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a woman feels happy after Contouring her Jawline

Contouring the Jawline | Medica Depot

Botox, Dermal Fillers, Face, Professionals, Radiesse / By  Medical Community

30 Jul

Introduction

Patients seeking facial rejuvenation often present with prominent nasolabial folds, marionette lines, perioral lines, loss of volume to the lips, and changes along the jawline. The patient’s appearance is significantly affected by the loss of definition along the mandibular border. A contoured jawline is often seen as indicative of a more youthful appearance.

Aging is a natural phenomenon and gravitational forces, increased tissue laxity, and progressive bone resorption all play a role in the facial manifestations. Atrophy and resorption of the malar, submalar, and buccal fat pads lead to volume loss in the midface. With aging, the jawline’s shape becomes less aesthetically appealing. As a result, there has been a significant increase in the number of non-surgical and minimally invasive procedures available to efficiently contour the jawline and restore lost facial volume.

Patient Analysis

Dr. Kate Goldie, an aesthetic practitioner, utilizes a full-face consultation to educate patients about the complex interplay of different facial structures, including the skin, fat, ligaments, bones, and muscles.

During a consultation, it’s important for the practitioner to discuss with their patients the cause and effect of each aesthetic concern. This allows patients to understand that addressing mid-face deficits is necessary for an overall positive effect. As cosmetic surgery evolves, many patients are seeking less invasive treatments with fewer side effects and faster recovery time. Although there are many therapeutic options available today, natural-looking results and patient safety have become the focus of modern aesthetic procedures.

The chin and jawline are common areas of concern and patients are particularly concered with loss of jawline definition, the formation of jowls, and deepening of the pre-jowl sulcus. The redistribution in volume and position of the soft tissue of the lower face creates undesirable shadows that detract from a patient’s appearance. Knowledge of age-related anatomy is vital in restoring a youthful face. Furthermore, a practitioner must recognize the form of an attractive chin and sculpted or well-contoured jawline.

Jawline Rejuvenation

In addition to age-associated volume loss that contributes to the structural changes of the face, the process of aging also visibly manifests in the skin. A multi-pronged approach is essential when contouring the jawline to deal with sagging, jowl formation, and chin widening.

While distinct age-related changes in the lower third of the face and neck can be addressed dramatically by a traditional face-lift or genioplasty, the last decade has seen minimally invasive procedures become the gold standard for facial rejuvenation. Soft tissue augmentation using dermal fillers and botulinum toxins are growing in popularity.

Plastic surgeons and aesthetic practitioners must include minimally invasive techniques in their treatment strategies for the lower face and neck. While both surgical and non-surgical procedures have varying degrees of risk, minimally invasive methods may soon go head to head with traditional aesthetic procedures or become a worthy replacement.

Soft Tissue Fillers

There are different dermal filler materials available for soft tissue augmentation, but not all are suited for jawline contouring. Hyaluronic acid (HA) is the most popular and widely used material for dermal filler treatment; it restores volume loss efficiently and can be reversed with hyaluronidase should overcorrection occurs.

However, many physician’s treatment of choice is Radiesse (Merz Aesthetics), a Food and Drug Administration (FDA)-cleared injectable filler made of small calcium hydroxylapatite (CaHA) microspheres. The 25–45μm microspheres of synthetic calcium hydroxylapatite are suspended in water, glycerin, and carboxymethylcellulose and can be used for volume restoration, lines and wrinkles, as well as lip augmentation.

Calcium Hydroxylapatite Fillers

Although CaHA can replenish lost volume in the mid and lower face and create a youthful, sculpted jawline, proper injection technique plays a critical role in achieving optimal results. The treatment area should be evaluated with the patient in an upright position. Photographs should be taken prior to treatment and the patient should be informed of any facial asymmetries before starting the procedure.

The filler is injected supraperiostally above the ala-tragus line and deep dermally below the ala-tragus line. In both areas, a 1:1 correction factor is enough and overcorrection is not necessary. Thread multiple tracks through one puncture using fanning technique to minimize the number of injections.

Treatment results usually last for 12 to 18 months. The patient should be counseled about the limitations of the product, potential risks and side effects, expected duration of results, and post-treatment care. Consent should be obtained after adequate briefing and counseling.

