How safe is JUVÉDERM VOLUMA® XC: Let's talk about the fillers - Part IV.

All medical procedures and treatments, along with their needed effects, may cause some unwanted effects. Regarding hyaluronic acid injections, it is no exception. In most of cases, side effects caused by hyaluronic acid fillers are minimal or absent and easily controlled.

Although not all of these side effects may occur, if they do occur they may need medical attention. For JUVÉDERM VOLUMA® XC, most side effects were moderate and lasted from 2 to 4 weeks.

The most common side effects include temporary reactions at the treatment site such as tenderness, swelling, firmness, lumps/bumps, bruising, pain, redness, discoloration, and itching.

Although most side effects will resolve with time, some side effects may persist longer than 30 days.

Your doctor may choose to treat them with medications, such as antibiotics, steroids, or hyaluronidase (an enzyme that breaks down HA).

As with all skin-injection procedures, there is a risk of infection.

One of the risks with using this product is unintentional injection into a blood vessel. The chances of vascular occlusion are very small, but if it does happen, the complications can be serious, and may be permanent, if no adequate measurements were taken. Fortunately, this condition can be treated with hyaluronidase, as it breaks down hyaluronic acid and unblocks the vessel. Noticeable, hyaluronidase should be injected as soon as posssible in order to avoid negative outcomes. Hyaluronidase will start to work immediately, reaching its peak within 48 hours. Hyaluronidase's mild enzymatic effect remains active for 2 weeks. Thus, in case of lumps and nodules, when visual, aesthetical reduction of a lump is the main goal and no vascular blockage is present, any additional treatments of hyaluronidase can be given within 2 weeks of the first treatment. A treatment protocol for vascular occlusion published by Beer et al. in 2012, suggests nitroglycerin paste 2%, prednisone, Aspirin, Sildenafil, warm compresses and hyperbaric oxygen in addition to hyaluronidase.

There have also been reported temporary scabs, or permanent scarring of the skin, associated with hyaluronic acid, though their incidence rate is very low.

As with all skin injection procedures, there is a risk of infection, which can be minimised by aseptic no touch technique and antibiotic prophylaxis. If any signs of infection appear, a site of an infection should be assessed by a Doctor (ideally, your Doctor or any other Aesthetics Doctor, who is familiar with possible complications and their further management), properly investigated and treated (in most cases, with topical / oral antibiotics).

Let me remind you when you should not opt for JUVÉDERM VOLUMA® XC [contraindications]:

- severe allergies with a history of severe reactions (anaphylaxis) in your past medical history

- allergy to lidocaine or to the proteins used to make the HA in JUVÉDERM VOLUMA® XC (Gram-positive bacterial proteins)

Please tell your doctor if:

- you have a history of excessive scarring (thick, hard scars)

- you have a history of pigmentation disorders

- you are on therapy used to decrease the body’s immune response (immunosuppressive therapy)

- you are using substances that can prolong bleeding, such as aspirin, ibuprofen, or other blood thinners

- you have experienced skin injury near the site of JUVÉDERM VOLUMA® XC implantation

To report a side effect with any JUVÉDERM® product, please call Allergan at 1-800-433-8871. Please visit Juvederm.com or talk to your doctor for more information.

Precaution is better than cure

Johann Wolfgang von Goethe

An article is prepared by using information provided by Allergan:

https://www.juvederm.com/volume-loss

The article was also prepared using:

- Beer J, Downie J, Beer K. A Treatment Protocol for Vascular Occlusion from Particulate Soft Tissue Augmentation. J Clin Aesthet Dermatol. 2012 May; 5(5): 44–47.