Is Juvederm better than Restylane?

Be careful with Juvederm injection in the tear trough areas.
Had some of my patients and other physicians who had prolonged swelling following injections. Never had it with Restylane. Otherwise, Juvederm and Restylane seem about the same.

Restylane is a bit clumpy compared to Juvederm and harder to sculpt precisely. Restylane seems to have more bruising as well. Each seems to last about 6 months. The two companies are dueling with who lasts longer, each getting longer FDA permissions to say which lasts longer.

In my practice I use these 2 fillers the most.  The one similarity is that both are hyaluronic fillers.  Also, know that there are 2 types of Juvederm - Ultra and Ultra Plus. 

Because of differences in the way Restylane and Juvederm are produced, they do not have identical properties when placed in the skin.  A good analogy is that Restylane fills like "jelly" whereas Juvederm fills like "Jell-o." 

An important consideration for me when choosing between the two is, where am I injecting the product?  There will be 3 important differences:  

• How it feels - especially in the lips
• The amount of swelling
• The size of the needle that can be used, which is especially relevant for correction of orbital hollows  

Juvederm is a filler made of Hyaluronic Acid. There are a number of products containing the same material. these include:

Rastylane, Perlane, Elevess, Prevelle Silk, Hylaform, and Captique

The differences in the products are subtle despite claims made by the manufacturer. The newest products are Elevess and Prevelle. These 2 contain a numbing medicine that decrease the discomfort associated with the procedure.

All the products mentioned above last about 6 months regardless of claims made by the manufacturers. And they are all avaiable off the shelf with no preparation.

Therefore, in the hands of a well trained and experienced plastic surgeon, you should get similar results with any of the hyaluronic acid fillers.

Other types of fillers include Radiesse and Sculptra. These are also available off the shelf with no preparation.

Radiesse is a hydroxyapatite product (similar to the material found in bone) and lasts about 8-9 months

Sculptra is a poly-L-lactic acid product (similar to suture material used in surgery) and lasts about 2 years.

All of these products can be used to effectively. However, as mentioned, all of the products listed above are temporary fillers.

The only FDA approved permanent filler that is available off the shelf is Artefill. This product can add volume permanently to the face with excellent results.

Last but not least is fat injections. Fat injections can also permanently add volume to the face. Although this is a surgical procedure, with proper technique excellent results can be achieved.

Both Juvederm and Restylane are Hyaluronic acid. Both are produced by Bacterial Fermentation. The consistency of Restylane tends to be granular and that of Juvederm smooth. Recently Restylane duration by approved FDA labeling was increased to 18 months and for Juvederm it is 12 months. These are of course approximations and results will vary from one individual to the next. I offer both products to my patients, but find that Juvederm tends to work better in the so-called "tear trough" area. Both products can give good results in the naso-labial folds and lips.
Sometimes I will have patients who have tried both and will prefer one over the other, sometimes Restylane and sometimes Juvederm. The good news is that we have these products available now for problems that could only be addressed by more complex surgical procedures in the past.
However, sometimes surgery is the better option, and so you should go to a board certified plastic surgeon for an opinion, since they can offer the full range of treatment possibilities.
Good Luck

Dr. Loewenstein

Juvederm, Restylane, and Prevelle Silk are all injectable wrinkle fillers made from hyaluronic acid. Many more wrinkle fillers are awaiting approval by the FDA so it will become increasing difficult to keep them all straight.

Fillers differ in formulation. Some are more plumping and some last longer than others. There is also a significant difference in cost. The key is to find the right office with a great injector who has access to the latest fillers and makes recommendations based on your goals and budget. 

We have been using Juvederm with great success since it originally came on the market. This year, the FDA confirmed our experience with the product....it lasts longer than other hyaluronic acid fillers. And in many cases, based on new clinical data, it is lasting up to a year with a single treatment. Even better, Juvederm, in conjunction with Botox®, makes both products last longer. 

Personally, I use both products.  I prefer Juvederm in the lips for most patients since it is softer and more natural.  I use Restylane more often for nasolabial folds although Radiesse is my favorite filler for nasolabial folds. Many of my patients still prefer Restylane for their lips.  I think that Juvederma and Restylane last a similar amount of time and some patients find one lasts longer than the other.