Hyaluronic Acid Fillers

Patients with thicker skin and poorly-defined bony structure of the mandible require incompressible or stiff fillers, such as Radiesse, to support the overlying tissues while contouring the jawline. However, those with thin skin over a well-defined mandible require a highly elastic HA filler such as Restylane Lyft (Galderma) and Juvederm Voluma XC (Allergan).

The injector should thoroughly examine the patient’s jawline to determine the best product or combination of products to use. Patients with thick skin and a reasonably prominent mandibular structure are suitable for both CaHA and HA products, the latter of which is reversible using hyaluronidase.

Dr. Goldie, like many practitioners, recommends the use of a cannula when treating the jawline to avoid vascular compromise. The superficial muscular aponeurotic system, also known as the SMAS, protects the facial artery in that region. While the injector may unknowingly go underneath the fascia using a long needle, the use of a cannula allows the injector to stay in the plane where no major arteries are present.

Botulinum Toxin

When contouring the jawline using injectables, the practitioner must consider the patient’s preferences, as those seeking cosmetic procedures are often influenced by culturally determined standards of beauty. An ideal female face, for example, is generally perceived as delicate, contoured, and oval-shaped while a square lower face is considered masculine. In some cultures, increased lower facial volume is seen as “rude.”

The main causes of a square face are muscle hypertrophy and prominent mandibular angle. In the Asian population, masseter hypertrophy, resulting in short, wide faces, is frequently observed while Caucasians often possess long, narrow faces.

Botulinum toxin injection is a non-surgical method of correcting masseteric muscle hypertrophy. In the past, surgical resection of the masseter or bony angle of the mandible was the only option for reshaping the lower jaw. Associated with side effects like pain, hematoma, infection, and facial nerve paralysis, it was not very popular. In 1994, Smyth, Moore, and Wood introduced the injection of botulinum toxin type A into the masseter muscle; the results were decreased masseteric girth and a gentler, more rounded jawline.

In 2005, Kim and colleagues treated 1,021 patients with botulinum toxin to reduce the volume of the masseter muscle. The team concluded that neurotoxin injection for aesthetic purposes requires simple technique, with few side effects and reduced recovery time, making it a better alternative to surgical masseter resection. Studies also claimed that botulinum toxin injection to the masseter could treat bruxism, indicating reduced frequency of teeth grinding events and decreased bruxism-associated pain, as well as high anecdotal patient satisfaction.

Thread Lifting

Threads are a safe and effective alternative to traditional lifting methods. According to Dr. Jacques Otto, polydioxanone (PDO) threads made of biodegradable synthetic polymer are great for lifting and tightening the jawline. The sutures stimulate collagen synthesis and elastin production for an overall rejuvenated effect, making this an ideal choice for patients with very lax and/or severely wrinkled skin.

An 18G needle is recommended for creating an entry point before inserting the threads with a blunt cannula. Practitioners should avoid using needles for thread insertion due to the risk of injuring blood vessels and nerves. When treating the lower face, combining thread lifting with botulinum toxin will produce even better results. Dr. Otto recommends injecting botulinum toxin at least two weeks before thread lifting to relax the platysma muscle. Thread lift side effects can include bruising, swelling, puckering or rippling, asymmetry, and visible threads under the skin; however, extensive practitioner training lowers these risks.

Patients should be informed that a thread lift is not a one-time treatment, as biodegradable threads are absorbed by the body over time. Post-treatment care and consistent follow-ups are necessary. Anti-inflammatory medications to minimize swelling must be avoided as they can interfere with collagen formation.

Radiofrequency and Ultrasound Therapy

For patients who are needle-averse or unsure about receiving injectables, ULTRAcel is a non-surgical facelift therapy that is a great initial treatment for patients with lower face concerns. An ULTRAcel machine combines high intensity focused ultrasound (HIFU) technology, radiofrequency, and fractional microneedling to lift and tighten facial contours without the downtime associated with surgical procedures. Radiofrequency stimulates fibroblasts and promotes the production and remodeling of collagen. Only trained practitioners should perform microneedling and radiofrequency; potential side effects include burns and pigmentation changes.

