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Meredith L Orseth, Nicole Lee, Omer Ibrahim, Kenneth A Arndt, Michael Kaminer
Nodule formation can be a potentially disfiguring adverse event of soft tissue fillers. Limited treatment consensus exists regarding the optimal approach for addressing recurrent and persistent nodules. Here we describe two challenging cases of nodules that developed following injection with Restylane and Juvéderm Voluma. We review suspected pathophysiology and discuss our treatment approach. J Drugs Dermatol. 2018;17(5):580-581.
May 1, 2018: Journal of Drugs in Dermatology: JDD
Michael B Hall, Sudeep Roy, Edward D Buckingham
Importance: Hyaluronic acid filler can be safely used as a soft-tissue filler for correction of infraorbital hollowing. It has a high overall patient satisfaction profile among patients. Objective: To report safety and patient satisfaction outcomes of Juvéderm Voluma XC for correction of infraorbital hollows. Design, Setting, and Patients: This was a retrospective observational study performed at a private ambulatory facial plastic and reconstructive surgery practice...
April 5, 2018: JAMA Facial Plastic Surgery
Dong Li, Xiaojun Wang, Yan Wu, Jiaming Sun, Qin Li, Shuzhong Guo, Yi Jia, Diane K Murphy
BACKGROUND: Hyaluronic acid gels are used to restore volume to the midface, but there are few data published on this use in Asian subjects. METHODS: This study evaluated the safety and effectiveness in Chinese subjects of Juvéderm Voluma, a 20-mg/ml hyaluronic acid gel formulated for midface volumizing. This prospective, multicenter study randomized 119 subjects aged 18 years or older to a treatment group and 27 subjects to a no-treatment control group. The primary effectiveness endpoint was the objectively measured magnitude of change from baseline in volume of the midface area (right and left combined) calculated by digital analysis at month 6 using three-dimensional images for all subjects in both groups...
June 2017: Plastic and Reconstructive Surgery
Margit L W Juhász, Melissa K Levin, Ellen S Marmur
BACKGROUND: Hyaluronidase is an enzyme capable of dissolution of hyaluronic acid (HA). There is a lack of evidence-based research defining time- and concentration-dependent reversal of HA filler using hyaluronidase. OBJECTIVE: To explore the efficacy of different concentrations of hyaluronidase in digesting commercially available HA-based reversible fillers-Belotero Balance (BEL), Juvederm Ultra XC (JUVXC), Juvederm Ultra Plus (JUVX+), Juvederm Voluma XC (JUVV), Restylane-L (RESL), Restylane Silk (RESS), and Perlane/Restylane Lyft (RESLYFT)...
June 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
Chytra Anand
BACKGROUND: The desire for and use of nonsurgical injectable esthetic facial treatments is on a rise in Asia. Recent advances, including more versatile facial fillers, refined injection techniques, and adoption of a global facial approach, have in turn contributed to improved patient outcomes and increased patient satisfaction. The sought after nonsurgical treatments include the use of botulinum toxin, con- touring of the face with soft tissue fillers, and thinning of the face with injection lipolysis...
December 1, 2016: Journal of Drugs in Dermatology: JDD
Derek Ho, Jared Jagdeo
BACKGROUND: Human immunodeficiency virus (HIV) facial lipoatrophy (FLA) is associated with the use of highly active antiretroviral therapy (HAART) and HIV disease. HIV FLA is primarily characterized by midface (cheeks and temples) volume loss, resulting in a "sunken" and aged appearance. Filler agents for treatment of HIV FLA can provide midface volumization and improve quality-of-life (QOL). A 20 mg/ml hyaluronic acid (HA) filler (Juvéderm Voluma® XC, Allergan plc, Irvine, CA) may provide an immediate, natural appearing facial enhancement outcome in one treatment...
September 1, 2016: Journal of Drugs in Dermatology: JDD
Karol A Gutowski
Hyaluronic acid soft tissue fillers include a range of products (Juvederm Ultra, Juvederm Ultra Plus, Voluma, Restylane Silk, Restylane, Restylane Lyft, and Belotero Balance) that are used commonly for facial rejuvenation and enhancement of facial features. Although these products are similar in many ways, they are not interchangeable and have unique characteristics that need to be considered. Injection sites and techniques for facial rejuvenation are discussed.
