All other currently approved hyaluronic acid dermal fillers utilize a gel particle suspension formulation. These gel particles can be seen under magnification as opposed to the smooth formulation used in JUVÉDERM™. The JUVÉDERM™ dermal filler family of products can be administered in a smooth-flowing injection, providing physicians with a high level of control for individualized, tailored facial contouring and for achieving a smooth and natural look.

What is cross-linked hyaluronic acid?
In its natural form, unbound hyaluronic acid forms a liquid made of highly-hydrated individual polymers (chains) that are metabolized in the body in just 12 hours. Cross-linking refers to a process in which the individual chains of hyaluronic acid are chemically bound (or "cross-linked") together, transforming the liquid hyaluronic acid into a soft solid, or "gel." The firmness of the gel depends on the degree of cross-linking of the individual hyaluronic acid chains. The body metabolizes cross-linked hyaluronic acid more slowly, resulting in a longer duration of effect when used for cosmetic or therapeutic indications.

Hyaluronic Acid Backgrounder
For more than a century, physicians have been developing ways to restore volume and structure to aging skin using a variety of approaches including paraffin, silicone and collagen injections. In the 1930s, researchers discovered a natural substance in the body that they named hyaluronic acid, and they found that it plays a key role in numerous areas of the body including the maintenance of skin volume and hydration, eye volume and shape and joint lubrication and cushioning. In the decades since, numerous therapeutic and aesthetic uses have been developed for this versatile natural substance. In 2003, the U.S. Food and Drug Administration (FDA) approved the first hyaluronic acid dermal filler for the correction of moderate to severe facial wrinkles and folds, such as nasolabial folds (the folds funning from the sides of the bottom of the nose to the outer corners of the mouth). Today, hyaluronic acidbased dermal fillers are the fastest growing non-invasive aesthetic procedure in the United States, according to the American Society for Aesthetic Plastic Surgery.

What is hyaluronic acid?
Hyaluronic acid is a natural complex sugar found throughout all living animals that retains water - absorbing more than 1,000 times in weight - and adds volume to the skin's surface. In addition, hyaluronic acid binds with collagen and elastin and transports essential nutrients to cells within the skin. The triple combination of collagen, elastin and hyaluronic acid provides structure, elasticity and volume to the skin and contributes to its overall appearance.

As the skin ages and is exposed to environmental pollutants and ultraviolet rays, the cells lose the ability to produce hyaluronic acid. As a result, the skin begins to lose volume, often resulting in the formation of facial wrinkles and folds. Dermal fillers compromised of crossed-linked hyaluronic acid are used by physicians to help temporarily replace lost hyaluronic acid and to restore skin volume and a smooth, natural appearance.

When was hyaluronic acid first discovered?
Hyaluronic acid was discovered in 1934 by Karl Meyer and John Palmer, scientists at Columbia University, New York. They isolated the substance from a cow's eye and conceived the name from hyalos (Greek word for glass) and the uronic sugar found in the substance. Hyaluronic acid has been used clinically for more than 20 years. Although it is now more commonly used for aesthetic purposes, hyaluronic acid has been used for eye surgeries and for injection into arthriric joints such as the knee to aid movement, and for wound repair.

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