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1. What is Juvéderm™?
2. What is the difference between Juvéderm™ and BOTOX®?
3. Common uses forJuvéderm™.
4. How much doesJuvéderm™ cost?
5. What does Juvéderm treatment feel like?
6. Can a face-lift or other surgery be performed after Juvéderm™ treatment?
7. Can Juvéderm™ be used during pregnancy?
8. Pre-treatment instructions.
9. Post-treatment instructions.
10. Am I “vain”?

What is Juvéderm™?
The resilience and youthful contours of your skin — its ability to counter the effects of time, wind and weather — owes much to hyaluronic acid (HA). Juvéderm™ made from NASHA gel (Non-Animal Stabilized Hyaluronic Acid). Because the NASHA used in Juvéderm™ is produced by fermentation, there is no risk of transmitting diseases between species, or eliciting allergic reactions in patients who are sensitized to common foods, such as beef, chickens and eggs – and Juvéderm™ is acceptable to vegetarians. No skin testing is needed before Juvéderm™ treatments.

HA plays an important role giving volume to the skin, shape to the eyes and elasticity to the joints. HA is present naturally thoughout our bodies, binding water, hydrating and softening the skin. HA has a chemical structure similar in some ways to sugar, and is identical in all species and in all tissue types.

Each of us has good natural lines that can be emphasized and improved. Juvéderm™ is a same-day treatment that can be used to give you a long-lasting and natural beauty lift: smoothing wrinkles and folds, or giving your mouth a fuller, more sensuous form, and replacing fullness which has been lost with age. The results are immediate and discrete, and there is little or no recovery time.

The consistency of the NASHA gel in Juvéderm™ is custom tailored to match the tissue structures in the skin being treated, and is stabilized to form a continuous 3-dimensional molecular network. Nutrients, oxygen and hormones pass freely though the gel, maintaining the health and vitality of your skin. Injections of Juvéderm™ can stimulate your body to produce more of its own natural collagen in the treated areas, and this can contribute to the improvement which you will experience. Since the body has its own system for absorbing hyaluronic acid, it slowly disappears over time without a trace.

Juvéderm™ is extremely safe. Hundreds of thousands of men and women in all age groups around the world have been successfully treated with Juvéderm™ since 2003. Studies show that the vast majority of them were so happy with their results they would be willing to have the treatment again – and would recommend Juvéderm™ to their friends.

Dr. Smith has performed over 4,600 treatment sessions with fillers, and has published and lectured extensively across North America and overseas on the use of fillers for facial enhancement. Dr. Smith has had the opportunity to compare many hyaluronic acid products, and has found Juvéderm to have the highest level of patient satisfaction and safety, with the longest duration of cosmetic benefit.

Many individuals are looking for that slightly fuller shape for their chin, or perhaps a rounder more sensuous line along the cheeks or lips. Just a touch of additional volume can make an enormous difference to your appearance. In some cases it will be nice for you to have a “finishing touch” of additional Juvéderm™ after 4-6 weeks to get the compete effect you desire.

The benefits of Juvéderm™ treatment may be visible for 6-12 months, sometimes longer, depending on the location and amount of the treatment and the nature of your skin. For example, highly mobile areas like the lips tend to require at least a touch-up treatment after about 6 months. Areas where there is less movement may only require additional treatment after 12 months. Experience has shown that smaller amounts of Juvéderm™ is often needed for maintenance than for the initial correction.

Some patients who are pleased with the results but desire a more long-lasting correction have follow-up treatments with ArteSense™.

What is the difference between Juvéderm™ and BOTOX®?
BOTOX® relaxes the muscles which cause many facial lines and unwanted facial expressions. Fillers like Juvéderm™, Perlane™ and Restylane™, collagen (Evolence®), ArteSense™ and other products fill creases, lips, cheekbones, and also defects like acne scars. Sometimes BOTOX® is used in combination with fillers when treating certain areas where permanent deep lines have resulted from over activity of the muscles, for example some frown lines on the lower forehead or wrinkles around the lips.

Common uses for Juvéderm™ include:

• Correcting folds and wrinkles of the face
• Acne scars
• Nasolabial folds (between your nose, mouth and cheeks)
• Horizontal (upper forehead) frown lines
• Glabellar (lower forehead) frown lines
• Chin augmentation
• Depressed corners of the mouth, also known as “marionette lines”

Lip enhancement, including treatment of the edges of the lips and wrinkles around the lips to stop lipstick from leaking from your lips onto the surrounding skin

In summary, Juvéderm™ is:

• Long lasting, but ultimately biodegradable and non-permanent.
• Benefits can be cumulative – smaller volumes are sometimes needed for maintenance treatments
• There are no animal ingredients
• No skin test is needed
• Treatment is quick, simple and comfortable; without the need for injections of local anesthetic

Other uses for Juvéderm™ include:

• Filling subcutaneous skin defects
• Filling the tear troughs, below the eyes
• Augmentation of cheek bones, chin or bridge of the nose
• Correcting some irregularities of the nose
• Rejuvenating the back of the hands, reducing the appearance of bones and veins. Dr. Smith can also use the Medlite C6 laser to fade or remove brown “sun spots” on the backs of your hands.

