Lip Augmentation – Juvederm or Restylane?

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Whether you were born with thin lips, they are thinning out as you age or just want a little more volume; it’s certainly possible to have the full, younger-looking lips you’ve always wanted with lip augmentation.

With today’s technology and the advancement of non-surgical solutions, especially in regard to lip augmentation procedures, it’s as simple as booking an appointment with an aesthetic specialist, dermatologist or board-certified plastic surgeon. In less than 30 minutes, you can have immediate, visible results.

During a lip augmentation procedure, while there may be a little discomfort, the worst part is the slight stinging of a few injections with a super-fine needle. Typically, you can expect between 15-20 injections in various parts of the lip area. There will be some swelling and possibly some bleeding, so go over the procedure in detail with medical staff so you know what to expect.

There are anesthetic options for your additional comfort, including the addition of lidocaine already mixed into your lip filler injections. In our experience, 100% of patients are comfortable with the application of benzocaine-lidocainte-tetrocaine (BLT) topical applied for 20-30 minutes before the procedure.

As with any procedure, there may be side effects, which can include swelling, bruising, itching, discoloration, stiffness, tenderness or redness at the injection sites. These side effects can be anywhere from mild to moderate and typically resolve themselves in 14-30 days or less.

Lip Augmentation Background Information

When researching your options to plump your lips, lip fillers are an FDA-approved, non-surgical alternative.  Two of the most popular lip fillers on the market today are Juvederm and Restylane.  In this article, we’ll take a look at both of them and do the comparisons research for you.

Both Juvederm and Restylane are made of hyaluronic acid (H.A.).  H.A. is a substance found naturally in your body, but decreases as we age.  The natural purpose of H.A. is to feed nutrients to the body that, in this case, help to keep lips hydrated, soft and full.

Hyaluronic Acid is a glycosaminoglycan consisting of D-glucuronic acid and N-acetyl-D-glucosamine disaccharide units that is a component of connective tissue, skin, vitreous humour, umbilical cord, synovial fluid and the capsule of certain microorganisms contributing to adhesion, elasticity, and viscosity of extracellular substances.” 

–  Pharmacology from NCIt

Both Juvederm and Restylane products are made from a modified (synthetic/stabilized) version of H.A. to recreate what our own bodies used to do.  In some cases, thin lips are inherited and these lip fillers can enhance Mother Nature’s near-perfect work.

All H.A. fillers are created from fermented bacteria, through a process called “cross-linking.”  It’s necessary for dermal fillers to be cross-linked because if they weren’t, the body would immediately absorb the fillers.

In fact, it’s the cross-linking process which gives the fillers their longevity, making it possible to maintain results for up to a year.  The method and intensity level of cross-linking will determine how long it takes the filler to break down by free radicals and internal enzymes for re-absorption into the body.

While all H.A. fillers are hydrophilic polymers, the cross-linking method determines whether the end product is a biphasic or monophasic gel.  Biphasic gels are comprised of a range of microsphere sizes, while monophasic gels contain homogeneous or same sized particles.

All lip fillers come in a sterile, stabilized gel form.  The difference between Juvederm and Restylane is how they are cross-linked, which results in the type of gel produced.

In almost all cases, lip fillers use butane diol diglycidyl ether (BDDE) in the cross-linking process, which creates the molecular bond necessary to turn the viscous liquid into gel form.  It’s this gel form that makes it possible to use these products as soft tissue (lip) fillers.

Other factors to consider in the processing of lip fillers are the G prime and viscosity methods.

G-prime basically refers to the “hardness” or durability of the gel (filler).  The higher/longer the G prime number, the better the filler will be at firming and lifting.  The lower/shorter the G prime number, the more subtle (soft) the result and the more easily the filler will spread into the skin.  The G prime measurement does not affect the filler’s longevity or duration of results.

In order to obtain more dense filler, which produces more noticeable results, the filler must use larger sized H.A. particles during the cross-linking process and have a higher G prime number.  For deeper wrinkles, more dense filler works best.  However, for mild to moderate wrinkling and superficial dermal treatments, less dense fillers work well.

Viscosity is a way to measure the force it takes to inject (push) the filler through a syringe.  It stands to reason that the denser the filler, the higher the viscosity.

Juvederm for Lip Augmentation

While Juvederm offers products to lift and enhance other areas of the face (plumping hollow cheeks, filling in lines and wrinkles), there are products specifically formulated to enhance the lips.  All Juvederm products are manufactured by Allergan.

