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« Dermacare Laser Clinics: Where in the world is Carl Mudd? | Main | Botox Scary: $100 vial from China? »
Thursday
Jul102008

Physician Training Review: How to inject Juvederm Injectable Gel by Allergan

By CHMD: Just viewed "How to inject Juvederm Injectable Gel" by Allergan 2007.  This instructional video was terrible! 

The technique was poor and anyone who tried to inject after watching this video is sure to get bad results.  Allergen should be embarrassed to put this video out. 
 
This points up two big problems with the injectable industry.
 
First, the instruction from the big companies is terrible, it stinks.  There videos are horrible and their instructional seminars are usually very bad as well.  They only show you one way to do things and you have to know many techniques.  The instructors many times don't know HOW they get the results and cannot explain and demonstrate how.  They use 3-4 syringes when we are only able to use 1 or 2 in clinical practice.
 
This is my recommendation to Allergan, Medicis and the others.  Make a great set of instructional videos which demonstrate and instruct how to do injections well.  Make them easily available to everyone.  Work together and share costs if you want.
 
Second, the FDA does not let the big companies instruct us how to do injections unless it is FDA approved for that area.  Since only the Nasolabial folds are FDA approved, that is the only instruction we get.  Allergan and Medicis TELL us to inject it everywhere, but they don't and can't tell us how to do it and get the best results.
 
My recommendation.  FDA, your rules are hurting, not helping us.  "Unintended Consequences"! Open your eyes and take a look at what is going on and modify your rules.
 
My other recommendation.  Allergan and Medicis, open your eyes and see how many BAD injections are done which turn patients (and their friends and family)off to injectables. Teach us how to do these injections correctly.  Don't just hire a plastic surgeon who does good work (and can't teach), hire someone who can teach.

Reader Comments (24)

I believe you that the video is bad because their botox video in the past was also bad but I'm still interested in seeing it. is it a dvd from allergan to get from the rep or is it online? thanks.

07.10 | Unregistered Commenterjmd

Go to www.thederm.org they have some fairly good instructional videos.

These should help.

07.10 | Unregistered CommenterLH

LH, I looked at those videos and they are very good. But they are still insufficient. I suggest everyone take a look. Very well done.

We need to see many more experts inject the tear trough, the nasolabial folds, etc. In these videos we see two plastic surgeons. There are many more techniques and many other expert injectors who we can learn from.

Again, the companies who sell us the material should put lots of videos on the internet for us to view. They should also do instructions the way that the ski magazines and the tennis magazines do their instructions. Lots of pictures, videos and diagrams which are explained in detail.

Maybe lots of medicalspamd participants can email this link to the director of marketing and sales of allergan, medicis, etc.

Let's bug them to death until they do the "right thing"

They spend so much money on their dinner programs. They should be spending the money to produce short videos which can help us all become better injectors!

Also, tell Allergan that they should put at least 1.0 cc in their Juvederm syringes. What is up with 0.8? You can't do much with this. I think we all should boycot Juvederm until they give us 1.0 (maybe 1.3 cc per syringe).

jmd, I got the allergan video from my sales reps.

07.10 | Unregistered CommenterMDR

MDR,

The reason that Juvederm is 0.8 cc is because it has the equivalent amount of HA as 1 cc of Restylane. restylane has 20mg/g and Juvederm has 24mg/g. What this means is that you get the same amount of HA in 0.8ml of Juvederm as you get in 1.0cc of Restylane.

Although, I do agree that they should make both larger and smaller syringes.

07.10 | Unregistered CommenterLH

I had an interesting question from a male aussie patient yesterday:

" Can you put these filler things into the knob (glan penis) to make it bigger ? "

I heard it had been done before. Comment?

dr stephen

07.10 | Unregistered Commenterdr stephen

LH,

Allergan is ARROGANT (beyone arrogant) to only give us 0.8 cc when Medicis gives us an overfilled 1.0 AND Radiesse gives us an overfilled 1.3 cc.

I understand that they give us a higher concentration of HA, BUT you need MORE volume to fill to full correction without using an additional syringe.

I will always use Juvederm as my LAST OPTION until they give us at least 1.0 cc per syringe. We are being treated like IDIOTS by Allergan and it pisses me off!

