Juvéderm Facial Fillers

Your skin is constantly under attack. Wind, sun, cold, pollution, fatigue, emotional changes, hormonal swings, and the simple passage of time all combine to wear away at its structure. And, as if that’s not enough, your skin’s natural moisture-retaining hyaluronic acid inevitably declines with age. This moisture loss creates lines around your lips, nose and eyes and reduces fullness in your cheeks and jaw, giving an older, more tired look.

Juvéderm ULTRA® and ULTRA PLUS® are injectable dermal facial fillers that offer different formulas to meet unique needs. Each formula results in a smoother appearance that lasts up to 12 months.

Juvéderm Voluma® XC is the first FDA-approved injectable gel to instantly add volume to your cheek area to correct age-related volume loss in adults over the age of 21. It can give you contour and a subtle lift for up to 2 years with optimal treatment.

How does it work?

The Juvéderm ULTRA range of products represent a new generation of hyaluronic acid (HA) fillers from Allergan, a world leader in surgical and non-surgical aesthetic products. They use a specially formulated type of hyaluronic acid that exists naturally in your skin. Juvéderm ULTRA products are natural, biodegradable gels that flow easily and smoothly into the skin, instantly filling troublesome facial lines and leaving a smooth and natural look and feel. You will notice an immediate difference after just one anti-wrinkle treatment. Treatment will need to be re-done at intervals to maintain your results.

What to Expect

We will clean your face when you arrive for your dermal filler appointment, removing any makeup in the proposed treatment area. Prescription-strength numbing cream will be applied before injection, which helps take the sting out of the needle sticks.  The injections themselves (typically it takes more than one injection to place the filler properly) are fairly easy to tolerate, particularly because in addition to the numbing cream used, the Juvéderm products also contain lidocaine, which begins to numb the treatment area after the first injection. You will be counseled as to how to best avoid bruising. After treatment with Juvéderm, the lines on your face should appear less noticeable and smoothed out. If your treatment plan includes lip enhancement, you’ll notice that your lips appear fuller and more defined. If your plan includes adding volume to your cheeks, you will notice that your cheeks look plumper, and your face looks more contoured and younger.

The effects of treatment with the Juvéderm ULTRA range of products have been shown to last up to 12 months with Juvéderm Ultra and Ultra Plus, and up to 2 years with Juvéderm Voluma!


The Food and Drug Administration approved a new drug that promises to get rid of double chins without surgery.

The drug is called Kybella, and it is an injectable substance that dissolves fat under the chin. It is expected to be commercially available in June, according to the company.

Here's what you need to know:

What is it?

Kybella is a version of deoxycholic acid, "a naturally occurring molecule in the body that aids in the breakdown of dietary fat," according to its manufacturer, Kythera Biopharmaceuticals, based in Westlake Village, California. The company had been calling it ATX-101 before deciding to name it Kybella.

How does it work?

"It disrupts the fat cell," said Dr. Derek Jones, who gave Kythera's presentation to the FDA in March. "When it disappears, it disappears permanently."

Jones said that the drug destroys the fat cell's membrane, causing it to burst. What remains of the fat cell is absorbed back into the body "via normal metabolic pathways," he said.

How much is needed?

Weinkle draws a grid of tiny dots beneath her patient's chin, she said, and injects 0.2 cubic centimeters into each dot.

"I actually mark the area that I see the max amount of fat," she said.

How long does it take?

It takes her five minutes to do the injections, she said, adding that she applies a little ice beforehand.

What's recovery like?

It takes two or three days to heal, Weinkle said. And no bandages are required.

How thoroughly has it been studied?

According to Kythera, it's been the subject of 19 clinical studies involving 2,600 patients.

Dr. William Stebbins, a dermatologist at Vanderbilt University Medical Center who was not involved in the studies, said he has seen Kythera's presentations at various dermatological meetings.

"I've been hearing about this for years, and I'm actually really glad it's coming out," he said.

Who isn't a good candidate?

"This is not necessarily a silver bullet that will solve the problem for every patient, but it certainly is a good option for appropriate candidates," said Dr. Joshua Zeichner, a dermatology professor at the Mount Sinai Hospital in Manhattan. He has not been involved in the drug's development.

People with a lot of excess skin under their chin and neck aren't good candidates for this drug, he said.

"That's not a fat problem," he said. "It’s a skin problem."

Are there side effects?

Yes, side effects were bruising, swelling and temporary numbness, Stebbins said.

Will insurance cover it?

Insurance will not cover this procedure. In trials, patients received the injections once a month for up to six months before reaching the desired effect.

Why can't we use this in other areas of the body?

Jones said it would take significantly more product to remove fat from other areas of the body, and liposuction and other options would be more efficient.


Daniel Shrager, M.D., Founder

Carly Overland, PA.C., Founder

Carla Hontz, Aesthetician

Michelle Buddock, Aesthetician