What it is
Juvederm Ultra Plus XC is a hyaluronic acid (HA) gel in Allergan’s Hylacross family — the same technology as Juvederm Ultra, with a higher cross-linking density that produces a firmer, more projecting gel.
The clinical difference: Ultra integrates softly and provides moderate volume with natural movement. Ultra Plus provides more lift, more projection, and a denser feel — which makes it the right tool when the goal is a more substantial enhancement, when native lip anatomy is very thin, or when previous filler sessions have shown the patient wants a fuller result than Ultra alone delivered.
FDA-approved for the correction of moderate to severe facial wrinkles and folds, with results typically lasting up to twelve months.
How Dr. Brown approaches it
Ultra Plus at Esvie is selected when the anatomic target needs density — typically a thin native lip seeking visible volume, a deep perioral fold beyond what Vollure can address, or a patient who has had Ultra previously and is ready for more body in the lip.
Dr. Brown evaluates lip anatomy and the broader perioral context before recommending Ultra Plus over Ultra. The selection between the two is technical, not preferential — the wrong choice produces either an under-corrected result that the patient will return to add to, or an over-projected lip that does not match the rest of the face.
Typical first treatment uses one syringe; some patients build to one and a half or two over consecutive sessions. The most common Ultra Plus error is over-correction in a single visit — Dr. Brown errs conservative at first treatment and evaluates at two weeks before adding.
Every syringe is placed by Dr. Brown. The lip contains the labial artery; only a physician injector should be in the room.
What to expect
Day of treatment: Topical numbing for ~20 minutes. Ultra Plus XC contains lidocaine for placement comfort. The visit runs 30–45 minutes.
Immediately after: Lips will swell, often more visibly than with Ultra because the gel is denser. The post-injection lip is not the final lip.
Days 3–7: Swelling settles. Some patients have firmness in the lip body for an additional week as the gel integrates. Bruising, if present, peaks at day 2–3 and fades by day 7–10.
Two weeks: The product integrates into final position. The two-week look is the result you booked for.
Aftercare: Sleep elevated for the first night. Avoid pressing or massaging the lips. No strenuous exercise or alcohol for twenty-four hours. Cold compress (not direct ice) helps with day-of swelling.
Candidacy
Good candidates have thin native lips wanting visible enhancement, deeper perioral or marionette folds requiring a denser product, or a clear preference for a fuller result than Ultra previously achieved. Patients building lip volume gradually across multiple sessions often work between Ultra and Ultra Plus depending on the session goal.
Not a candidate if your goal is the most subtle, restrained lip — Volbella is the appropriate choice. Not a candidate for tear-trough work; denser products are visible and palpable in that anatomy. Not a candidate if you are pregnant or nursing or have active skin infection at the site.
If Ultra Plus is not the right product for you, Dr. Brown will name the one that is. Some patients are best served by a combination — Ultra Plus for body, Volbella for border definition — placed in a single visit by the same hand.