Juvederm, Volumna or Volbella to the Nasolabial Folds?

I currently receive Juvederm injections to my nasolabial folds but in my opinion, the injections don't last long enough. Is there a better filler out there that lasts longer? I know Volbella was recently FDA approved for lips and I'm wondering if that would work for this region? What about Volumna? Is that better than Juvederm? 


SHX434

F, 48, New Jersey

Dermal fillers can be non-permanent, semi-permanent, or permanent. This is because different dermal filler products vary in chemical composition, longevity, and the area of the face that they are best suited to: some products are softer while others are sturdier.

Juvederm is a very common non-permanent filler that is used to fill in the nasolabial crease. When injected by an experienced plastic surgeon, it can produce excellent results, softening lines, and creating fullness mid-face.

Many plastic surgeons recommend that patients start with non-permanent fillers, such as Juvederm, Juvederm Ultra Plus, Restylane, and Radiesse, before committing to a more permanent option. This allows the patient to see if they feel comfortable with the results before trying the more permanent alternatives.

Yes, Volbella can be used to fill nasolabial folds. However, it is more commonly used for lips, as some plastic surgeons find it too soft for use in the nasolabial fold area.

Voluma is an FDA-approved hyaluronic acid for the malar or cheek area. This treatment corrects the cause of the nasolabial folds, which is volume loss: the plumping of the cheeks helps to lift the skin, thus reducing nasolabial folds. However, Voluma should never be injected directly into the nasolabial folds.

Non-permanent fillers last six to eight months on average, because the body absorbs the product over that time period. Patients who are ready to try out more permanent alternatives have several options: semi-permanent fillers containing polyacrylamide, such as Aquamid, or polylactic acid, such as Sculptra, or permanent fillers such as Bellafill, which contains polymethyl-methacrylate microspheres.

All options can soften the nasolabial folds and produce excellent, long-lasting results. Aquamid lasts up to five years, Sculptra lasts up to two years, while Bellafill lasts indefinitely. Permanent fillers can only be removed surgically.

Juvederm is a hyaluronic acid-based dermal filler used to reduce depressions in the skin and to improve contours. Hyaluronic acid is a non-permanent dermal filler, and is extremely popular with individuals who are new to dermal fillers as the injections can be easily reversed with the enzyme hyaluronidase.

Juvederm Voluma is the longest-lasting hyaluronic acid filler, with some patients reporting that it lasts up to two years. However, it is not commonly injected directly into the nasolabial folds, but into the cheek area to restore lost volume.

Increased cheek volume helps to subtly lift lax skin and soften the nasolabial folds. Some plastic surgeons then complement Voluma in the cheeks with Juvederm in the nasolabial folds to fully fill out the creases in a balanced way.

However, if you are interested in semi-permanent or permanent dermal filler options, you may wish to talk to your aesthetic provider about products such as Sculptra or Bellafill. Sculptra is a non-toxic synthetic dermal filler that stimulates your body to produce collagen over time, with final results appearing after a few months.

Most patients need approximately three monthly treatments to achieve desired results. Sculptra works particularly successfully in the lower half of the face, treating deep nasolabial creases. The treatment is semi-permanent, so there may be a need for occasional touch-ups.

Bellafill is a generally considered a permanent dermal filler, and is most often used to treat medium to deep wrinkles. It is composed of bovine collagen and PMMA beads that cannot be absorbed by the body. The PMMA beads stimulate the skin to make new tissue as the bovine collagen is absorbed over three to six months. If you have deep nasolabial folds and feel ready for a permanent solution, Bellafill may be appropriate for you.

However, it is important to note that semi-permanent and permanent fillers may carry the risk of granulomas, or small lumps forming beneath the skin at the injection site. Risks of adverse effects can be significantly minimized if you place yourself in the care of an experienced, board-certified plastic surgeon. Bellafill, in particular, requires sophisticated injection technique to ensure optimal long-term results.

Nasolabial folds are most commonly caused by the descent of malar or cheek fat. Hyaluronic acid fillers such as Juvederm, or Radiesse, which is composed of calcium-based microspheres, can be injected into the folds to fill slight creases.

These fillers are thin and malleable, and lay smoothly against the contour of the skin. Unfortunately, these fillers are non-permanent, lasting six to 12 months on average. Some individuals, however, metabolize and absorb the product much faster than others.

With some patients enjoying results for up to two years, Juvederm Voluma is one of the longest lasting non-permanent fillers. It can lift and help to smooth out the nasolabial folds but cannot be injected directly into the nasolabial folds themselves. It is specifically designed to be injected deep into the dermis to lay on top of the cheekbones.

This provides a lifting and volumizing effect in the upper and mid-face area that also corrects the nasolabial folds by addressing the loss of volume in the upper cheeks and under the eyes.

Treatments where an area is corrected by addressing the source of the issue are becoming more and more common as improved aesthetic results can be achieved. According to this logic, the nasolabial creases do not need to be directly injected.

Volbella has been indicated by the FDA as a suitable product for lip augmentation. It is not commonly used to correct nasolabial lines as it is very soft and it is more typically used for areas on the face that need only superficial corrections, such as smile lines or vertical lines around the mouth. The nasolabial folds benefit from a more robust product.

It sounds as if you're ready to consider dermal filler treatments with greater longevity. Ask your plastic surgeon about options such as Sculptra or Bellafill, both of which are semi-permanent dermal fillers.

These options stimulate your skin's own collagen production but require a highly-skilled plastic surgeon or dermatologist to administer the injections as the results irreversible.

Dr. Alexander Ovchinsky has 1 Fillers before & after:

Fillers before image performed by Dr. Alexander OvchinskyFillers after image performed by Dr. Alexander Ovchinsky

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I like restylanelyft, jueverderm ultra plus, or volume in the nasolabial folds. 

In my opinion, most filler products on the market have a best practice application. For folds, it depends a bit on the depth of your folds. For mild folds, I like Juvederm or Restylane. For heavier folds, I typically prefer Restylane Lyft. If you are looking for a longer lasting product, you might consider Sculptra - a product that is usually recommended for mid face volume but is a slower process and is best for patients that have significant facial volume loss

I hope this is helpful.


Jack Peterson MD

http://www.drjackpeterson.com

The answer depends on the nature of your skin and depth of injection.  Also, Voluma and Volbella aren't FDA approved for smile lines, but they are often used by competent injectors in these off label areas.  For most patients Juvederm does a nice job in the smile line, but it's reasonable to explore alternatives with your physician.

My choice Juverderm Ulta + 

Dr. Darryl Blinski has 1 Restylane before & after:

Restylane before image performed by Dr. Darryl BlinskiRestylane after image performed by Dr. Darryl Blinski

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Yes, Voluma can be used for the folds but it is a little firmer of a product which may be undesirable in this area. Volbella is also a good option and is reported to last slightly longer then Juvederm. Good luck