07.11 | Unregistered CommenterMDR

Infraorbital Area:

I am finding that I can get by with one half syringe of Restylane per side if the tear troughs are not very deep (total one syringe).

If the tear troughs are deep OR if I have to fill the whole infraorbital area (medical to lateral), I need at least one syringe per side and sometimes more to get full correction (total: two syringes).

Are others having similar experiences? Most training videos only talk about .3-.5 cc per side, but they are usually injecting only medial tear troughs that are not very deep.

07.11 | Unregistered CommenterJEE

If I am injecting nasolabial folds:

2 syringes of Juvederm. 1.6 cc. Cost to me $500.
1 syringe of Radiesse. 1.3 cc. Cost to me $250.

To do NL AND Marionette Lines:

4 syringes of Juvderm. Cost to me $1000.
2 syringes of Radiesse. Cost to me $500.

YOU WOULD HAVE TO BE AN IDIOT TO USE JUVEDERM!!!
How is Allergan selling this stuff? Are they selling to Idiots?

I don't care how much HA they put in their .8 cc syringes. I need VOLUME! All the other stuff "COULD BE" a bunch of bull! (amt of HA, smoothness, the pictures of juvederm next to restylane). I think this is all bulls___t to fool a bunch of idiots who don't know enough to say "the emperor has no clothes!).

Allergan, give us VOLUME! Stop treating us like idiots!
ps. I don't work for Radiesse. I am a doctor who is just plain fed up and pissed that all these companies continue to treat us like idiots and we continue to buy their bulls__t.

I recently had an unpleasent experience with alma The laser was blowing a fuse. they wanted me to send it back to chicago , I later found out a simple consult with a local technician solved my problem. Their rep is a good guy but the company cannot be trusted,

07.14 | Unregistered Commenterm norman

I agree with you Needle Nose. I use Radiesse predominantly now for every area that I can. I bought two syringes of Juvederm and the syringe mechanism on one syringe gave me difficulty,the needle came off and squirted the product all over the patient! I will not buy Juvederm again. I use Radiesse and Restylane and recently purchased some Perlane & Artefill just to try. My clients LOVE Radiesse. The bottom line; max affect, min. cost to me = successful business women. Allergan is in this for the money. They don't even give a discount to buying multiple vials! And why would I buy more of Botox so that I could say I am a platinum rated with the company????? Allergan is greedy. Are they not selling their own skin care product now?

As for Dr. Stephen, I have a lot of gay guys in this community. I wonder if they heard we were willing to inject and plump up their glans penis, they would be come in? Very interesting use of product. However, I haven't had anyone interested in getting G-spot enhancement with cosmetic fillers. So, I don't know how far this will go.

Alma's equipment is underpowered (junk), except their IPL.

Is anyone doing Smartlipo or Coollipo to the lower eyelids to reduce fat?

PacificMedDoc,

I have also had the top come off a couple of times. The volume issue is too bad with Juvederm because its easy to work with.
I have used it with a 30 gauge, slow but nice for detail.

Check out Dr Roger Bassin in Florida for the lower lids. Ophthalmologist who does a lot of facial plastics. I believe he is a national trainer for smartlipo also

07.21 | Unregistered CommenterFlorida PA

Has anyone seen any injection videos on the web which instruct how to do infraorbital injections?

www.thederm.org is good, but are there any others?

07.26 | Unregistered CommenterJEE

Yes, they cover all 3 levels of the face.

07.26 | Unregistered CommenterLH

PacificMed Doc:
It sounded awefully painful of a procedure to do. I am not even sure if it is safe to do there?? Any thoughts?? With Radiesse, we have to massage down the substance. Not sure if this can be done well after injection. Lumpiness might be a problem.
I would not invest in SmartLipo or Cool Lipo since you still end up having to perform liposuction in most cases since all these laser-assisted lipolysis platform can do is to suck out the "oil part" not the more problematic fat particles. Dr. Bruce Katz from NY conducts lots of the SmartLipo seminars in association with the Medical Spa Society people. I got their email spams often, :-(

07.27 | Unregistered Commenterpmdoc

Are you able to get the Teosyal injectable range in the States? Great product. Injected thousands of syringes over the last three years and never had a problem.Also comes in different consistencies for different areas.