July 2016: Clinics in Plastic Surgery
Steven Liew, Terrence Scamp, Mauricio de Maio, Michael Halstead, Nicole Johnston, Michael Silberberg, John D Rogers
BACKGROUND: There is increasing interest among patients and plastic surgeons for alternatives to rhinoplasty, a common surgical procedure performed in Asia. OBJECTIVES: To evaluate the safety, efficacy, and longevity of a hyaluronic acid filler in the correction of aesthetically detracting or deficient features of the Asian nose. METHODS: Twenty-nine carefully screened Asian patients had their noses corrected with the study filler (Juvéderm VOLUMA [Allergan plc, Dublin, Ireland] with lidocaine injectable gel), reflecting individualized treatment goals and utilizing a standardized injection procedure, and were followed for over 12 months...
July 2016: Aesthetic Surgery Journal
Vic A Narurkar, Joel L Cohen, Steven Dayan, Michael S Kaminer, Alexander Rivkin, Ava Shamban, Jonathan M Sykes, Craig F Teller, Susan H Weinkle, W Philip Werschler, Adrienne Drinkwater, Michael L Pucci, Conor J Gallagher
BACKGROUND: The HARMONY study is the first clinical trial to assess the impact of a global approach to facial rejuvenation with several minimally invasive modalities, using patient-reported outcome measures. OBJECTIVE: Provide details of this treatment approach and describe investigators' experiences and recommendations based on this study. METHODS: This multicenter, 4-month study evaluated subject satisfaction with and psychological impact of combined treatment with VYC-20L (Juvéderm Voluma XC), HYC-24L (Juvéderm Ultra XC), HYC-24L+ (Juvéderm Ultra Plus XC), onabotulinumtoxinA (Botox), and bimatoprost 0...
May 2016: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
Leslie Baumann, Rhoda S Narins, Kenneth Beer, Arthur Swift, Kimberly J Butterwick, Julius Few, Adrienne Drinkwater, Diane K Murphy
BACKGROUND: Juvéderm Voluma XC (VYC-20L; hyaluronic acid gel) is approved in the United States for correction of age-related midface volume deficit (MVD). OBJECTIVE: Assess safety and effectiveness of VYC-20L after repeat treatment. METHODS: Subjects with MVD underwent optional repeat treatment 12 to 24 months after initial treatment if correction was lost or at 24 months regardless of loss of correction (n = 167). Investigators rated outcomes on the Mid-Face Volume Deficit Scale (MFVDS) and the Global Aesthetic Improvement Scale (GAIS)...
December 2015: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
Gregory J Goodman, Arthur Swift, B Kent Remington
BACKGROUND: Hyaluronic acids (HAs) are very popular temporary fillers with a very good safety record. Improvements and adaptations in clinical use are continuing. METHODS: We have assessed the available literature to investigate the relatively new Vycross technology that uses a mixture of high- and low-molecular-weight HAs with a relatively low but varying HA concentration with enhanced cross-linking to produce a number of products that have differing clinical indications...
November 2015: Plastic and Reconstructive Surgery
Hema Sundaram, Rod J Rohrich, Steven Liew, Gerhard Sattler, Sergio Talarico, Patrick Trévidic, Samuel Gavard Molliard
BACKGROUND: Biophysical characteristics of hyaluronic acid gel fillers reflect individual manufacturing processes. They confer rheologic properties that provide scientific rationale with Evidence Level II clinical correlation for selection of appropriate fillers for specific clinical applications. Cohesivity, a key property, maintains gel integrity, contributes to tissue support with natural contours, and diminishes surface irregularities. In this publication, a new, standardized visual assay for hyaluronic acid cohesivity is presented, applied, and discussed...
October 2015: Plastic and Reconstructive Surgery
Derek Ho, Jared Jagdeo
BACKGROUND: Dermal fillers are important for facial aesthetic enhancement as patients are favoring non-surgical procedures with minimal recovery time. Voluma is a volumizing hyaluronic acid filler, 20 mg/ml HA dermal filler, which was FDA-approved in 2013 as the first dermal filler for treatment of age-related volume loss in the midface. OBJECTIVE: We sought to systematically review clinical studies and expert opinions of this 20 mg/ml HA dermal filler and to provide evidence-based recommendations and expert opinions...
