juvederm

Facelift by by Dr. BCK Patel MD, FRCS in Salt Lake City and St. George, Utah

“Well, the last time I had a picture taken I could hardly see my eyes because of the weight of heavy eyelid. Then I paid attention to how I was actually using my eyes and I really noticed when I was looking at anything especially the computer I was straining my forehead to see better. Since I have had it done I no longer have to lift the forehead and tilt my head to see. It is amazing! I love…” D. Rock 63 Yrs Old with Fat Droopy Eyes – Salt Lake City, UT

WHAT IS JUVEDERM?

Juvederm is hyaluronic acid (more accurately called hyaluronan since the polysaccharide synthesized by mammalian cells is a salt and not an acid) is an important component of the body: it is found in synovial fluid in joints where it increases viscosity of the fluid. Hyaluronic acid is a major component of skin: production of hyaluronic acid decreases with age and with sun damage.

Juvederm is one of several hyaluronic acid fillers available for augmenting tissues. It is formulated with different characteristics which allows different products to be made to give the best results in different areas:

JUVÉDERM VOLUMA® XC injectable gel is for deep injection in the cheek area to correct age-related volume loss in adults over 21.

 JUVÉDERM VOLLURE™ XC injectable gel is for injection into the facial tissue for the correction of moderate to severe facial wrinkles and folds (such as nasolabial folds) in adults over 21.

 JUVÉDERM® XC injectable gel is for injection into the facial tissue for the correction of moderate to severe facial wrinkles and folds (such as nasolabial folds). 

JUVÉDERM® Ultra XC is for injection into the lips and perioral area for lip augmentation in adults over the age of 21.

  JUVÉDERM VOLBELLA® XC injectable gel is for injection into the lips for lip augmentation and for correction of perioral lines in adults over the age of 21.

Juvederm fillers to treat nasolabial folds and lips in a female

“Well, the last time I had a picture taken I could hardly see my eyes because of the weight of heavy eyelid. Then I paid attention to how I was actually using my eyes and I really noticed when I was looking at anything especially the computer I was straining my forehead to see better. Since I have had it done I no longer have to lift the forehead and tilt my head to see. It is amazing! I love…”  D. Rock  63 Yrs Old with Fat Droopy Eyes – Salt Lake City, UT

WHAT ARE THE COMMON SITES WHERE JUVEDERM AND OTHER HYALURONIC ACID FILLERS MAY BE USED?

The commonest sites are:

  1. Cheeks
  2. Nasolabial
  3. folds
  4. Lips
  5. Mid-forehead frown lines
  6. Chin
  7. Brows
  8. ​Lower eyelid grooves
Juvederm fillers to treat nasolabial folds and lips in a female
Juvederm fillers to treat nasolabial folds and lips in a female
Juvederm fillers to treat nasolabial folds and lips in a female
WHAT ARE POSSIBLE SIDE-EFFECTS?
The most commonly reported side effects with JUVÉDERM® injectable gels included injection-site redness, swelling, pain, tenderness, firmness, lumps/bumps, bruising, discoloration, and itching.
One of the risks with using these products is unintentional injection into a blood vessel, and while rare, the complications can be serious and may bepermanent. These complications, which have been reported for facial injections, can include vision abnormalities, blindness, stroke, temporary scabs, or permanent scarring.
As with all skin injection procedures, there is a risk of infection.
 
Juvederm Voluma injected into Cheeks
WHAT MAKES THE TISSUES CHANGE ON THE FACE?

Volume loss of the cheeks occurs because of loss of fat as well as ptosis of tissues. This can result in flattening of the cheek prominence, indentations and wrinkles. Further ptosis of the tissues results in further flattening of the cheek eminence. The overlying skin will descend (or sag!). Loss of hyaluronic acid and collagen also results in static lines on the face. These are seen around the nose and the mouth. Similarly, volume is lost in lips as well. ​​

WILL I BRUISE?

Remember that the face is full of vessels. We use cooling of the skin to reduce the risk of bruising. Some areas are more likely to bruise than others: for example, the lower eyelids and peri-oral tissues are very vascular and may bruise more easily than the forehead or the frown muscle injections. After the injections, use of ice can reduce bruising. ​

Juvederm fillers to treat nasolabial folds and lips in a female
I HATE NEEDLES: WILL IT BE PAINFUL?

We apply an anesthetic cream when patients want it. Our regular patients have an anesthetic cream prescribed which they apply before they leave home: this reduces the sensitivity of the skin sufficiently to make the injections almost pleasant! We also apply ice and we have a Zimmer cooling device which is very helpful in reducing bruising as well as discomfort. ​

Juvederm XC injected into nasolabial folds
 

​HOW LONG WILL THE EFFECTS OF THE INJECTIONS LAST?

Different hyaluronic acid fillers have different compositions and will have varying degrees of survival. Furthermore, areas where there is a lot of movement, like lips, the fillers get digested and absorbed by the body more quickly than more static areas like the forehead and cheeks.

Juvederm XC injected into nasolabial folds show results after one year

Juvederm fillers to treat cheeks, nasolabial folds and lips in a female
Juvederm fillers to treat cheeks, nasolabial folds and lips in a female

​In general, fillers in the lips and nasolabial folds will last about six months, fillers in the frown lines last longer than a year, and, using the correct materials, cheek fillers will last one to two years.