In contrast with ULTRAcel treatment, Ultherapy is an FDA-approved procedure that uses microfocused ultrasound energy to target different depths within the skin, which lifts and tightens the jawline and neck. This collagen-boosting procedure incorporates ultrasound imaging, which allows practitioners to visualize the layers of tissue being treated, ensuring precise administration without needles or incisions. Ultherapy may be combined with dermal filler injection, although a two-week interval is required. Patients may experience slight bruising or redness, but nothing significant or persistent.

Skin Care

In aesthetic practice, skincare is an important part of any successful treatment. A healthy and functioning skin barrier protects the skin from dehydration, penetration of allergens, irritants, microorganisms, and radiation. While a daily skin care regimen that increases cell regeneration is necessary for smoother and more radiant skin, preventing the degradation of primary structural constituents like elastin and collagen is critical. Counseling patients about the importance of sunscreen to protect the skin should be every practitioner’s priority.

While the cosmeceutical market is notorious for making false claims, some products are indeed better than others. The use of products containing Vitamin A is recommended because it stimulates the production of collagen, glycosaminoglycans, and elastic fibers. Alpha Hydroxy Acids (AHA) are also beneficial as they increase skin cell turnover, resulting in reduced discoloration and evenly pigmented skin, reduced pore size and the softening of lines and wrinkles. Keeping the skin hydrated with a good humectant is an important final skin care step.

Conclusion

When it comes to contouring the jawline, aesthetic practitioners must recognize patient’s motivation in seeking less invasive procedures. If deemed appropriate, one should offer alternative non-surgical treatments for addressing the lower face and neck.

In the surgeon’s pre-operative evaluation, proper patient selection is critical to successful treatment. The practitioner can only plan the best treatment strategy if he or she is familiar with the benefits and limitations of each technique.

A happy woman is satisfied by the usage of Juvederm and Radiesse for Marionette Lines

Juvederm vs Radiesse for Marionette Lines | Medica Depot

Cosmetic Treatments, Dermal Fillers, Face, Juvederm, Radiesse / By  Medical Community

12 Jun

How do dermal fillers treat marionette lines?

As the body ages, it slows production of elastin, collagen and hyaluronic acid, which are essential to keeping the skin firm, elastic, and plump. As these substances degrade, the skin becomes weaker and begins to loosen and sag, causing lines and wrinkles to form.

Dermal fillers treat marionette lines by volumizing the skin, and some formulations boost essential proteins. The added volume from the implanted dermal filler gel lifts the skin, smooths lines and wrinkles, and adds a youthful plumpness to the skin that is often lost due to the process of aging and other harmful environmental factors.

How long do results last?

Aside from the difference in ingredients, the biggest difference between fillers from Juvederm and fillers from Radiesse is the longevity of the effects of treatment.

Juvederm offers longer lasting results than many other hyaluronic acid-based fillers currently available on the market. On average, the results of Juvederm fillers last from 12 to 18 months, with some patients seeing results up to 2 years after treatment.

The results of Radiesse fillers typically last from 9 to 18 months. Some patients may experience longer lasting results as the skin forms new collagen and is strengthened. It is important to note that the longevity of results varies according to patient and depends on a number of factors, including the lifestyle and age of the patient, as well as the severity of correction required and the injection technique used during treatment.

Juvederm vs Radiesse for marionette lines

Hyaluronic acid fillers like Juvederm are great for marionette lines because they are easy to inject and the results are reversible if the patient is unhappy. Juvederm also hydrates the skin and assists with the intracellular structure. It is most effective on marionette lines that are superficial to deep, and provides a filling effect without the patient looking overstuffed or frozen. Juvederm is favored for its natural-looking results.

Radiesse is also an effective filler for marionette lines. Unlike Juvederm, which is simply a wrinkle filler, Radiesse is a stimulatory filler that boosts the production of collagen within the skin, leaving collagen in its place even after it has been metabolized. For deeper marionette lines, Radiesse may be the best option, as it is thicker and provides more lifting capabilities.

A study comparing Juvederm Ultra Plus and Radiesse found that Radiesse required less filler to achieve the desired effects. While Radiesse does provide some immediate effects, optimal results emerge gradually, as collagen is produced over time. However, different patients will require different treatments, and what will work best for one patient may not be the same for another. The best dermal filler for a patient should be based on the patient’s desired results and facial anatomy.