Each patient has different needs and we customize our choices according to how much enhancements and fullness they are trying to achieve.  We will use new fillers and combine them to soften and fill the lines of the face.

hello,

Juvederm does last longer and seems to cause a smoother effect than Restylane.  Now Elevess has arrived and has replaced Juvederm and Restylane both .   Elevess is reported to be more cross linked and therefore should last longer than either one.  Also it is a 1cc syringe whereas Juvederm is 0.8 cc.  The major difference may be the fact that Elevess has lidocaine mixed in it which should cause less pain on injecting the material.  It runs about $550 per syringe which is the same price to patients as the Juvederm and Restylane is currently.

sincerely,

Dr. Hansen

Juvederm and Restylane are both hyaluronic fillers.  There are three differences that stand out between hyaluronic acid fillers.

One is concentration of the actual product per cc, a second is whether or not the hyaluronic acid is fully saturated on injection, and the third is the amount of cross linking a free hyaluronic acid in each filler. 

Concentration bears somewhat on longevity.  Juvederm is more concentrated than Restylane.  The saturation on injection tellls you whether your results will get better with time or whether your effect is as it is after injection. 

To explain this, think of hyaluronic acid as a sponge.  If it is only partially saturated it will stay the same volume after injection.  If however it is under-saturated, it will swell and give a better or fuller result with time. 

The third difference is the cross linking.  The simple rule is the more cross linking the longer the result.  No product can be 100% cross linked or it becomes harder to inject as it nears being a solid.

As a guide in my office I use Restylane under the eyes because it lasts longer there.  In other areas, such as nasolabial folds and lips, I use Juvederm or Perlane.

Good Luck

Gail Humble MD

The jury is still out, but it is possible that Juvederm does, in fact, last a few months longer than Restylane in some, not all, patients. I have seen the reverse as well.

I am in the midst of a one year test checking the longevity of Restylane vs. Juvederm. In general, they are roughly equivalent when you ask most physicians who perform filler injections.

Juvederm and Restylane are both hyluronic acid fillers and are competitors of each other. In experienced hands, we can get very nice results with each, but it all depends on the specific area being treated. For example:

• I use Juvederm for lips and for nasolabial folds because I feel it is softer and a bit more hydrophilic (attracts fluid to the area) so it tends to provide a very smooth result.

• However, this extra bit of swelling is not as helpful around the eyes, so I use Restylane for the tear troughs (area underneath the lower eyelids).

• For very fine lines, I will use a newer product called Prevelle Silk, which is also a hylauronic acid filler, but not as thick as Juvederm or Restylane.

• Finally, for deeper wrinkles or to add volume to the cheeks, I will use Radiesse, which provides excellent results in this area.

So, it's important for your doctor to really listen to what your areas of concern are, and then pick the right product to treat those specific areas.

Juvederm and Restlane are so-called “Non-Animal Stabilized Hyaluronic Acid” (NASHA) fillers. Hyaluronic acid is derived as a product from bacterial cultures which are specially bio-engineered. The product is then purified and treated so as to stabilize it, and also to make it more viscous and to create micro-spherical particles of varying sizes. Hyaluronic acid is a naturally-occurring complex carbohydrate molecule found in the human skin matrix in the space between cells. The molecule is hydrophilic, attracting water molecules to the area where it is found or placed. Since the human form of hyaluronic acid is identical to the form produced by the bio-engineered bacteria, there is no need for allergy testing, and virtually no risk of immune reactions to the NASHA products.

Juvederm and Restylane both have variants, which are essentially the same product with different particle sizes. Juvederm (Allergan, Inc.) has four particle sizes (Juvederm 18, Juvederm 24, Juvederm 24 HV, Juvederm 30), used to treat the progression from fine to deep lines. Restylane (Q-Med, Medicis) has four particle sizes (Restyane Touch, Restylane, Perlane, Restylane Sub-Q) with progressively larger particle sizes used to treat the progression from fine to deep lines and facial atrophy.

Since both Restylane and Juvederm are NASHA products with varying particle size, what’s the difference? Some injectors have a preference for one product over the other based on ease of injection, viscosity, the “feel” of the syringe, quantity of the product in each syringe, etc. There have been no studies to date to document that one product lasts longer or out-performs the competitor’s comparable product in a controlled, double-blind test format. Both products can provide excellent results when properly administered.

