Restore Volume & Smooth Deep Wrinkles
with JUVÉDERM® ULTRA 4
As we age, some lines become more like crevasses and youthful plumpness gives way to hollows. JUVÉDERM® ULTRA 4 (often equivalent to Juvederm Ultra Plus in certain markets) is here to help.
At Parpar Medical Spa, we use this powerful filler to address severe wrinkles and areas needing a stronger volumizing lift, such as the cheeks, chin, and deeper nasolabial folds. If you’re looking for a non-surgical way to replenish lost volume and soften pronounced lines, Juvederm Ultra 4 might be the perfect solution to rejuvenate and redefine your features.
What Makes Juvederm Ultra 4 Different?
Juvederm Ultra 4 is a high-density hyaluronic acid filler. Here’s what sets it apart: – Thicker Gel Formula: It’s more viscous and more highly cross-linked than lighter fillers, which means it’s designed to lift and support tissue in areas with significant volume loss. It’s perfect for deeper injection planes. – Deep Wrinkle Eraser: Ultra 4 can fill in deep nasolabial folds and marionette lines that softer fillers might not adequately correct. – Facial Contouring: It adds structure – for example, it can augment a weak chin or add definition to cheekbones. – Longer Lasting: Because of its robust nature, it tends to last a bit longer than thinner fillers. Patients often enjoy results for 12 months or more, depending on the area and individual metabolism. – Smooth Consistency with Lidocaine: Despite being thicker, it’s still a smooth gel that integrates well. Plus, it contains lidocaine for comfort during treatment.
Where We Use Ultra 4
Cheeks & Midface
To restore volume that has flattened or sagged, providing a mild lift to the midface and improvement of under-eye hollows by proxy.
Nasolabial Folds
For especially deep folds, Ultra 4 provides a robust fill to smooth the transition from nose to mouth corners.
Marionette Lines & Corners of Mouth
It can uplift the corners and fill the lines that run down from the mouth, reducing that “sad” look.
Chin & Jawline
We can build out a receding chin or add definition to the mandible area, creating a stronger profile.
Temple Hollows
In cases of significant temple hollowing, a filler like Ultra 4 can nicely round them out (though sometimes a slightly softer filler is used; we’ll choose what’s best).
Nose (Non-surgical Rhinoplasty)
Its thicker consistency can be advantageous for more structural nose tweaks, like raising a nasal bridge or filling a depression, as it holds shape well (only performed by experienced injectors due to precision required).
By design, Ultra 4 is versatile for severe volume deficits, but it requires skilled hands – that’s where Parpar’s expertise shines. We strategically place this filler to support and lift, often in combination with other treatments (like softer fillers for fine lines or Botox for dynamic wrinkles) as part of a full-face approach.
Benefits of Juvederm Ultra 4 with Parpar’s Expert Touch
Significant Revitalization
Ultra 4 can take years off by rebuilding facial structure that time has diminished. Think fuller cheeks (no more gaunt look), softened deep folds, and a more defined jawline. The changes are substantial yet crafted to look natural.
Non-Surgical Lift
Many clients considering a minor facelift or implants find that Ultra 4 filler treatments can postpone or even replace the need for surgery when expertly done. It provides a liquid lift – replenishing volume lost from fat pads and bone density reduction, which in turn lifts sagging skin.
High Patient Satisfaction
The areas that Ultra 4 addresses (like deep nose-to-mouth lines or a weak chin) are often major aging concerns. Correcting them yields dramatic improvement in one’s appearance and confidence. People frequently comment after treatment that they feel they’ve got their “old self” back – or in some cases, an improved version they never had (hello, defined chin!).
Smooth and Flexible
Despite being sturdy, Juvederm Ultra 4 maintains Juvederm’s hallmark smoothness. Treated areas won’t feel hard or lumpy. Movements like smiling or talking remain comfortable and look natural. Over a few weeks, the filler attracts water and integrates, often looking even better after the initial settling.
Duration and Value
With its longer lifespan (often around a year, sometimes up to 18 months in lower-movement areas), Ultra 4 offers great value. You won’t need to be in our office frequently for touch-ups – maybe once a year for maintenance. Some patients do a series of injections initially (spread over a couple sessions) to build up correction, then simply come annually to keep the results going strong.
Collagen Stimulation
Like its siblings, Ultra 4’s presence can encourage collagen around it. Additionally, by keeping skin more taut (due to the volume supporting it from beneath), it may help slow the formation of new wrinkles in those areas.
