Juvéderm is the name for a family of hyaluronic acid products. Each one is tailored to different tissue levels of injection. All are pre-packaged containing Lidocaine, which is a local anesthetic, hence the ‘XC’ designation. All syringes are pre-packaged with a pair of either ½” 27 gauge needles (Voluma XC and Juvéderm XC (Ultra-Plus) or pair of ½” 30 gauge needles (Juvéderm Ultra XC). Many fillers are now injected with a blunt cannula to reduce pain and bruising and protect against intravascular injection. I generally use a 27 gauge blunt cannula.

The strength of a gel is dependent on the total number of crosslinks (both chemical crosslinks and natural entanglements). One important aspect of gel strength is Cmin, the concentration of HA in the fully swollen gel in an excess of solvent. The stronger the gel the better is the lifting capacity and the expected duration. Stronger gels swell less and have a value for Cmin. G* is the complex modulus measured by rheology. It is a measure of the total resistance to deformation. Stronger gels have a higher resistance to deformation and a higher value for G*.

Lifting Capacity of Hyaluronic Acid Dermal Fillers Åke Öhrlund, Katarina Edsman, Cecilia Sturesson, Lars Nord, Anne Helander Kenne and Jacques Näsström Q-Med AB, Seminariegatan 21, SE-752 28 Uppsala, Sweden.

Voluma XC is the longest lasting and the thickest of the Juvéderm suite of products. Voluma XC has the highest lifting capacity. This is injected close to the facial bones to primarily enhance the cheeks, chin and jawline. It can be placed right along the bone or into the deep fat compartments, usually in the cheek area. Voluma XC can last, in my experience, from 6 months to a year. Length of action is subjective depending on what is considered optimum correction, which can affect the need for more treatments. Most treatments start with a minimum 2 cc. or two syringes.
Juvéderm XC formerly Juvéderm Ultra Plus XC is the next product down in terms of thickness and lifting capacity. This is the ideal treatment for lip augmentation as well as soft-tissue correction generally. Usually recommended in the naso-labial folds (smile lines) it is very versatile and can be used instead of Voluma as well as for filling out hollows in the temporal region and the sub-malar area (area beneath the cheek bone extending from the nose to the ear). Pictures below show two patients with Juvéderm XC to vermilion margin and philtral columns, Patient #43233 and to vermilion only Patient #31641.

Patient # 43233


Patient # 31641

Oblique View. Juvederm Ultra Smile Lip Injection

Juvéderm XC is the last one on the list, the thinnest (lowest ratio of gel to solvent) with the least lifting ability. Ideal for subtle corrections and filling in wrinkles and acne scars.

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