The gold cube trumps the silver cube symbolize the comparison of Radiesse and Restylane dermal filler

Radiesse and Restylane : Which is the best filler to you?

Cosmetic Treatments, Dermal Fillers, Face, Juvederm, Radiess / By  Medical Community

10 May

The cosmetic injectable industry is enjoying massive growth in recent times due to increasing demand for minimally invasive aesthetic procedures like botulinum toxin and soft tissue augmentation treatments. Along with this growth is the frequent addition of new dermal fillers to the market, spurred by constant innovation and improvements in formulation. While this increase in therapeutic options may be a positive for consumers, an unfortunate effect of this is the substantial influx of information (and misinformation) about dermal filler treatments that can potentially mislead patients to make the wrong decision. There are plenty of choices when it comes to dermal fillers, each with their own benefits and downsides. This article hopes to shed some light on 2 very popular dermal filler treatments, Restylane vs Radiesse, and see how they fare in comparison to each other.

What’s the difference between Radiesse and Restylane?

Due to the sheer number of fillers currently available, it helps when discussing them to break them down into groups. There are many ways to categorize dermal fillers, but here we will go by mode of action. The first type of dermal filler is implanted into soft tissue for the purposes of adding volume, therefore these are known as fillers with replacement volume as a primary mechanism of action. Hyaluronic acid fillers like Restylane, which constitute the most commonly used dermal fillers, fall into this category. The second dermal filler group is implanted not to replace volume but to stimulate collagen growth at the treatment site. These are known as collagen biostimulators. They are typically made out of a synthetic material that is introduced to the skin to stimulate fibroblast cells for collagen synthesis. This is the category that fillers like Sculptra injectables belong to. Here, it is important to note that Radiesse actually has both mechanisms of action—it not only has the immediate effect that comes with volume replacement, it also confers long-term effects through its role as a collagen stimulator. In this respect, Radiesse is unique among dermal fillers.

Radiesse, the versatile collagen biostimulator

Radiesse products are made of microparticles of synthetic calcium hydroxylapatite. This compound is identical to a natural component of teeth and bones. The way in which it stimulates collagen growth is considered non-inflammatory, as no foreign body response is generated; rather, Radiesse merely acts as a scaffold around which collagen is able to form. With time, these microparticles break down into calcium and phosphate ions by phagocytes, leaving behind collagen.
The benefits that Radiesse provide do not stop at its collagen-forming capabilities. Radiesse is also formulated with physical characteristics that afford it excellent volume replacement capabilities. Radiesse is highly elastic and viscous; hence, it has good lifting and augmenting properties. In short, Radiesse can function both as volumizer and collagen stimulator, and it does both of these roles well. With natural-looking results that last beyond 2 years, Radiesse has many qualities that make it an ideal dermal filler.

Restylane, a hyaluronic acid filler treatment mainstay

Even if you are only marginally familiar with dermal filler treatments, it is still likely that you would have heard of Restylane. The first commercialized hyaluronic acid filler in the United States, the ever-popular Restylane brand is a stalwart in aesthetic practice.
As mentioned before, Restylane dermal fillers are composed of cross-linked hyaluronic acid. The material is a naturally occurring, hydrophilic sugar not specific to any tissue or species, making the product biocompatible and non-immunogenic. When it is implanted into the skin, the water-retaining properties of the product keep the skin firm and hydrated. Results of a Restylane treatment are relatively durable, lasting 6–12 months on average.

Which filler should you choose, Radiesse or Restylane?

The simple answer: It depends. Because these two products are so different, they will produce different clinical effects. Thus, each filler will provide better results than the other depending on the application.
The Restylane brand comprises numerous products that can be used for many different applications, making it easy for the practitioner to develop a personalized treatment plan that meets the specific aesthetic needs of the patient. In contrast, Radiesse only comes in one formulation.

The area of treatment is another factor to consider. Many practitioners have noted that Radiesse is particularly suited for hand contouring. Its opacity—typically a drawback for a dermal filler—is valued in this instance, because it is able to hide the veins and tendons normally visible in an aging hand. However, due to its high elasticity and volumizing properties, Radiesse is not the best product for treating delicate areas with thin skin like the under-eye area or forehead.