So, when it comes to the choice between Restylane or Juvederm as a filler, it’s a matter of individual preference or taste, not much different than the preference of Coke vs. Pepsi as a beverage. A NASHA is a NASHA, and a cola is a cola, whether or not you agree with my choice.

Juvederm and Restylane are both hyaluronic acid fillers. Juvederm is more recent than Restylane.

So far both Juvederm and Restylane seem to go head-to-head. However, since Juvederm is very new, it is hard to definitely draw a conclusion.

Juvederm and Restylane are both non animal, stabilized hyaluronic acid fillers (NASHA). They are both excellent products that are safe and effective in restoring youthful volume to the deflated aging face and hands.

Hyaluronic acid is a substance that is ubiquitous in our bodies. These products are made to look very much like our own hyaluronic acid so they only very rarely cause allergic reactions and they are very well tolerated. They are stabilized so that they last longer in the body than our own hyaluronic acid.

Restylane and its big sister, Perlane, are more robust than Juvederm Ultra and its big sister, Juvederm Ultra Plus. This means that a Restylane product may be better in some uses than a Juvederm product and in some applications Juvederm may be better than Restylane. For example, I prefer to use Juvederm (softer and smoother) for lip enhancement, but I prefer Restylane or Perlane (more structure) for filling in the area in front of the jowls.

In some patients Juvederm seems to last longer than Restylane and in other patients Restylane seems to last longer than Juvederm. The area injected may make a difference. I have not seen a good clinical study that concludes that one lasts longer than the other, so there is a certain amount of patient specific variation that has to be learned.

As usual, the management plan for each patient has to be customized for the individual.

Both of these products have very similar properties.

In general, what I have noticed is that Restylane is a bit stiffer and maintains its shape better, while Juvederm is smoother and conforms better. So, I take advantage of this and use Restylane in areas were I want the bulk to help push the tissue up. For example, around the eyes I generally use Restylane when injecting the tear troughs and brows. When treating lips, I like Juvederm because I find its smoother quality makes the lips feel softer and more natural. Further, because it does tend to spread around more, I use it to treat the fine lines around the lips.

In other areas, such as the nasolabial folds, both products work great. And whether one lasts longer than the other seems to be related to the to the site of injection and the individual being treated.

Both are excellent products. The key to an excellent outcome is going to be more dependent on the quality of the person injecting it than between Juvederm vs. Restylane.

Both Restylane and Juvederm are excellent products, and are both hyaluronic acid.

Restylane remains the "gold standard." We utilize both products as they do have slightly different benefits. For example, Restylane is better for the lip border. However, it is more important to have a trained and experienced injector, with the general preference of most patients that a board certified physician does the treatment.

Both are great tools for non-surgical rejuvenation. It has always been my opinion that "it is not the filler, it is the Filler", that makes the difference. Therefore, is important to be injected by a board certified dermatologist or plastic surgeon who understands the differences between products, how and where to inject them, and how to manage any complications (although they are rare).

Restylane and both forms of Juvederm: Ultra and Ultra Plus contain hyaluronic acid, which is found naturally in your skin. Hyaluronic acid products are very safe and effective when properly injected.

There are differences in the products because of proprietary differences in the manufacturing process. Juvederm Ultra is softer, making it superior in the lips. Juvederm Ultra Plus gives an extraordinarily soft lift to cheeks. Restylane is a bit stiffer, making it stay in place better, so I like it for an eyebrow lift and to define the lip border (although Comsplast is STILL the best for that).

Most of my patients have reported Juvederm lasts longer, but some people feel strongly otherwise. If in doubt, try both and see which lasts longer in you. After all, every patient is different so it is important to see a doctor who can deliver YOUR best result.

"It is not the filler it is the Filler."

Both Restylane and Juvederm are great filler agents.

Restylane was the first FDA approved hyaluronic acid filler in this class. I feel that Juvederm is a better filler because it is smooth and lasts somewhat longer. If you compare the two fillers - Restylane is like blowing jello through a straw and get small cubes as they come out vs. Juvederm which is like a very thick syrup.