Juvederm Ultra

  • Used to add fullness to the lips
  • Uses Hylacross cross-linking technology featuring smaller H.A. molecules which produces a semi-thick but smooth texture
  • FDA approved in 2015
  • Added side effect may include dryness of lips/injection site
  • Highest concentration of H.A. (24 mg/cc)
  • Cross-linking process produces monophasic gel by mixing a set amount of H.A., adding more H.A. and mixing again. Mixing and cross-linking done together.
  • Contains a greater H.A. concentration, higher level of cross-linking (BBDE bonding agent) and longer G prime number
  • “XC” refers to product containing 0.3% lidocaine (anesthetic)
  • Lasts for approximately 6-9 months

Juvederm Ultra Plus XC

  • Used when even more volume is desired (as compared to Ultra XC)
  • A thicker (denser) product cross-linked with larger H.A. particles
  • Lasts approximately 9-12 months

Juvederm Ultra XC and Juvederm Ultra Plus XC fillers produce a smooth, well-blended gel for natural-looking lips and promote increased production of collagen.

Juvederm Volbella

  • Used to add subtle volume, soften the look of vertical lip lines, corrects asymmetry of lips
  • Newest lip filler product, receiving FDA approval in 2016
  • More cross-linking makes this filler a bit thicker and a more dense mix of molecules. Mix of molecules includes only 10% high H.A. molecular weight and 90% low H.A. molecular weight.
  • Features Vycross cross-link technology to reduce water absorption, swelling
  • Typically lasts for 8-12 months
  • After 12 months, up to 98% of patients were satisfied with results
  • “XC” refers to product containing 0.3% lidocaine (anesthetic)
  • Our preferred Juvederm product for lip augmentation
Restylane for Lip Augmentation

Much like Juvederm, Restylane offers a full product line to address various areas of filling wrinkles and lifting of the face.  For lip augmentation, the company offers Restylane, Restylane-L, and the newest member of the family, Restylane Silk.

All products manufactured by Medicis and produced by Galderma.

Restylane, Restylane-L

  • Used to add fullness, volume to lips
  • Restylane and Restylane-L both work well for lifting the corners of the mouth or defining lip borders, lips that have fallen or have flattened out
  • Lasts for approximately 8-12 months
  • Restylane-L contains lidocaine (anesthetic)

Restylane Silk

  • Offering a thinner texture than traditional Restylane, it works better to treat vertical lip lines
  • Longer G Prime than Juvederm, resulting in more of a lift effect, maintains its positioning a little more due to greater “hardness” of gel
  • NASHA cross-linking technology using smaller, smoother H.A. particles
  • One step cross-linking process produces large masses of biphasic gel. Large gel masses are then broken down into smaller, average size pieces by processing through sieves.  This allows large gel masses to be sized down for injection into skin.
  • Results include softer, smoother more symmetrical looking lips
  • Less discoloration (Tyndall effect) once the product settles into place after injection
  • Has an H.A. concentration of 20 mg/cc
  • Higher viscosity (measurement of force required for gel to exit syringe) than Juvederm
  • Approved by the FDA in 2014
  • Lasts for approximately 6 months
  • 98% reported visible results/improvement approximately 14 days after first treatment
  • 76% continued to see results 6 months after initial treatment
  • Contains lidocaine (anesthetic)
The Lip Augmentation Winner Is…

Both are winners.  Both Juvederm and Restylane produce very similar positive results. It’s important to discuss specific goals with your plastic surgeon or aesthetic specialist in terms of exactly what results you are looking to achieve.

While Restylane provides a more firm lifting effect and Juvederm produces a softer look, Juvederm tends to last a little longer (from 6-9 or 9-12 months depending on the product).

All products contain lidocaine, which is mixed into the injection for minimizing pain or discomfort.  The addition of lidocaine has not shown any negative effects on the longevity of any of the fillers.

Lip Filler Reviews

According to actual users of both products, there are equally positive results and comments for both Juvederm and Restylane products.  It simply boils down to a matter of preference.

Although the results of Juvederm lip fillers may last a bit longer due to containing a higher concentration of H.A., the results of Juvederm also seem to be more subtle than Restylane.

Several users have experienced more initial bruising with Juvederm, but found it to be less bumpy than Restylane and many have claimed it gave them a “softer” look.  If a more dramatic or lifted look is what you’re after, you may be more inclined to go with a Restylane filler.

At the end of the day, consider what your specific goals are and based on this and your individual situation, your doctor or specialist can help make an appropriate recommendation for you.

It should also be noted that fillers that are injected into areas of the skin that are more active, like the lips, may shorten the results.  This is because increased activity promotes faster re-absorption back into the body.  It’s possible to need another Juvaderm or Restylane treatment as early as 3-4 months after receiving an initial injection.

It should also be noted that if you are not happy with the results from any of the Restylane or Juvederm lip fillers, the procedure can be reversed by injecting an enzyme into the lips.  The enzyme injection allows the filler to break down and quickly absorb back into the body.

Whatever your decision, both Restylane and Juvederm lip-enhancing products are safe and both can give you natural-looking, temporary-yet-effective, positive non-surgical results


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