Description
Juvederm Ultra 4 Injectable Gel 2 x 1 ml – Filler for Deep Folds and Lip Volume: A Complete 22-Section Guide
Quick answer:
Juvederm Ultra 4 by Allergan (an AbbVie company) is a thicker hyaluronic acid gel from the Ultra range, marked with 4 of 5 dots on the box: 24 mg/ml cross-linked HA made with HYLACROSS technology plus 0.3% lidocaine, in a box of 2 prefilled 1 ml syringes. Doctors use it for deep wrinkles and folds such as nasolabial folds and marionette lines, and to add lip volume and contour. It is a prescription medical device injected only by a qualified doctor in a clinic, never at home. Results typically last around 9-12 months, often shorter in the lips, and they vary.
Urgent warning: pale or patchy skin, severe pain or any vision change during or after the injection means stop and seek immediate help from the injector or emergency care, because filler may have entered a blood vessel.
Key Facts About Juvederm Ultra 4
| Name | Juvederm Ultra 4 Injectable Gel 2 x 1 ml |
| Manufacturer | Juvederm by Allergan (an AbbVie company) |
| Active content | Cross-linked hyaluronic acid 24 mg/ml (HYLACROSS technology) |
| Local anaesthetic | Lidocaine hydrochloride 0.3% |
| Pack | Box of 2 prefilled syringes x 1 ml, with needles as supplied in the box, single use |
| Range position | Ultra range, 4 of 5 dots on the box |
| Placement | Mid-to-deep dermis, decided by the doctor; no fixed dose |
| Who injects it | A qualified, trained doctor only; never self-injected |
| Expected duration | Around 9-12 months, varying with the area (lips often shorter) |
| Expiry | Printed on the pack |
Short description: The folds-and-lips gel of the Juvederm family: firmer than light lip gels for a more visible fill, but softer than deep volumisers made for cheekbones.
On this page
- Introduction
- What is it?
- How it works
- What it is used for
- Examples from the clinic
- Who may suit it?
- Who should avoid it
- What happens at the appointment
- When to book
- Results timeline
- Mistakes to avoid
- Myths and facts
- Side effects
- Interactions
- Warnings
- Checks
- Combining treatments
- How it compares
- Red-flag symptoms
- NSL expert tip
- FAQ
- Conclusion
Introduction to Juvederm Ultra 4
Juvederm Ultra 4 sits in the middle ground of the filler world. Some lines on the face are too deep for a soft, fine gel, yet do not need the lift of a cheek volumiser: the folds running from nose to mouth, the marionette lines at the corners of the mouth, and thin lips that have lost shape. Juvederm Ultra 4 was made for this kind of work, where a doctor wants a visible but still natural fill.
Below we describe the gel, the conditions it is used for, what an appointment looks like, how long results may last, and the warning signs everyone should know. It is general information for patients and clinics; it is not an injection guide, because a dermal filler must only be injected by a trained doctor. If you are new to fillers, start with our overview of types of dermal fillers.
What Is Juvederm Ultra 4?
Juvederm Ultra 4 is a sterile injectable gel of cross-linked hyaluronic acid at 24 mg/ml, produced with Allergan’s HYLACROSS technology and combined with 0.3% lidocaine hydrochloride. The box holds two prefilled 1 ml syringes with the needles supplied by the manufacturer. On the pack, the Ultra range uses dots to show gel strength, and Juvederm Ultra 4 carries 4 of 5 dots, meaning it is one of the thicker gels in that range.
Like every dermal filler, Juvederm Ultra 4 is a prescription medical device for professional use. Each syringe is for one patient and one session only.
How Juvederm Ultra 4 Works
The body naturally contains hyaluronic acid, a molecule that holds water and keeps skin supple. In Juvederm Ultra 4 the HA chains are cross-linked so the gel resists breakdown and stays where the doctor places it in the mid-to-deep dermis.
- Filling the fold: the gel lifts the base of a deep crease from beneath, so the line looks shallower.
- Shaping the lips: it can add body to the lips and define the border, with a firmer feel than lighter lip gels.
- Hydration: HA attracts water, which adds to the smoothing effect.
- Numbing: the built-in lidocaine reduces discomfort in sensitive areas such as the lips.
- Temporary and reversible: the gel is slowly metabolised, and a doctor can dissolve it with hyaluronidase if needed.
What Juvederm Ultra 4 Is Used For
- Nasolabial folds: softening the deep lines from the side of the nose to the corner of the mouth.
- Marionette lines: reducing the downturned look at the mouth corners.
- Lip volume and contour: adding fullness and defining the lip outline for patients who want a noticeable change.