I like the smoothness of Juvederm and I primarily use Juvederm Ultra Plus in all areas and if i want to use it in finer lines I use it through a 31G needle (very small). I think it is much better and gives lips a more natural fill.

In skilled, experienced hands, Juvederm and Restylane are both extremely effective in filling and smoothing out facial lines and wrinkles. However, Juvederm claims to last longer.

Juvederm and Restylane are both hyaluronic acid products used to fill wrinkles and lines on the face and to add volume in areas such as the lips, tear troughs (lower lid hollows), and in the cheeks. They are competitors of each other and both work well.

There may be differences in how long they last, and in my practice, the Juvederm does not last as long as long as the Restylane. The Juvederm seems to feel softer than the Restylane, so we often use it in the lips.

Both are very good products.  It appears that in scientific studies, Juvederm may last longer than restylane.  I prefer Juvederm for this reason as well as for the ease with which I can inject the product.

Juvederm and Restylane are actually both very good products, marketing aside. In my opinion the key differences are that Juvederm is more cross-linked leading to a longer lasting effect. It also injects more smoothly typically. I have noticed a tendency to spread through the tissues if the pressure on the syringe plunger is too much. Restylane is a stiffer product, and in my opinion, stays where you put it more efficiently. Finally, the decision regarding which product to use often boils down to which product your injectionist feels most comfortable with.

As an aside, one thing that you need to realize with the use of any hyaluronic acid (HA) product is that it will ultimately be absorbed. Their is little data to suggest that they have a collagen building effect. Some experts even suggest that longterm useage of HA may lead to thinning in the areas injected. You may find yourself shelling out a lot of money over time from repeated injections. If more long term effects are desired, some of the volumizers (Radiesse, Sculptra, autologous fat, etc.) might be better. They are thought to actually build collagen. Repeated use then stack collagen up creating a volumizing effect. They however need to be used deeper and are not appropriate to treat fine lines. They are great in areas like the nasolabial folds, marionettes lines, cheeks, along the jowls, temple areas, etc.

Hope this helps.
Dr. Shah

Marketing companies will have you believe that one is better than the other, but they are comparable to each other.

Each product has its pros and cons. However, my personal experience has caused me to use Juvederm much more than Restylane.

Similarities:

• Both products are safe and effective.
• They cost about the same.
• They are both made of hyaluronic acid, which is a normal component of your skin's matrix. That is why, unlike some other collagen based products, allergy testing is not needed. Because of this you can be treated on the same day as your consultation.
• Both products tend to be smooth and plane out after injection.

Key Differences:

• Although Restylane typically lasts 6-9 months, Juvederm often lasts 9-12 months and has FDA labeling saying that it "may last up to 12 months."

• Microscopically, Juvederm is a smoother compound than Restylane, although I am not sure that it behaves much differently in patients.

• Juvederm has a higher concentration of the active product, hyaluronic acid.

• A treatment session with Juvederm uses a complete syringe (it can't be shared or stored for later use). Restylane is offered in both 0.4cc and 1.0cc sizes, so you have the ability to purchase a smaller syringe at a lower cost if you have a low volume issue requiring correction.

• Also, Restylane syringes typically have 1.2 or 1.3cc while Juvederm has 1.0 or 1.1cc. So, you get more physical product with Restylane than Juvederm.

• The reason that I use Juvederm more is that I feel it does settle in smoother. My patients agree on this fact.

• I also believe Juvederm lasts a little bit longer than Restylane.

• Finally, the design of the syringe makes it easier to inject, increasing the precision of the injections.

As a cosmetic dermatologist, I inject both Juvederm and Restylane, both are excellent products from the same class of fillers: hyaluronic acid based gels.  They are not that different except in subtle ways. 

Some patients have anecdotally claimed they feel Restylane lasts a bit longer, and some patients claim they feel Juvederm feels 'smoother' in their skin. Much of this is up to the skill of the injector. 

In general, these fillers can be used in the:

• Nasolabial folds (laugh lines)
• Marionette lines (sides of chin)
• Lips
• Earlobes
• Under the eyes (tear troughs). 

Both can last up to a year in ideal cases.  Neither appears to have any allergenic problems and test spots are not necessary.  Neither is formulated with anesthesia yet (stay tuned, it is coming), so topical anesthesia or a nerve block might be necessary if you are pain-sensitive.