How much does Juvéderm™ cost?
In Canada, Juvéderm™ is not expensive; however there is a cost involved. Many cosmetic treatments were once considered a luxury item only for those who had a high disposable income. Juvéderm™ is very affordable even for those with modest incomes, but some people need to budget for these treatments, just as they would for buying accessories like shoes and having their hair styled.

“Having successful cosmetic treatments for your face is not expensive,
it is priceless.”

Juvéderm™ costs $475 for the first syringe, with a $75 discount for additional syringes used on the same day. One syringe might be used for the lips, or for the nasolabial folds, for example.

What does Juvéderm™ treatment feel like?
Dr. Smith has pioneered the use of ice to prevent discomfort when doing Juvéderm™ treatments, and has taught this technique to other physicians at meetings across North America and overseas. Patients are very pleased that Dr. Smith can take good care of them without having to administer local anesthetic.

Unlike many other fillers, Juvéderm™ has lidocaine anesthetic added to it to further improve your comfort.

Patients are also pleased with the immediate improvement in their appearance, and delighted with the smooth look and feel of their skin.

Can a face-lift or other surgery be performed after Juvéderm™ treatment?
Yes. A face-lift can be performed after Juvéderm™ treatment. The skin on the face is thick enough to prevent the implants from becoming visible after a face-lift. Juvéderm™ treatments can sometimes reduce or eliminate the need for a facelift or other surgery, or can delay the need for repeated surgery.

Can Juvéderm™ be used during pregnancy?
There is no technical or medical reason why Juvéderm™ should not be used during pregnancy.
Dr. Smith has treated pregnant women with BOTOX® and Juvéderm™, helping them to look and feel their best during this important time in their lives.

Pre-treatment instructions:
It is good to pamper yourself on treatment day! If you have a nice big breakfast or lunch, and an extra glass of water, you will be more comfortable. Many patients like to take a couple of plain Tylenol before treatment (similar to what you might do before having a flu shot) to prevent discomfort. As a practical matter, bruising is seldom a major problem after Juvéderm™ treatment. The chance of bruising can be reduced by minimizing your consumption of ASA, alcohol and Vitamin E for 3 days before Juvéderm™ treatment.

Please wear no makeup, or makeup that is easy to remove, so that the area to be treated can be clearly seen. You can bring makeup with you, and you may apply your makeup immediately after treatment.

Post-treatment instructions:
Enjoy! There are no restrictions on your activity after Juvéderm™ treatment, and you will be completely kissable when you get home.

After Juvéderm™ treatment, there is seldom any discomfort or significant swelling. If the lips are treated the chance of swelling during the night after treatment can be reduced by sleeping with your head elevated on 3-4 pillows.

You should not expose the treated area to intense heat (e.g. hot packs) or extreme cold for a day or two.

Am I “vain”?
Many people at some time before Juvéderm™ treatment for wrinkles, lip augmentation or scarring have fears and doubts. A common concern is that they are being vain. My experience has been that just about all patients who have Juvéderm™, Artesense™, laser hair removal, Botox® treatment, and other procedures to maintain their appearance and comfort are no more vain than anyone else. What does distinguish these individuals is a desire to get the most out of life, and to look as good as they feel.

Looking after our appearance is not a fault. After all, would you leave your house with broken gutters or peeling paint? Why do less for your body? I think you should feel proud of yourself for having the will and the ability to change something that you find unacceptable. I emphasize that you should only have Juvéderm™ and other treatments if it is for you. It is a big mistake to do these things if it is just for somebody else.

The same self-esteem that leads our patients to be successful in their chosen fields, well groomed and dressed, and often careful in their diet, exercise, and other aspects of health maintenance leads them to seek help for their wrinkles and frown lines. These individuals are normal healthy people, and the same degree of self-interest that prompts them to exercise, be selective in what they eat and drink, and protect themselves from sun damage leads them to explore the benefits of Juvéderm™. Our patients simply want to look their best.

Consultations about Juvéderm™ can usually be arranged at your convenience simply by calling our special line at 905 356 8013 or toll free 866 760 1000. No referral is needed.

Treatment can be done the same day as the consultation, if you wish.

Our staff can take the time to discuss your wishes and options, and answer your questions. No referral is required.

Niagara Falls Dermatology & Skin Care Centre Limited
Kevin Smith, MD, FRCPC Dermatologist
Licensed and inspected by the College of Physicians and Surgeons of Ontario

Fellow of the Royal College of Physicians and Surgeons of Canada
Board Certified in the United States by the American Board of Dermatology
Suite 201, 6453 Morrison Street, Niagara Falls, Ontario

Please call us Toll Free: 1-866-760-1000 if you have any questions, and to arrange for a prompt, confidential consultation and treatment. No referral is needed.