Juvéderm® ULTRA 4 is an injectable Hyaluronic acid-based implant used in filling any deep depressions of the skin via deep dermis injection, as well as lip enhancement and cheekbone augmentation. The presence of lidocaine is meant to reduce the patient’s pain during treatment.

Juvéderm® is a range of smooth consistency gels made of hyaluronic acid (HA) — a naturally occurring substance in your skin that helps to add volume and hydration. Your clinician gently eases the injectable gels under the skin to instantly restore your skin’s volume, smooth away facial wrinkles and folds and redefine lips.

Juvéderm® ULTRA 4 is a sterile pyrogen-free physiological solution of cross-linked hyaluronic acid which is not of animal origin. The gel is presented in a graduated, pre-filled, disposable syringe. Each box contains two 1 mL syringes, 4 single-use 27G1/2” sterile needles to be used only for injecting this product, an instruction leaflet and a set of labels in order to ensure traceability.

Injection Technique

• This formulation requires deep dermal injection due to its density.
• A 27G needle is commonly used for precise placement.
• Cannulas can be an option for specific areas to minimize bruising and bleeding risks.
• Injection technique will vary depending on the desired outcome:
  • Linear threading for wrinkle filling
  • Bolus injections for volume augmentation
  • Serial puncture technique for precise distribution

Important Considerations

• Juvederm Ultra 4 is for licensed practitioners trained in dermal filler injections.
• Thorough facial analysis is crucial to determine injection points and amount of filler needed.
• Aseptic technique is essential to minimize infection risks.
• Lidocaine helps with pain management, but additional local anesthesia might be necessary with some patients.
• Massage the injected area gently to ensure even product distribution.
• Advise patients on potential side effects like bruising, swelling, and tenderness.

Additional Tips

• Employ blunt cannulas for areas with rich blood vessels to reduce bruising.
• Use aspiration during injection to minimize vascular occlusion.
• Start with a conservative amount of filler and perform touch-ups if needed after two weeks.

Remember

• This product is not intended for the under-eye area or thin lips.
• Refer to Allergan’s product information for full prescribing details and safety instructions.

Contraindications

• Do not inject in the eyelids.
• Do not inject into the blood vessels (intravascular). Intravascular injection may lead to embolization, occlusion of the vessels, ischemia or infarction.
• Do not overcorrect.
• Must not be used in:
  • Patients suffering from untreated epilepsy;
  • Patients who tend to develop hypertrophic scarring;
  • Patients with known hypersensitivity to hyaluronic acid and/or to gram positive bacterial proteins as hyaluronic acid is produced by Streptococcus type bacteria;
  • Patients with known hypersensitivity to lidocaine or to amide-type local anesthetics;
  • Patients suffering from porphyria;
  • Women who are pregnant or breastfeeding;
  • Children.
• Must not be used in areas presenting cutaneous inflammatory and/or infectious processes (acne, herpes, etc.).
• Should not be used simultaneously with laser treatment, deep chemical peels or dermabrasion. For surface peels, it is recommended not to inject the product if the inflammatory reaction generated is significant.

2-After-care

• You should avoid strenuous exercise, excessive sun or heat exposure, and alcoholic beverages in order to help minimise the risks of temporary redness, swelling and/or itching.
• No treatment can halt the ageing process; you will require top-ups if you want to maintain the effect so do ask your clinician when they’d recommend rescheduling another appointment. To help you keep a record of treatments, you will receive the Juvéderm® beauty passport