Synergistic Treatments
At Parpar, we often combine Ultra 4 with other fillers (layering thinner fillers superficially and Ultra 4 deeper), or with energy treatments if needed. For example, pairing volume restoration with some skin tightening (like radiofrequency or ultrasound) can address both sagging and skin laxity for a comprehensive rejuvenation. During your consult, we’ll advise what combination, if any, will give you the best result. We have all the tools in the aesthetic toolbox – the artistry is knowing how to use them together.
Safety and Precision
Juvederm Ultra 4 is an FDA-approved product used worldwide. Our injectors are highly experienced with it. We use techniques to minimize discomfort and risk, such as aspiration and careful knowledge of anatomy to avoid injecting in vessels. We also might opt for cannulas in certain areas (like cheek or jaw injections) to reduce bruising and improve safety. You can trust that at Parpar, your treatment is performed with the utmost care.
Your Juvederm Ultra 4 Treatment Experience
Assessment & Mapping
We start by analyzing your facial anatomy, often both at rest and with expressions. We’ll discuss what areas bother you most. For significant volume restoration, sometimes multiple syringes are indicated – don’t be alarmed if we suggest, say, 2-4 syringes; keep in mind 1 syringe is only 1ml (less than a teaspoon). We’ll map out injection points with a white pencil perhaps, to guide the process.
Anesthesia
Juvederm Ultra 4 has lidocaine, but for areas like cheeks or jaw, most patients do fine without additional numbing. If we work on very sensitive areas (like around the lips or nose), we may use topical numbing or dental nerve blocks to ensure you’re comfortable. We also provide ice to pre-numb the skin and minimize bruising.
Injection Technique
For cheeks, we often use a cannula: a single entry point per side near the cheekbone, then the cannula threads through the cheek area depositing filler in a fan or linear technique. This allows broad coverage with minimal pokes and typically minimal bruising. – For nasolabial folds, either small needles along the fold or a cannula from the cheek area can fill them. – For marionette lines/chin, we might use a needle to place filler precisely along the prejowl sulcus or chin apex, or a cannula from near the chin. – For jawline, a few injection sites along the jaw, depositing filler right on the bone to sharpen the edge. – We go deep – often down to bone or just above periosteum – for these structural placements. You might feel some pressure or a strange “deep ache” for a moment as filler goes in near bone, but it’s usually very tolerable with the lidocaine effect kicking in quickly.
Procedure Duration
If multiple areas are addressed, the session can take around 30-40 minutes. The actual injection time per syringe is just a few minutes, but we go slowly, evaluate, and communicate with you during it.
Immediate Aftermath
You’ll see an instant improvement – cheeks are fuller, folds diminished, etc. Some swelling will occur (cheeks often swell a little, and any needle entry might cause a small localized swell). Bruising risk is there, especially around mouth or if needle used – we do our best to avoid it, but if a bruise pops up, we’ll advise care (arnica, etc.). We’ll give you a mirror to check out the new you, and address any questions.
Frequently Asked Questions
How is Ultra 4 different from Voluma or other Juvederm types?
Juvederm’s line has a few products: – Ultra 4 (Ultra Plus): a robust, high-lift HA filler, not as thick as Voluma in terms of G-prime (stiffness) but quite strong. Great for deep folds and moderate lifting of midface. – Voluma: specifically formulated for deep cheek augmentation and mid-face volumization. It’s very high G-prime (firm) and can last up to 2 years. It’s more cohesive, meaning it holds shape strongly. Some providers choose Voluma over Ultra 4 for cheeks because of longevity. At Parpar, we consider which is better for you – sometimes it’s Voluma for maximal lift in cheeks; other times Ultra 4 suffices especially if treating multiple areas. – Others (Vollure, Volbella): are softer, for finer lines or lips. So, Ultra 4 is somewhat the “original” go-to for deep lines and volume before Voluma and newer variants came along. It’s still widely used and effective. It tends to be a bit more versatile than Voluma (which is mostly cheeks/chin), since Ultra 4 handles folds and lines well. If we feel a newer product fits your needs better (for example, Vollure for moderate folds or Voluma for strong cheek lift), we’ll discuss that. Rest assured, we pick the right filler for the right job.
How many syringes might I need of Ultra 4?
For a deep nasolabial folds correction, often 1 syringe can treat both sides if they’re moderate. For very deep folds, 1 syringe each side may be needed (2 total). For cheek volumization, Allergan (the maker) often suggests 2 syringes (1 per cheek) as a starting point – some patients do even more if volume loss is significant and they want a major lift. For jawline augmentation, it could be 1-2 syringes per side for a noticeable contour change. It truly varies by individual. We focus on achieving a balanced, natural result rather than an arbitrary number of syringes. We’ll give you an idea of an optimal plan, and you can decide based on budget and goals. Treatment can be staged (e.g., do 2 syringes now, come back in a month for more if desired). Full correction often yields the longest-lasting and most satisfying outcome, but we understand everyone has their own plan – we work with you.
