Fillers: Juvederm Family of Hyaluronic Acid Fillers

Dr. Walrath offers injectable fillers (Juvederm) in the region around the eyes and midface and in the lips. Often times these products can be used instead of surgery, though often they are part of a combination of techniques, including botulinum toxin and possible surgery.

Juvederm is a so-called NASHA (non-animal stabilized hyaluronic acid) filler.  Hyaluronic acid is present in all animals — it’s the matrix that is present in our tissues.  Translated: our bodies can tolerate it pretty well, so it’s unlikely to cause a bad reaction. The NASHA material is grown in the lab and treated chemically so that it lasts longer in the body.

These fillers can be used in several different places on the face:

  • The “tear trough” – the hollow that develops at the junction between the lower eyelid and the cheek
  • Wrinkles between the eyebrows that don’t go away with Botox
  • The nasolabial fold — which runs from the edge of the nostril to the outer corner of the mouth
  • The “marionette line”, which runs from the corner of the mouth down to the jaw on each side
  • The fine “smokers lines” on the top of the upper lip
The fillers can also be used to fill in:
  • Deflated lips
  • Deflated space (hollow) above the upper eyelid
They can also be used to improve the definition of the lips and to augment the “cupid’s bow”, or philtrum, of the upper lip.

Dr. Walrath uses Juvederm products: Juvederm Voluma for the midface, Juvederm Ultra for the eyelids, and Volbella for the lips.  Some recent clients are seen below:


Video 1. Injecting the lips with hyaluronic acid-based fillers.


Figure 1.After lip filler, with philtrum and lip line definition.


Figure 2. After lip filler, with philtrum and lip line definition.  The philtrum has been vertically elongated with filler.


Figure 3. A few days after lip filler: philtrum and lip line definition.  The philtrum has been augmented with filler.


Figure 4.  After lower lid filler.  Post-injection photo was taken in the evening on the day that the filler was injected.


Fillers can also be quite gratifying, because: there is very little down-time, the procedure is subtle, and it is generally reversible, at least with the NASHA class of fillers.  Using topical anesthetic creams for most of the injection sites can make the procedure comfortable.  Lip injections require a local lip block, which is well-tolerated.