When Juvederm doesn’t seem to be working.
Thank you!! It really helps to know your age but I wish I knew your facial structure as well. So let’s talk a little about the causes of those deep lines from the nose to the mouth. In most women over 40, a good percentage of the problem is actually coming from the volume loss in your cheeks as you mentioned yourself. If that’s the case, then just filling the lines won’t give you a great result. You will need some volume put back in your cheeks with Sculptra, or with the Juvederm Ultra Plus or Perlane (like Restylane). These are more dense and hold up better in the cheeks. Usually a combination of adding some volume back into the cheeks, filling the lines and putting some volume back into the chin area will work nicely. Correct placement is also key, so try to find a very experienced injector.
Some doctors like Radiesse for the cheeks and get nice results with it. To me it always looks a little wooden when people smile but some people love it.
At 48, the bio-therapeutic treatments are unlikely to do much. I’d vote no on those. Dr. I