I have very deep wrinkles; will filler alone fix them completely?
Ultra 4 will dramatically improve deep folds and creases by filling them from beneath. In many cases, yes, the fold will practically vanish when you’re not animating, and be much softer when you smile. However, extremely etched-in lines (like very deep smoker’s lines or accordion lines on cheeks) sometimes also benefit from additional treatments like laser resurfacing or RF microneedling to resurface the skin itself. Filler works from below to push the wrinkle up; skin therapies work from above to smooth the crease line. We might recommend combining approaches if your wrinkles are very etched. But for the classic deep nasolabial or marionette lines, filler alone does wonders. For very thin-skinned patients, we may layer a softer filler superficially after using Ultra 4 deep, to ensure the skin’s surface is smooth. We’ll customize as needed. Our goal is you looking in the mirror and not seeing that deep crease anymore.
What about sagging skin – will filler fix jowls or sagging neck?
Fillers like Ultra 4 can indirectly improve mild jowling by filling the prejowl sulcus (the hollow in front of a jowl) and by lifting the cheeks to take some slack out of the nasolabial area and jawline. It’s impressive how a well-placed chin/jaw filler can mask early jowls – the jawline appears straighter. However, if jowls are pronounced or skin is very lax (and especially neck skin laxity), fillers have limitations. They don’t physically remove loose skin. In such cases, we often pair fillers with skin tightening treatments (like radiofrequency microneedling, Ultherapy, or threads), or honestly advise if a surgical facelift would be the definitive solution. Many times, patients in their late 40s to 60s can avoid or delay surgery by combining fillers for volume and an energy treatment for tightening. We’ll evaluate your degree of laxity. But yes, filler does help sagging up to a point – it re-volumizes the scaffold that holds skin up. If there’s just a bit of sag, restoring that volume can nicely lift it. If there’s a lot, we’ll incorporate other methods too.
How long before I see full results and how long do they really last?
You see results immediately – but keep in mind immediate result includes some swelling. Within about 5-7 days, swelling subsides and you see the “true” result. At two weeks, things are fully settled. We often have you come in at that point for a quick check. If everything’s perfect, great; if you want a tad more in some area or have a question, we address it then. As for longevity, Ultra 4 is quoted as lasting up to 12 months, sometimes more. Many of our patients find that certain areas like cheeks can maintain improvement for 18 months easily, whereas areas with lots of motion (mouth area) might be closer to 9-12 months. We recommend a maintenance treatment before it all fully dissipates – for instance, a smaller “touch-up” at 9-12 months can keep your look consistent rather than letting it go back to baseline. With regular upkeep, you might always have some filler present so you never drop back to where you started. Also, if you decide not to continue, that’s fine – the filler will gradually metabolize, and your face will age normally from that point (no, it won’t sag worse – that’s a myth; in fact your skin might have slightly more collagen than if you’d never done filler). Many love the results so much they come yearly to keep them.
Are there any special aftercare instructions for larger filler treatments?
After getting multiple syringes or treating multiple areas, the aftercare is essentially the same as with any filler: – Avoid heavy pressing or massaging of those areas for a few days (unless we instruct specific massage for something). – Sleep with head slightly elevated the first night if possible, to reduce swelling. – Do not plan strenuous exercise or significant dental work for 24-48 hours. – Stay hydrated and maintain a healthy diet (excess salt and alcohol can exacerbate swelling for a couple days). – Bruising, if any, can be treated with arnica or bromelain supplements, and covered with concealer as needed. – We also say: enjoy how you look, but remember day 1 you might be a bit swollen, so don’t judge final results yet. If you have an event, ideally get treated at least 1-2 weeks prior to be safe. If you ever feel lumps or unevenness after swelling goes down, come see us – usually gentle massage resolves it, and we can guide you. Significant lumps are uncommon with Juvederm when properly placed. We’ll provide you a detailed handout with all do’s and don’ts.
Schedule Your Consultation
Reclaim your youthful contours and say goodbye to deep lines with Juvederm Ultra 4 at Parpar Medical Spa. Our patients from Suffern, Montebello, Ramsey, and beyond have loved their transformations – from lifted cheeks to smoothed folds – all accomplished in under an hour, with minimal downtime.
Your most radiant, confident self is just an appointment away!
Why not you, too? Book a consultation and let our aesthetic experts create a personalized plan to bring back volume, symmetry, and confidence to your face. With Juvederm Ultra 4, you can defy gravity and embrace a rejuvenated you – no scalpel required!