07.29 | Unregistered Commenterskinrenwal

I am in the Memphis, TN area. I have been injecting Botox and HA's for about 2 1/2 yrs and started injecting Radiesse in the last 6 months. We get excellent results with Juvederm which we find more comfortable for our patients than Restylane. We have developed very good protocols for evaluating what and where injections are needed. Trainers for Radiesse disappointed us. We really didn't need instructiing, the rep was impressed with our results. The instructor was insistent that we inject using her technique which caused unneeded trauma to the tissue. We continued to use our technique which our patients are extremely happy with. 95% of our patients have no bruising, very small amounts if any of swelling , they can usually leave our office and meet friends for lunch without them knowing what they have had done. Contact me if anyone is interested in training. Bad injectors hurt everyone!!

08.20 | Unregistered CommenterDianaCo

DianaCo,

What is your contact information? I would be happy to help you explain your technique on this blog and even set up a site (free) where we could post diagrams and drawings (maybe Jeff Barson could make this happen). I have been injecting for 3 years and I get very good results, but they could be better and it would be nice to get less bruising (I do lots of small threads). I would love to know your technique and I think others would as well. I am not sure people would be interesed if you have a training course where you charge thousands of dollars. We have plenty of these and I agree with your assessment that most are not very good.

I still have a big problem with Juvederm because they only give you 0.8 cc. Without VOLUME, it does not matter how good you are. You get 60% more Volume with Radiesse (25% more Volume with Restylane)! Almost twice as much volume with Radiesse. Volume, Volume, Volume. Allergan, do you hear me . . . Volume. Volume. Volume . . .

Bad injectors do hurt everyone! No using enough material also hurts eveyone because results are not good enough.

08.21 | Unregistered CommenterJEE

Nice information shared buddy.

DianaCo, where are you?
Did JEE call your bluff?
Are you a Juvederm Salesperson?

No swelling? No pain?
I don't believe it.

More like "no truth"!!!

08.27 | Unregistered CommenterMDR

I have had Radiesse . I looked great , no bruising, swelling , but a few hours later my finger joints were swollen and reddish . I called the Cie. they couldn't have been least interested. This side effect didn't last.
I feel Allergan has a monopoly and that is never good. In Europe, Myobloc is used widely , it is a lot less expensive.
Check the Florida University Miami Cosmetic site for info. They even have procedural diagrams for injections. I'm sorry , I don't remember the web site address.
My husband is a physician and he is going to inject my marionette lines (now with added loose skin).
I had a face lift more than one year ago but I developed a large hematoma post-op. I look worse than I did before my surgery . My plastic surgeon is a friend and proceeded to pick all the Radiesse I had had injected , (he doesn't do fillers,) the hemmatoma left me with more sagging skin and we don't know how the Juvederm will remedy this , I can pinch my skin , so it will take at least 1 serynge . Any advice would be appreciated. .
I am more interested in the 1-2 stich lift. but no one does it in my area.
You are right, the CDs are useless.

12.2 | Unregistered Commenterthe RN

Added tidbit, I am always researching on the Net and one Dermatologist mentioned that she actually places an an ice bag on the sites she is going to inject.

12.2 | Unregistered Commenterthe RN

If gay men knew that you were injecting juvederm into the penis to make it larger, you would have more office visits than you can handle, I assure you.

03.23 | Unregistered Commenterinterested

I've had light redness around the head of my penis which only lasted a day and there was minor discomfort for 2 days after getting juvederm injected into the glans(head) of my penis. I didn't see much gain but there was gain so I got my desired outcome. After all, I didn't want it to be 50% larger than the shaft. I had the procedure 3 months ago and it is still in effect. This is the last time I am using it though. I heard it will go away in a year or so but I ain't too worried. It was just a test I guess and since it seemed pretty safe for other uses, I had no trouble submitting my penis. But I was a little concerned if there was going to be long-term effects such as redness or swelling in the injected area. Luckily I seen no such thing 3-4 days after. Sometimes tho some guys wish they had the luxury like women to make them 'bigger' While there are proven ways to do so, none of them are really too long-term. While breast enlargement isn't either at times, we do wish we could have some doctor do something safely and surgically stretch the penis and do something 'medical' to make it stay. lol

10.29 | Unregistered CommenterRodney

I complained to company because you practitioners have made my face look awful my lips are lopsided you''ll take my money and not give a Damn that you made me look like a clown.

10.18 | Unregistered Commentertam

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