September 2015: Journal of Drugs in Dermatology: JDD
Connie Brennan
Treatment guidelines are a crucial part of every medical aesthetic practice and must be in place before utilizing aesthetic medical injectables. An "Aesthetic Policy and Procedure Manual" features specific details (e.g., patient assessment, indication, contraindications, warnings and precautions, injection techniques, documentation, etc.) around dermal fillers (e.g., Restylane, Juvéderm, Voluma), hyaluronidase, neurotoxins (e.g., Botox Cosmetic, Dysport, and Xeomin) and Sculptra. This article describes why an "Aesthetic Policy and Procedure" manual is a necessary tool in every aesthetic provider's armamentarium, what it is composed of, as well as how these guidelines serve as a protective mechanism for the aesthetic provider's clinic if legal action is brought against their staff, their medical director, and/or their clinic...
July 2015: Plastic Surgical Nursing
Shannon Humphrey, Jean Carruthers, Alastair Carruthers
BACKGROUND: A 3-dimensional approach to facial rejuvenation restores volume lost over time. Hyaluronic acid (HA) filling agents provide long-lasting correction with minimal side effects and a high level of patient satisfaction. The newest HA formulation is a 20-mg/mL smooth cohesive filler (Juvéderm Voluma [HA-V]) that combines both low- and high-molecular-weight HA for more efficient cross-linking and greater lift capabilities. OBJECTIVE: To document the clinical experience with HA-V over the course of 68 months...
September 2015: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
Dee Anna Glaser, Jeffrey M Kenkel, Deepali Paradkar-Mitragotri, Diane K Murphy, Linda Romagnano, Adrienne Drinkwater
BACKGROUND: Juvéderm Voluma XC (VYC-20L) is approved in the United States for correction of age-related volume loss in the midface region in adults. OBJECTIVE: To characterize the effects of VYC-20L in 3 midface subregions based on injection volumes. METHODS: In this single-blind controlled trial, subjects with midface volume deficit received VYC-20L in ≥1 of 3 facial subregions (zygomaticomalar, anteromedial cheek, and submalar), with touch-up treatment available 30 days later...
August 2015: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
Katie Beleznay, Jean D A Carruthers, Alastair Carruthers, Mark E Mummert, Shannon Humphrey
BACKGROUND: The shift from 2- to 3-dimensional soft tissue augmentation has allowed the development of hyaluronic acid (HA) fillers, which are long lasting and also reversible. Delayed-onset inflammatory nodules have recently been reported with the use of HA fillers. OBJECTIVE: The authors document their experience with delayed-onset nodules after 3-dimensional facial injection of Juvéderm Voluma (HA-V) over 68 months. MATERIALS AND METHODS: The authors conducted a retrospective chart review of patients who were treated with HA-V between February 1, 2009, and September 30, 2014, to evaluate for delayed-onset nodules...
August 2015: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
Julius Few, Sue Ellen Cox, Deepali Paradkar-Mitragotri, Diane K Murphy
BACKGROUND: Juvéderm Voluma XC is a volumizing hyaluronic acid filler used for correction of age-related midface volume deficit (MVD). OBJECTIVES: The effectiveness of Juvéderm Voluma XC was examined from the patient perspective. METHODS: Patients with moderate to severe age-related MVD (N = 235) received Juvéderm Voluma XC. At quarterly follow-up visits for 2 years, patients rated treatment outcomes on the Global Aesthetic Improvement Scale (GAIS), overall satisfaction with facial appearance, satisfaction with midfacial regions, achievement of treatment goal, Look and Feel of the Midface (LAFM), and Self-Perception of Age (SPA)...
July 2015: Aesthetic Surgery Journal
Melanie D Palm
The amount of fillers approved by the United States Food and Drug Administration (FDA) for use in facial volume augmentation is diminutive in comparison to filler products employed worldwide. In the near future, several new hyaluronic acid filler products will be available to the United States market. Already approved fillers include Belotero Balance for fine lines, Juvéderm Voluma XC for midfacial volume loss replacement, and Restylane Silk for perioral lines and lip augmentation. Volbella, currently under FDA evaluation, will be used for fine-line correction and lip augmentation...
December 2014: Seminars in Cutaneous Medicine and Surgery
Derek Ho, Jared Jagdeo
BACKGROUND: Hyaluronic acid (HA) dermal fillers are effective and safe for correction of facial rhytides. A new volumizing HA filler, 20 mg/ml HA dermal filler (Juvéderm® Voluma®, Allergan Inc., Irvine, CA), is the only HA filler with a FDA indication for facial volumization due to age-related facial volume loss. OBJECTIVE: Evaluate the biological properties, including biochemical, biophysical and rheological, of this new 20 mg/ml HA dermal filler and discuss the importance of these properties in clinical applications...
January 2015: Journal of Drugs in Dermatology: JDD
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