereas Juvéderm Ultra is best for contouring and volumizing medium depth facial wrinkles and lip augmentation. Various studies have shown the superiority of the HA filler products compared with collagen fillers for duration, volume needed, and patient satisfaction. Restylane, Perlane, and Juvéderm are currently the most popular dermal fillers used in the United States.