- Other deep wrinkles and folds that the doctor judges suitable for a mid-to-deep dermal gel.
Juvederm Ultra 4 does not lift sagging cheeks, treat skin laxity or stop ageing. Outcomes differ between people and are never guaranteed.
Examples from the Clinic
A patient in her fifties says her smile lines stay visible even at rest; the doctor checks whether the folds are deep creases or a sign of midface volume loss, because the answer changes the plan. A younger woman wants fuller lips; the doctor discusses whether a firmer gel like Juvederm Ultra 4 fits her goals or whether a softer lip gel would look more natural. A man has marionette lines that make him look sad; the doctor may treat them alone or alongside other areas. The final choice of product and amount is always the doctor’s decision after examination.
Who May Suit Juvederm Ultra 4?
- Healthy adults with moderate-to-deep folds around the nose and mouth.
- Adults wanting clearer lip volume and contour rather than a very subtle change.
- People who understand that the effect is temporary, often shorter in the lips, and that touch-ups may be needed.
- Patients willing to be treated and followed up by a qualified doctor in a licensed clinic.
Who Should Avoid Juvederm Ultra 4
- People with a history of severe allergies or anaphylaxis.
- Allergy to hyaluronic acid, to any component of the gel, or to lidocaine or other amide local anaesthetics.
- Active cold sores, infection, inflammation or acne on or around the lips or folds.
- Bleeding disorders.
- Pregnant or breastfeeding women, since use has not been studied.
- Anyone under 18 or under the label’s minimum age.
- Autoimmune disease, keloid tendency, or a recent laser or chemical peel in the area: discuss with the doctor first.
People who often get cold sores should tell the doctor before lip treatment, because injections can trigger an outbreak.
What Happens at a Juvederm Ultra 4 Appointment
Juvederm Ultra 4 is injected only by a qualified doctor. It is not for home use, beauty salons or non-medical staff. This is what the patient experiences; the technique and amount remain the doctor’s decision.
- Consultation: health history, medicines, supplements and allergies, plus a discussion of goals, risks and alternatives.
- Planning: the doctor explains which lines or lip areas will be treated and photographs may be taken.
- Numbing and cleaning: the area is disinfected and a numbing cream may be applied, especially for lips.
- Injection by the doctor: the gel is placed in small amounts, with the built-in lidocaine improving comfort.
- Aftercare: for about 24-48 hours avoid makeup, heavy exercise, saunas, alcohol and pressing or massaging the area, unless the doctor advises otherwise; a cold compress may be suggested.
- Review: a follow-up visit checks symmetry once swelling settles.
When to Book
Lips in particular can swell noticeably for a few days, so book at least two weeks before a wedding, photos or travel. Avoid the appointment while you have a cold sore, infection or irritated skin, and space it away from laser or peel treatments in the same area.
Juvederm Ultra 4 Results Timeline
Folds look softer immediately, while lips often look larger at first because of swelling. Over about 1-2 weeks swelling settles and the true result shows. Results of Juvederm Ultra 4 typically last around 9-12 months, varying with the area: the lips move constantly, so results there are often shorter. Metabolism, the amount used and lifestyle also matter, and a touch-up may be needed. See our article on how long do fillers last for more detail.
Mistakes to Avoid
- Trying to inject Juvederm Ultra 4 yourself or having it done outside a medical clinic.
- Asking for a lot of lip volume in one session instead of building gradually.
- Treating deep folds alone when the real cause is cheek volume loss that the doctor should assess.
- Not mentioning cold sores, aspirin, fish oil or vitamin E before treatment.
- Kissing pressure, lip massage or intense workouts in the first 24-48 hours without the doctor’s approval.
- Waiting at home with blanching, severe pain or blurred vision.
Myths and Facts
Myth: A thicker gel always looks better in the lips. Fact: A firmer gel suits some lips and goals but not others; the doctor chooses.
Myth: Lip filler stretches the lips permanently. Fact: HA is gradually broken down, and appropriate treatment by a doctor aims to respect natural proportions.
Myth: Small lip injections carry no serious risk. Fact: The lips have important blood vessels, so vascular complications, while rare, can happen anywhere.
Side Effects of Juvederm Ultra 4
Our article on dermal filler side effects covers these in more depth.
- Common: redness, swelling (often more marked in the lips), tenderness, bruising, lumps or itching at the injection site, usually settling within days to about 1-2 weeks.
- Rare but serious: vascular occlusion causing blanching, mottling, severe pain and possible skin necrosis, and very rarely vision loss or stroke; infection; delayed nodules or granulomas; allergic reactions.