As alluded to above, the dual-role of Radiesse allows it to have both immediate and long-term clinical effects, making this treatment more attractive to patients for whom longevity of results is a priority. However, these effects are irreversible, meaning that the patient will have no other recourse but to wait for the effects to wear off if the results were not what they expected. The effects of Restylane, on the other hand, can be easily reversed with hyaluronidase treatment.

Summary

In conclusion, while both Restylane and Radiesse are remarkable fillers with proven track records of efficacy and safety, the practitioner must take into account factors like type of treatment, area of treatment, as well as the preferences of the patient when it comes to matters like longevity and reversibility of treatment, in order to select the more appropriate product for treatment.

A young woman gets a Mesotherapy procedure for Facial Skin Hydration

Case Study: Mesotherapy for Facial Skin Hydration

Face, Mesotheraphy, Rejuvenation Treatment / By  Medical Community

28 Jan

It goes without saying that good skin dramatically improves the aesthetic appearance of any individual. Not only that, the appearance of the skin also influences the results of aesthetic dermal treatments like dermal fillers or botulinum toxin injections: if the condition of the skin is good, results of these treatments are further enhanced. For these reasons, improving skin condition should be a top priority and always be the first recommendation given to patients before deciding to implement other treatments.Mesotherapy was first introduced by the French doctor Michel Pistor, who in 1976 described a technique that entails administering medications directly into the skin. This is performed to preserve or achieve youthful and/or healthy skin. To achieve such skin, biocompatible and absorbable medications that brighten, firm, and moisturize the skin are injected into the superficial dermis. This procedure also assists in encouraging skin rejuvenation through fibroblast activation and hydration replenishment that restore skin elasticity and tone. In addition to skin rejuvenation, mesotherapy products can also help improve other skin and hair conditions, such as cellulite, fat pockets, hair loss, rosacea, stretch marks, and acne, among others. With its many benefits, it is worthwhile for the aesthetic practitioner to familiarize themselves with mesotherapy and offer it in their practice. This article will outline the recommended procedure protocol, guidelines, and expected outcomes associated with mesotherapy through the case study of a patient who received mesotherapy treatment for her dry skin in the under eye and mid-cheek areas.

Treatment Protocol

A typical mesotherapy regiment consists of four sessions conducted weekly or biweekly. For even distribution of the product, it is recommended to use an automated mesogun, which would ensure that each injection has the same product volume and is injected the same injection depth.

The Treatment Session

Each of the four sessions are carried out in the same manner. The same products are used, which are typically a mix of products that each target different facets of the skin. This cocktail of ingredients can be customized according to the patient’s aesthetic need (e.g. regeneration, anti-aging, or skin firming, etc.). For instance, older patients may benefit more from an anti-aging cocktail, whereas younger patients may request for a treatment that is geared towards promoting skin radiance.
As an example, the following protocols and ingredients can be used when treating for skin hydration:

• 30% medium-molecular-weight non-cross-linked hyaluronic acid;

• 30% poly-revitalizing complex (hyaluronic acid, 25 amino acids, four nucleic acids, two reducing agents, 10 vitamins, and two co-enzymes);

• 32% mesolift cocktail (hyaluronic acid; vitamins B, C, A, and E; sodium DNA; organic silicium; and DMAE);

• 8% 20mg/ml of 2% procaine.

If the patient requires a cocktail better suited for older skin instead, the following mixture may be used:

• Centella asiatica—Helps the skin heal;

• Dexpanthenol—Dermal regenerative agent;

• Elastin —Improves collagen quantities;

• Organic silicium—Used for optimal collagen synthesis.

Pre-treatment Considerations

As with any aesthetic procedure, a medical history of the patient should be taken to ensure that mesotherapy is an appropriate treatment for them. At this juncture, the patient should also be fully briefed on the details of the procedure; for instance, they should be informed on how long the treatment will take; what to expect; and any post-treatment measures, including their implications, potential cost, and level of commitment required, that the patient needs to do to maintain the results.
After obtaining consent, pre-treatment documentation in the form of photographs of the patient and skin condition should be taken to serve as a baseline from which the progress of the mesotherapy treatment can be monitored.

