Juvederm Los Angeles, Santa Monica CA
“ He is a skilled injector. He has an eye for what looks good. ” - NF
Understanding Juvederm
Dr. Behnam loves to teach and is the first thing you will notice when you come in for a consultation with him. Dr. Behnam wants all of his patients to learn and be educated about the various products he uses for facial rejuvenation. Below is a list of questions and answers about Juvederm Ultra and the other Juvederm family of products.
Please note that the opinions and techniques expressed below are that of Dr. Behnam and not of Allergan, the manufacture of Juvederm. Most of the topics and recommendations are off label uses of Juvederm Ultra & Juvederm Ultra Plus and are based upon Dr. Behnam's experience, teaching and expertise in using Juvederm over the years. Please note that portions of the article below have been reproduced and published with the permission of Dr. Behnam in various newspapers and magazines. Any questions should be directed to Dr. Behnam at dermhair@gmail.com
What is Juvederm Ultra?
Juvederm Ultra is stabilized Hyaluronic acids used for soft tissue augmentation and smoothing out wrinkles and folds. Juvederm Ultra is FDA approved for improving the smile lines, also known as parenthesis lines or nasolabial folds. No allergy or collagen testing is required and the procedure typically takes a few minutes.
How does Juvederm Ultra differ from Juvederm Ultra Plus?
Juvederm Ultra is a finer molecule and is used to treat lips and fine wrinkles. Juvederm Ultra Plus is a thicker product that is used for deeper folds and more severe wrinkles, like the parenthesis lines around the mouth.
What areas are typically injected with Juvederm Utra and Juvederm Ultra Plus?
Juvederm Ultra can be injected in many areas on the face, depending upon experience and expertise. Dr. Behnam uses the latest techniques and injects multiple locations on the face to give a more youthful appearance. Below is a list of areas that Dr. Behnam uses Juvederm to rejuvenate the face.
Smile lines
Also known as parenthesis lines or nasolabial folds, this is the most common area that is injected with Juvederm Ultra or Juvederm Ultra Plus. As we age, we lose fat and muscle around the mouth, thus leading to the development of hollowness around the mouth. These areas are injected to fill and smooth them, giving a much more youthful appearance within minutes.
Marionette Lines
Hollowness at the angles of the mouth is known as Marionette lines. Improving the appearance of these areas will significantly enhance the aesthetic look of a person. Typically, the Marionette lines are injected at the same time as the parenthesis lines around the mouth. Patients love the results because it instantly removes years off the face.
Lips
Juvederm Ultra is used to augment and plump the lips. Natural lips abide by a certain rule of thumb: the lower lip is typically larger than the upper lip. When injecting the lips, this rule must be maintained. Dr. Behnam’s philosophy of lip is that it must look natural and bigger does not necessarily look better. Lips, just like everything else on the face, must be balanced with the rest of the face. In fact, when Dr. Behnam teaches other physicians and residents, this is the most important concept that he preaches: Lips must look natural.
When analyzing lips, there are aspects that must be evaluated. The lip has 3 important characteristics that are aesthetically very important. As we age, we lose substance of the lip and the lip deflates. Thus, injecting and plumping the lip will give patients a younger look.
Secondly, there is the lip lining, also known as the vermilion border. As we age, the vermilion border thins out and in some patients it practically disappears. The loss of the vermilion border results in lip gloss and lipstick smudging around the mouth.
Finally, another important characteristic of a younger looking lip are the philtrum columns. One could pick up a New Beauty magazine and look at a lip of any young person. One characteristic that always stands out is the two columns on the upper lip below the nostril, also known as the philtrum. You might say why is this important? Well, the philtrum unconsciously signals the brain that you are looking at a younger more beautiful face.
Thus, when Dr. Behnam analyzes the lips, the goal is not just to make the lip plumper and larger. It is the combination of injecting the appropriate amount of products in the lip in order not to make it too large, preserving the exact ratio of upper to lower lip, creating nad augmenting the philtrum columns and improvement of the vermilion border. This combination will give your lips a naturally younger appearance.
Acne scars
There are many different treatment options for acne scars, including chemical peels (Jessner's Peel, TCA Peels, CROSS technique), Fractional CO2 laser, subcision, punch excision, saline injections and fillers. Juvederm Ultra can be used to fill in a depressed scar. The results are instantaneous and impressive. Juvederm Ultra is typically used, as opposed to Juvederm Ultra Plus which is a thicker material. The area is cleansed and Juvederm Ultra is injected directly into the depressed scar at the appropriate level within the skin, which raises the scar.
Frown lines
Frown lines, also known as 11's or glabellar lines, can be treated in a variety of ways. Neurotoxins, like Botox and Dysport are the first line of therapy. Once these two products are maximized, then the areas can be injected with Hyaluronic acids only, such as Juvederm Ultra or Restylane. Small aliquots are injected, and sometimes over several sessions. Radiesse, Sculptra or other products are not recommended here.
Pre-Jowl sulcus
As we get older, we lose fat, muscle and bone, particularly in the pre-jowl area. Pre-jowl sulcus is defined as the hollowness or depression seen on the jaw line in front of the jowl area. This is one of the tale tale sings of aging. The depression in the pre-jowl sulcus will make the jowl look worse than it is. The area is easily and satisfactorily injected with Juvederm Ultra Plus. The results are so remarkable that patients jump in joy after this injection. The adequate amount is injected over the bone and then pressed into place. It can also be injected in the subcutaneous fat area as well to give a great result. Other fillers can do the same job as well.