Interactions: Blood Thinners, Supplements and Lidocaine
- Bruising risk: blood thinners, aspirin and NSAIDs increase bruising and bleeding; do not stop a prescribed blood thinner without your prescribing doctor.
- Supplements: omega-3 and vitamin E may also raise bruising, so list them for the injector.
- Lidocaine allergy: Juvederm Ultra 4 contains lidocaine, so anyone allergic to lidocaine or other amide anaesthetics must not have it.
Warnings for Juvederm Ultra 4
Know the emergency signs. Whitening or mottling of the skin, severe or worsening pain, or any change in vision during or after injection may mean vascular occlusion. It needs immediate treatment by the injector, who can use hyaluronidase to dissolve HA fillers, or emergency care.
- For use by trained doctors only, in a clinical setting.
- Single use; never reuse or share syringes or needles.
- Store according to the label and do not freeze.
- Results vary; no result is guaranteed.
Checks Before and After
Routine blood tests are not usually required, but the doctor reviews bleeding history, medicines, allergies, cold-sore history and the skin before treating. After Juvederm Ultra 4, attend the review visit and report any lump, colour change or persistent pain.
Combining Treatments
- A deep volumiser such as Juvederm Voluma when folds are partly caused by cheek volume loss.
- A flexible gel such as Teosyal RHA 2 when the doctor prefers a softer product for fine lines around the mouth.
- Collagen stimulation in selected patients; read about Sculptra.
- Lip balm with sun protection and gentle care while healing.
How Juvederm Ultra 4 Compares
These five injectables are all for professional use by doctors, but each one targets a different layer and purpose.
| Product | Type | Concentration | Lidocaine | Typical area |
|---|---|---|---|---|
| Juvederm Voluma with Lidocaine | Deep volumising HA filler (VYCROSS) | 20 mg/ml | Yes, 0.3% | Cheeks and midface, chin and jawline, temples |
| Juvederm Ultra 4 (this page) | Thicker HA gel for folds and lips (HYLACROSS) | 24 mg/ml | Yes, 0.3% | Deep folds, marionette lines, lip volume and contour |
| Teosyal RHA 2 | Flexible resilient HA (RHA) gel | 23 mg/ml | Yes, 0.3% | Dynamic lines around the mouth, moderate folds, subtle lips |
| Aliaxin SV | High-volume HA filler | 25 mg/ml | No | Cheekbones, midface and chin |
| Croma PolyPhil | Skin booster, not a filler (polynucleotides) | No HA; polynucleotides 20 mg/ml | Not stated on the label | Skin quality of face, neck, decollete and hands |
Red-Flag Symptoms
- Skin around the lips or folds turning pale, grey or blotchy.
- Pain that is severe or keeps getting worse.
- Any vision change, severe headache, facial weakness or trouble speaking.
- Increasing redness, warmth, pus or fever.
- Rapid swelling of the face or throat, hives or breathing difficulty.
- Firm or tender lumps that appear later.
NSL Expert Tip
From the No Style Like pharmacy team: before lip treatment with Juvederm Ultra 4, ask your doctor whether a firmer gel really suits your lips, and agree on a gradual plan. If you get cold sores, mention it early. And remember that deep smile lines sometimes reflect cheek volume loss rather than a problem in the fold itself.
Juvederm Ultra 4 FAQ
Is Juvederm Ultra 4 for lips or for wrinkles?
Both: it is used for deep wrinkles and folds and for adding lip volume and contour, as chosen by the doctor.
What do the 4 dots mean?
The Ultra range uses dots on the box to show gel strength; 4 of 5 means a thicker gel within that range.
How long does it last in the lips?
Results typically last around 9-12 months overall, but lips are often shorter, and individual results vary.
Can I inject it at home?
No. Juvederm Ultra 4 must be injected only by a qualified doctor.
Can it be removed if I dislike the result?
Yes, a doctor can dissolve HA fillers with hyaluronidase.
What is the expiry date?
The expiry date is printed on the pack.
Conclusion
Juvederm Ultra 4 is a 24 mg/ml HYLACROSS hyaluronic acid gel with 0.3% lidocaine in 2 x 1 ml syringes, used by doctors for deep folds, marionette lines and lip volume. It is injected only by a trained doctor, results typically last around 9-12 months and vary, and blanching, severe pain or vision changes are an emergency. Clinics and doctors can order it from No Style Like pharmacy with delivery across Egypt.
Reviewed by the No Style Like Pharmacy content team. This information is for educational purposes only.
This is a prescription medical device for professional use; follow the treating doctor’s instructions, and this content does not replace medical advice. Learn more at FDA – Dermal Filler Dos and Don’ts.
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