Also Read: Skin changes with seasons

Instrumentation: The Mesogun

The mesogun delivers microinjections that are uniform in terms of volume and depth of injection, both of which are important factors in terms of achieving optimal results. Usually, the mesogun is set to deliver injections at 1mm depth at a rate of 300 injections per minute. Some of the injectors have reported that the use of the mesogun increases patient comfort levels when compared with manual injections. This is supported by findings from a study that found that mesogun use improved patient experience and lowered their perceived pain sensation.

Case Study

The patient (Patient One) is a female who is 37 years of age and had previously received botulinum toxin treatment for dynamic wrinkles, dermal fillers for volume replenishment, and hyaluronic acid for hydration of the skin. The latter treatment was giving positive effects but at an insufficient level: the patient often found her skin very dry by the end of the day. Mesotherapy treatment was discussed as a viable option to improve the patient’s chronic skin dryness. The patient agreed to four sessions of mesotherapy on the face.

First Treatment

For the first treatment, the skin was cleansed with chlorhexidine solution, and the mesogun was prepared with 5ml of the protocol mixture for hydration. One major consideration with mesotherapy treatments, including the one with Patient One, is ensuring that the product was injected to the right depth. Usually with mesotherapy treatments, there will be excess product left on skin after the injection; this is absorbed into the skin with time, thereby enhancing product penetration. Patient One did not experience any pain save for the upper lip area, where the treatment process caused some minor discomfort.

The Injection Technique

The choice of injection technique greatly affects the quality of results obtained. The most common injection technique used in mesotherapy is termed the nappage technique. This technique consists of quick linear injections to the superficial or mid-dermis.[6] The needle is inserted at an angle of 30° to 60°. The recommended amount of volume injected is 0.1 ml for each single droplet, which should be spaced a few millimeters apart from each other. This technique was used with Patient One.

Post Treatment

After her injections were completed, the mesotherapy session ended with the application of a recovery cream to soothe and calm any unintended after effects like bruising or redness and a SPF50 broad-spectrum sunscreen. Patient One was advised not to cleanse her face a few hours after treatment. Patient One did not experience any bruising after the procedure. In general, mesotherapy results in less downtime when compared to other aesthetic treatments, such as microneedling.

Ensuing Sessions

As per protocol, the treatment extended to a total of four sessions scheduled two weeks apart. Each session followed the first treatment regimen in terms of preparation, dosage, technique used, and post-treatment care. Photographs were taken before each session.

Feedback and Outcome

After her first treatment, Patient One reported an improvement in skin texture and in hydration at levels that exceeded her expectations. It was observed that the most significant changes occurred after the third and fourth sessions, with the patient reporting her skin as looking revitalized and rested.
At the final review session conducted four weeks after the final treatment session, Patient One reported an overall positive outcome with mesotherapy treatment. Where previously the patient would note that her skin would start to feel dehydrated by mid-afternoon due to stress stemming from the patient’s occupation, her face would feel fresh all the way to the evening with the mesotherapy treatment. She therefore felt satisfied with her treatment and was keen to maintain its benefits.

Maintenance of Results

The initial benefits obtained from a mesotherapy treatment can be further extended through repeat treatments conducted every two to three months, depending on the skin condition. After two months, the skin is assessed, and a treatment is scheduled accordingly, usually for the next month or earlier if needed.

Conclusion

Mesotherapy can greatly aid in hydrating and rejuvenating the skin, effects that benefit the health and appearance of the skin in the long term. Additional advantages of treatment include minimal side effects and downtime, and suitability for all skin types. In conclusion, mesotherapy is a treatment that can be of great benefit to patients and should be an integral part of any aesthetic medical practice.

Reference

• Pistor, M., ‘What is mesotherapy?’, Le Chirurgien-dentiste de France, 46 288 (1976), p. 59.

• Savoia, A., Landi, S., & Baldi, A., ‘A new minimally invasive mesotherapy technique for facial rejuvenation’,Dermatology and therapy, 3(1) (2013), 83-93.

• Lacarrubba, F., Tedeschi, A., Nardone, B., & Micali, G., ‘Mesotherapy for skin rejuvenation: assessment of the subepidermal low-echogenic band by ultrasound evaluation with cross- sectional B-mode scanning’, Dermatologic Therapy, 21(s3) (2008), S1-S5.