Although there are differences between Juvederm and Restylane, the injector's preference is the most important issue in obtaining your optimal result. Some other things to consider:

• Both contain hylauronic acid.
• Restylane comes in 1 cc syringes where Juvederm comes in 0.8 cc syringes.
• Although you get a little more Restylane than Juvederm in the syringe, there is actually a little more Hyaluronic Acid in the Juvederm syringe.
• The Juvederm absorbs a little less water after it is injected than the Restylane, but after a few days the difference appears to be minimal.
• I find that I get a little less lip swelling with Juvederm so I prefer Juvederm when doing lip enhancements. In the nasolabial folds (smile lines), the difference in swelling is barely visible.

As far as pain goes, the skill of the injector is FAR more important in minimizing pain than the choice of fillers. Many injectors will mix anesthetic into the fillers before injecting (this is off-label). By combining a custom made topical anesthetic and mixing the local anesthetic into the syringe, most of my patients rate the pain of the injections as a 1 or 2 out of 10. In the next few years, almost all of the fillers will be shipped premixed with local anesthetic.

As far as bruising is concerned, there is not much difference. Again the skill of the injector is far more important for minimizing bruising. Having the patient avoid asprin, Aleve, Motrin, Ibuprofen, etc. for a week prior to the injection is also very helpful. If I think the patient is going to have any excessive bruising, I may treat the site with an IPL device to stop the bruising before it starts.

Lumps should rarely be a problem with either Restylane or Juvederm. By injecting slowly and massaging the area, the fillers should not show any visible lumps. Keep in mind that both products are actually surgical implants - this means you may feel them with your fingers or tongue, but you should not see any lumps. If a lump does develop, it is very easy to dissolve it with Hyaluronidase.

The cost of both products is about the same in the USA. The price that a patient will pay varies widely and depends more on the location of the injection - some areas are easier to inject than others.

Some studies say Juvederm lasts a little longer, but that varies a lot between individual patients. If either product is injected too deeply, they will appear to disappear more quickly. If either product is injected to superficially, both can leave a blue discoloration (this is called the Tyndall effect).

Excellent results can be obtained with both Restylane and Juvederm.

Juvederm has been rated by the FDA to last up to one year.

This does vary somewhat by location on the face. In areas with a lot of movement, like the lips, it may dissolve in 3-6 months but does leave a small amount of new collagen behind.

I only use Juvederm in my practice, and abandoned Restylane in the beginning of 2007.

There are some newer products coming out in the next six months that may be significantly cheaper and last almost as long.

There is no one product that is better or worse here, but I can say that Juvederm is a little more expensive than Restylane, so until the syringes of Juvederm contain the same amount of Restylane (they contain 27% less filler than Restylane syringes), I will use more Restylane.

As a board certified dermatologist, I like both products and actually did the studies for Perlane, a new form of the Restylane product that is used for filling large wrinkles. Juvederm seems to go in a little bit more smoothly and is not as likely to be lumpy. On the other hand, however, it doesn't seem to provide the lift that Restylane and Perlane provide.

The best thing to do is to try them both! I frequently will use both for patients that ask and let them decide.

They are both very good products. I find that Restylane is more dependable than Juvederm. I have used both in the lower eyelid. Restylane behaves itself there. I have had two cases with Juvederm where the patients looked fine and "under corrected" when they left my office, only to have excessive swelling a few days later.

Likewise, the only time that it was necessary to decrease the size of lips was after a very small amount of Juvederm was injected in a high profile patient. Fortunately, after Widase injections the lips were corrected.

I have had many patients who did fine with Juvederm, but the risk of excess swelling in that occasional patient has me using Restylane more often. My experience is that when I use equal amounts of the products, Restylane lasts longer.

I do not think one is better than the other in all people.

Depending on the location it is being used, and the type of problem being addressed, I will choose one product or another.

For example, are you treating deep, narrow grooves between the nose and the mouth? Or are you addressing an overall loss of volume on the lower face? Are you addressing the very fine lines on the upper lip? Are you filling the lips?

One size doesn't fit all, and each of the fillers has its place in our arsenal against aging.