Tear Trough areas
The tear trough area, technically known as the nasojugal fold, is the normal anatomic depression that exists between the side of the nose and rim of the orbital bone. As we age, we lose fat in the upper cheek area and the hollowness makes this natural depression a lot more noticeable. The tear trough depression in combination with the sagging of the upper cheek muscles create hollowness underneath the eye, thus known as dark circles. This is one of the most noticeable areas in peoples face and one of the most satisfying areas to inject. Due to various reasons, the general contention is not to use Juvederm in the tear trough areas. Dr. Behnam uses Restylane with great success in this area to achieve great results.
Cheek Bones
As we age, we lose fat, muscle and bone in the upper cheek areas. In addition, gravity over the years takes its toll on the cheek muscle, and they start to sag downward. Thus, older individuals lose the cheek bone, which disrupts the natural Triangle of Beauty on the face (se below for definition of the Triangle of Beauty). Cheek bones may be injected with variety of different materials, including Juvederm Ultra Plus. Juvederm Ultra Plus is typically injected over the cheek bones, which lifts up the muscle of the cheek, creating a younger appearance. The cheek bones can be injected medially and laterally, depending on where correction is needed. Other filler materials can be used as well, including Radiesse and Sculptra. To understand the importance of cheek bone anatomy, it is important to understand the significance of the Triangle of Beauty. If you draw a horizontal line between the two cheekbones and then connect it to the chin, this creates the Triangle of beauty. As we age, we lose this triangle of beauty. The importance of cheek injections is that it recreates the Triangle of beauty.
Earlobes
Earlobes can be injected using Restylane. Small amounts are placed in the earlobe, making it bigger. The significance is that when you wear diamond earrings, the bigger earlobes push out the earrings, making them pop out more and look bigger.
Eyebrows
Injection of Juvederm Utra in the upper portion of the eyelid and/or near the eyebrow will raise the eyebrow, instantly. This technique in combination with Botox will raise the lateral brow, creating a beautiful curve.
FREQUENTLY ASKED QUESTIONS
I need a brow lift, can Juvederm Ultra help?
Yes. Juvederm Ultra can be injected to lift and raise the brow instantaneously.
How can I make my diamond studs stand out more?
Juvederm Ultra can be injected into the earlobe to make it bigger. When wearing diamond stud earrings, it will push out the earrings more, making it more obvious and bigger.
How can I get rid of the droopy angles of mouth?
The downward angles of mouth can be corrected by a combination of Juvederm Ultra and Botox. Juvederm Ultra is injected at the corners of mouth and in the Marionette lines. This technique eliminates the Marrionete lines, the dark shadows under the lips and straightens the mouth corners. The Juvederm Ultra injection takes effect immediately. The Botox is injected in a special muscle around the mouth known as the Depressor Anguli Oris. This muscle acts to pull down the angle of the mouth. By slightly immobilizing it, it stops pulling down at the angles of mouth. The combination of Botox and Juvederm works great. Patients love it.
I dislike the smile lines, how can Juvederm Ultra help?
Yes, Juvederm Ultra and Juvederm Ultra Plus can be injected in the smile lines around the mouth to fill them in and smooth them out. Injections take a few minutes and the results look great.
How long does Juvederm Ultra last?
Juvederm Ultra lasts anywhere between 8 months to a year, depending on the person.
How are the injections performed?
The area is first prepped with alcohol and topical numbing medication is applied. After 10 to 15 minutes, the area is cleansed with alcohol again and the area is injected with Juvederm Ultra. Most people don’t feel any pain. The procedure is quick, taking about 5 minutes to inject the areas desired and overall tolerated very well. The results are immediate. Patients are amazed at how 5 minutes can change the way they look. The lines look smoother and overall they look younger, naturally, in a matter of few minutes.
Does it hurt?
Typically, the injections are tolerated very well by most people. The area is numbed with topical numbing medication. Our numbing medical is a combination of three numbing creams, giving it a very powerful anesthetic property. In addition, the Juvederm Ultra XC also has numbing pre-mixed with the Hyaluronic acid, thus making the procedure even more tolerable.
What are Juvederm Ultra XC and Juvederm Ultra Plus XC?
Juvederm Ultra XC and Juvederm Ultra Plus XC are the latest inventions from Allergan. These products combine the same stabilized proven Hyaluronic acid as in the regular Juvederm Ultra but combined with numbing medication Lidocain. They are as smooth as the regular Juvederm Ultra line and the results look as natural. The benefit is that Juvederm Ultra XC and Juvederm Ultra Plus XC are better tolerated since they are premixed with numbing. They can be used in all the areas as the regular Juvederm Ultra and Juvederm Ultra Plus are usually injected.
How do I know what I need?
You need to see the expert, Dr Behnam. Dr. Behnam was trained under world renowned cosmetic dermatologist and has injected over thousands of patients. He is an expert in advanced techniques of Juvederm injections. He will strategically explain where the Juvederm should be injected to give a you a much more younger and youthful look.
Is the consultation complimentary with Dr. Behnam?
Yes. Cosmetic consultations are at no charge. You are welcome to meet Dr. Behnam. He will sit down with you, analyze your skin, discuss the various options and explain how the procedures are performed.
