In modern aesthetic medicine, hyaluronic acid dermal fillers have become an essential tool for non-surgical facial rejuvenation. One of the most widely used products in clinical practice is JUVEDERM® ULTRA 3, part of Allergan’s renowned line of fillers. Designed to treat medium to moderately deep wrinkles and enhance lip volume, this product has earned a solid reputation among aesthetic professionals in Spain and worldwide.
This article provides a comprehensive technical overview of JUVEDERM® ULTRA 3, including its composition, indications, application techniques, comparison with other fillers, adverse effects, and clinical considerations for aesthetic physicians.
1. Technical Characteristics of JUVEDERM® ULTRA 3
JUVEDERM® ULTRA 3 is a cross-linked, sterile, and biodegradable hyaluronic acid (HA) gel, indicated for facial wrinkle correction and improvement of lip contour and volume.
- Type of HA: Non-animal origin, highly purified
- Concentration: 24 mg/ml of hyaluronic acid
- Lidocaine: 0.3% to improve patient comfort during injection
- Technology: Hylacross™, providing a homogeneous and cohesive gel structure
The gel structure offers excellent tissue integration capability, making it ideal for areas with moderate facial movement, such as the nasolabial folds and lips.
2. Clinical Indications
JUVEDERM® ULTRA 3 is indicated for:
- Correction of moderately deep wrinkles:
- Nasolabial folds
- Marionette lines
- Perioral folds
- Enhancement of lip volume and contour
- Correction of mild facial asymmetries
- Lip definition in adult patients
Contraindications
- Hypersensitivity to hyaluronic acid or lidocaine
- Active autoimmune diseases
- Pregnancy and breastfeeding
- Infections or inflammation at the treatment site
3. Application Techniques
The professional use of JUVEDERM® ULTRA 3 requires precise anatomical knowledge and mastery of various injection techniques. Depending on the treated area, the following may be used:
A. Needle or Cannula
- Recommended needles: 27G 1/2″
- Cannulas: 25G or 27G for larger areas or where vascular risk exists
B. Depth of Application
- Mid-to-deep dermis for wrinkles
- Subdermal / supraperiosteal for volume loss areas
C. Common Techniques
- Linear retrograde technique
- Fanning technique
- Bolus technique for localized correction
- Microdeposits for lip contouring
D. Anatomical Considerations
- Avoid the facial artery and infraorbital nerve branches
- Always aspirate before injecting when possible
4. Comparison with Other JUVEDERM® Products
| Product | Indicated For | Crosslinking | Consistency | Estimated Duration |
|---|---|---|---|---|
| ULTRA 2 | Fine superficial lines | Low | Soft | 6–9 months |
| ULTRA 3 | Medium wrinkles and lips | Medium | Medium | 9–12 months |
| ULTRA 4 | Deep volume (cheeks) | High | Dense | 12–15 months |
| VOLIFT | Deep folds and contouring | Vycross™ | Flexible | 12–15 months |
| VOLBELLA | Fine filling for lips and tear troughs | Vycross™ | Soft | Up to 12 months |
JUVEDERM® ULTRA 3 stands out for its balance between elasticity and cohesion, ideal for mobile areas without risk of overcorrection.
5. Clinical Results and Longevity
The clinical effect of JUVEDERM® ULTRA 3 lasts between 9 and 12 months, depending on factors such as:
- Treated area
- Patient metabolism
- Injected volume
- Application technique
- Lifestyle (smoking, sun exposure)
For lips, where movement is higher, touch-ups may be needed between 6 and 9 months.
6. Adverse Events and Management
Common Events
- Mild erythema
- Temporary swelling or edema
- Bruising
Less Common Effects
- Subcutaneous nodules
- Asymmetries
- Local immune reactions (rare)
- Vascular compression
Clinical Management
- Apply local ice
- Gentle massage if irregularities occur
- Use hyaluronidase in cases of overcorrection or vascular compromise
Important: Always have hyaluronidase available in your practice.
7. Clinical Recommendations for Professionals
- Conduct a detailed medical history
- Inform the patient of possible risks and alternatives
- Obtain signed informed consent
- Take pre- and post-treatment photos (with consent)
- Schedule a follow-up at 2–3 weeks for touch-ups if needed
8. Documentation, Training, and Support
Allergan offers training for professionals through platforms such as:
- Allergan Medical Institute (AMI)
- Certified instructor-led training programs
We recommend consulting clinical evidence sources to stay updated.
9. Conclusion
JUVEDERM® ULTRA 3 is a versatile and safe option for the treatment of medium-depth facial wrinkles and lip enhancement when used by trained professionals. Its balance between crosslinking and elasticity provides natural and lasting results. For professionals searching for effective solutions, juvederm ultra 3 is frequently chosen due to its reliable performance and patient satisfaction. Correct product selection, appropriate technique, and thorough clinical evaluation are key to optimizing outcomes and minimizing risks.
References
- Micheels P, Besse S, Vandeput E, et al. “Skin Integration and Morphometric Analysis of Different Hyaluronic Acid-Based Fillers” Dermatol Surg. 2016.
- Brandt FS, Cazzaniga A. “Clinical indications and injection techniques for the 5 available formulations of Juvederm XC” Aesthet Surg J. 2008.
- Goodman GJ, Roberts S. “Management of post-injection complications in aesthetic medicine” Clin Cosmet Investig Dermatol. 2019.
- Allergan. “Juvederm® ULTRA 3 Product Information Leaflet”. 2022.
- Allergan Medical Institute. “Educational Materials and Technique Guides”. 2023.