• Knoll, B. & Sattler, G., Illustrated Atlas of Esthetic Mesotherapy. (London: Quintessence Publishing Company, 2012)

• Duncan, D. I., & Chubaty, R., ‘Clinical safety data and standards of practice for injection lipolysis: a retrospective study’, Aesthetic Surgery Journal, 26(5) (2006), 575-585.

• El-Domyati, M., El-Ammawi, T. S., Moawad, O., El-Fakahany, H., Medhat, W., Mahoney, M. G., & Uitto, J., ‘Efficacy of mesotherapy in facial rejuvenation: a histological and immunohistochemical evaluation’, International journal of dermatology, 51(8) (2012), 913-919.

• Tosti, A. & Pia De Padova, M., Atlas of Mesotherapy in Skin Rejuvenation, (London: Informa Healthcare, 2007)

A red apple near an orange sybolizes the Similarities & Differences between Stylage and Juvederm

Stylage vs Juvederm: Similarities & Differences | Medica Depot

Dermal Fillers, Face, Juvederm, Lips, Skin, Wrinkles / By  Medical Community

17 Sep

While many patients know of the Juvederm brand, smaller, more niche brands like Stylage, a French line of hyaluronic acid fillers, may be comparable and even more suitable for your patient, depending upon their aesthetic aims. This article will shed some light on these leading brands and examine how they compare to one another.

Similarities Between Stylage and Juvederm

The Juvederm line of dermal fillers are considered an integral component of the aesthetic doctor’s armamentarium. These best-selling dermal fillers are regularly used in many cosmetic injectable procedures. Products include Juvederm Voluma, a highly volumizing filler that is used to add fullness to large areas of the face, Juvederm Volbella, which is used for lip augmentation, and Juvederm Vollure, Ultra, and Ultra Plus, which are used for softening lines and wrinkles.

Generally speaking, Juvederm products have high G prime (a measure of the hardness of the gel) and medium to high cohesivity, resulting in a gel that is smooth, malleable, resistant to deformation.

Stylage is a European brand of injectable dermal fillers that are hyaluronic acid based. Their products include Stylage S, M and L, three products of varying viscosities that are used to improve the appearance of wrinkles and lines, and rejuvenate the back of the hands. They also have a filler used specifically for lip contouring, Stylage Special Lips.

A unique characteristic of Stylage dermal fillers is the formulation’s addition of mannitol. This antioxidant prevents free radical damage, improving the stability and longevity of the gel in dermal tissue. The antioxidative effects of mannitol also help lessen side effects like swelling and bruising.

How Do Stylage and Juvederm Compare?

Both the Stylage and Juvederm brands offer a range of products with varying hyaluronic acid densities that suit various treatment purposes. In this regard, they both cater to a wide variety of aesthetic indications.

Stylage is made using IPN-like Technology, which involves the transformation of individual cross-linked matrices into a monophasic gel through an interpenetrating network-like (IPN-like) process. This increases the density and degree of cross-linking without the need for additional cross-linking agent. Juvederm products, on the other hand, are made using Hylacross and Vycross Technologies, which both involve a single cross-linking process. In Vycross, high- and low-molecular-weight hyaluronic acid chains are incorporated to form a monophasic, monodensified gel.

Different manufacturing processes result in products with distinguishing physical characteristics that affect the way they integrate with dermal tissue. A microscopic analysis of Juvederm products reveal a cohesive consistency while Stylage products have a lighter, less dense structure with fewer continuous networks. When implanted into the dermis, the gel distributes evenly among the area of treatment in large pools.

As mentioned previously, another distinguishing feature of Stylage products is the addition of mannitol. This antioxidant preserves the physical characteristics of the gel by preventing damage incurred by free radicals, which are molecules generated by enzymes present as a result of the inflammatory response cause by the injection.

Differences Between Stylage and Juvederm

Stylage and Juvederm products share many common features, as the starting material in both these fillers is hyaluronic acid. However, the differences in the cross-linking technologies used to create the final products results in gels with different rheological and physical properties that affect their behavior within the dermis.

Additionally, Stylage contains mannitol, which is incorporated to decelerate product degradation, enhancing result longevity. The practitioner must understand these differences in order to select the right product for their patient.