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Juvéderm, an injectable facial filler, is used by cosmetic, dermatological, and plastic surgeons to soften deep folds and reduce wrinkles in the faces of patients. The substance is largely hyaluronic acid, a substance normally found in the skin, muscles, and tendons of mammals.
Approved in June 2006 by the U.S. Food and Drug Administration, Juvéderm’s prime use is removing nasolabial folds, or “smile lines,” creases of skin which run from the corners of the nose to the corners of the mouth.
It is also used as a lip augmentation agent, and to fill in hollow places and scars on the face. However, all hyaluronic acid facial filler products are eventually absorbed by the body, usually within six to nine months, causing the patient to undergo repeat injections to maintain the younger look. Juvéderm is also used by physicians to plump lips, which also lose fat and internal shape with normal aging.
Mechanism of action
Juvéderm works well for cosmetic and plastic surgery applications because hyaluronic acid can absorb up to 1,000 times its own weight in water, thereby adding new volume under the surface of sagging skin. Older faces take on more youthful aspects because hyaluronic acid is known to bind with collagen—the material that supports human facial skin—and elastin to move more basic nutrients into the skin.
When the University of Michigan organized a study on the dermal filler Restylane — a close chemical sibling of Juvéderm—researchers found that hyaluronic acid stretches cells in skin known as fibroblasts in a way that causes the skin to create new collagen. The new collagen helps decrease the appearance of facial creases and wrinkles. An unexpected—and welcome—finding cropped up: hyaluronic acid also seems to stop the breakdown of existing collagen.
Potential risks and side effects
Patients, physicians and researchers say usual, expected side effects include temporary redness, pain and tenderness during injections and swelling and bruising at the injection sites. The more serious side effects include immune system reactions that result in facial lumps and bumps known as granulomas, bothersome reactions that are very difficult for physicians to treat.