Juvederm Voluma injected into cheeks show results after two years

Juvederm fillers to treat cheeks, nasolabial folds and lips in a female
HOW OFTEN WILL I NEED INJECTIONS?

This is very much a combined decision between the surgeon and the patient. As the fillers gradually wear off , there is no fixed time between fillers. Overall, photographs taken prior to any fillers being used are useful in helping decide when the next fillers may be helpful. Furthermore, a conservative volume augmentation is always better than an aggressive over-filled appearance. ​

Juvederm XC injected into nasolabial folds

“I had a excellent eye lift done by Dr. Patel. He knows what he is doing and is very pleasant. Dr.Patel was easy to get an appointment and he works with you. The office staff was very pleasant and made you feel calm.” D. Gull Highly recommended for eye lift surgery – Salt Lake City, UT

Juvederm fillers to treat cheeks, nasolabial folds and lips in a female
HOW DO I AVOID THE “STUPID OVER-FILLED” LOOK?

By following our advice! Just as discretion is always the better part of valour, so is a conservative filling regime better than overly-aggressive injections. We will guide you and always choose the minimal filler to give you an improvement in volume, shape or position. Carefully and anatomically placed fillers can achieve wonders: it isn’t just ​a matter of shoving it in willy-nilly.

Juvederm XC injected into nasolabial folds

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FAQs

Facelifts are performed in an operating theatre for the sake of sterility and your comfort. We have a team of anesthesiologists and nurses who are trained to specifically look after patients undergoing these procedures.
 
 
General anesthesia is best for facelifts, although in some instances, sedation anesthesia may also be used.
 

With a 3-D procedure, there are several layer of sutures, accurately placed to give the lifting, tightening and filling, without leaving any tell-tale pull-lines. Some are slow dissolving sutures, others are more permanent. The skin sutures are generally removed between 7 and 14 days. ​

Lasers will be used to treat peri-oral lines, “sleep lines” on the cheeks and other skin irregularities. The advantage of using all the skills and modalities available to us, rather than performing quick or weekend or one-hour facelifts is that it allows us to give you a remarkable improvement not only in the structure and appearance of the face, but also the health and smoothness of the skin as seen here:
 
Facelift surgery can take between 3 and 5 hours of surgery time, depending upon the planned procedures, patient’s face-type, age and other factors. ​
 
Bruising and swelling are de rigeur! However, significant long-lasting complications are rare.
Bleeding is not common as we pay close attention to proper hemostasis. On rare occasions, a small hematoma may collect.

Everyone will experience some numbness in the face: this resolves over weeks to months. This occurs because of the dissection of the face. This is not a complication.
Because of the dissection and repositioning of the tissues, it is common for there to be small differences in the smile between the right and left sides: this is usually only noticeable to the patient and to Dr. Patel! It recovers over a few weeks.

All faces have asymmetry and there will be some degree of asymmetry. This is to be expected.
Permanent weakness of nerves and muscles is rare.
The scars are usually very well hidden. However, some patients may have a tendency to cause hypertrophic scarring: in such cases, certain lasers and treatments will help. By-and-large, scars are rarely a problem. With Caucasian skin, pinkness of scars is to be expected for several weeks. With darker skin, some hyperpigmentation may occur. 
 
Bruising around the jawline and upper neck is common for the first two weeks. The face itself usually will not get much bruising, but may be pink from any laser work. Swelling is to be expected because of the extent of the surgery: the swelling abates over about two weeks. ​
 
Only if insurance will buy you a Rolls Royce (Phantom, of course). ​
 
A sensation of firmness will be there because of the swelling: this is present for the first few days. Most patients do not need prescription pain medication after the first two to three days. ​
 
We will provide you with a special neck dressing which you will wear as much as you can for the first couple of weeks. You will also apply a moisturizer (any brand will do) to the face as healing skin and lasered skin requires moisturizer. Icing the face also helps for the first two to three days. Many of our patients will ice the face for longer as it feels good. You may be up-and-about the day after surgery. Gentle exercise (treadmill and stationary bicycle) may be commenced by day 3. More vigorous exercise like skiing and tennis may be resumed by about day 10. ​
 
Ideally, you should be within about 3 – 5 pounds of your desired weight. Whereas I can create the most beautiful angles and curves in slim patients, if you are able to get close to your ideal weight, we can wonders as can be seen in this patient who lost some weight before her surgery and is absolutely chuffed at her result:
 

In the first few days, everyone will experience some degree of dryness and blurry vision. You will also feel that your lids look a little tight on the outer corner where you will also feel some of the deeper sutures if you put your finger there: this is of no concern. The tightness and the bumps under the skin settle over a few weeks.
More serious complications which are very rare include excessive bleeding, hemorrhage and loss of vision. 

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    Contact Info

    ​Dr. BCK Patel MD, FRCS
    ​1025E 3300S
    Salt Lake City, Utah 84106, USA

    (801) 413-3599 (phone/text)
    E-Mail: bckpatelmd@gmail.com
    bckpatel.info

    Dr. BCK Patel MD, FRCS
    617 E Riverside Dr Suite 101
    ​Saint George, UT 84790, USA
    (435) 215-0014
    ​E: drbckpatel@gmail.com