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Degrees of separation

Article-Degrees of separation

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  • Several physicians have reported sporadic problems with Juvederm needles popping off syringes in mid-injection

Dr. Popp
NATIONAL REPORT — Several physicians have reported sporadic problems with Juvéderm (hyaluronic acid [HA], Allergan) needles popping off syringes in mid-injection in recent months.

"It's happened to me twice" between mid-February and early March, says Jeffrey Popp, M.D., a cosmetic surgeon in private practice in Omaha, Neb., and a member of the Cosmetic Surgery Times Editorial Advisory Board.

Allergan officials say they are investigating a "limited" number of such reports, and say the problem could be associated with the filler's viscosity which dictates a different injection technique than doctors may be using.

While some physicians interviewed for this article disagreed about whether Allergan had fixed the problem as of press time, none doubted that the company would soon put the issue behind it. To date, the incidents appear confined to Juvéderm Ultra, sources say.

"The needle shoots right off the syringe," spilling filler all over the patient's face, Dr. Popp relates. In one case, he reports, "It ran into the patient's eye, and the needle stuck" in the patient's nose.

Dr. Schlessinger
Joel Schlessinger, M.D., reports that he's experienced needle separation twice in about 50 Juvéderm syringes, once while being filmed for a TV segment.

Dr. Beer
"This happens with other [filler] products as well, but the incidence with Juvéderm seems to be a bit higher" due to its viscosity, says Dr. Schlessinger, a board-certified dermatologist and general cosmetic surgeon and president, American Society of Cosmetic Dermatology and Aesthetic Surgery.

"It's very unsettling," says Kenneth Beer, M.D., director, Palm Beach Esthetic Institute and clinical instructor of dermatology, University of Miami. He reports that in his practice, the problem has occurred approximately five times in six months.

"There have been no injuries," he adds, "but that's just luck."

TEPID RESPONSE? Perhaps more distressing than the problem is Allergan's initial response, says Dr. Popp.

"I can't get the truth," just form letters in response to his incident reports, he explains. Each communication says the company is investigating the problem, says Dr. Popp, "But it's cold and uncaring. They don't even say they're sorry."

Dr. Carruthers
"We have received limited reports of this nature," says Caroline Van Hove, Allergan's vice president, corporate communications, in an e-mail response to Cosmetic Surgery Times . She states that Juvéderm differs from other currently approved HA fillers in that "it is a smooth flowing gel which requires less extrusion force during the injection." Therefore, injectors accustomed to stiffer HA fillers might be "using more force than necessary with Juvéderm."

However, Dr. Beer says that Juvéderm's smooth flow "makes needle separation more problematic. We are using less force, and it still separates."

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