The War of the Wrinkle Removers

Walter Armstrong

Coke or Pepsi? Shiite or Sunni? Ennis or Jack? And now—Restylane or Juvederm?

A new cosmetic injection called Juvederm is set to hit the market in January, and the company that makes it has devised a pre-launch marketing ploy that even evil Eve Harrington would envy. The facial filler is being given away gratis to people who have already used its rival, Restylane.

But the company isn't giving it just to any wrinkled-up nasty old white-trash Restylane consumer but to a select group of very special people who are contacted by a secret list of top-drawer cosmetic surgeons through whom Allergan Medical, Juvederm's maker, is distributing its revolutionary new product. Ten thousand very special people, to be exact. Taste-makers, trend-setters, 90210ers—and by the way, have you gotten your invitation? No? Too bad, loser.

The New York Times has dubbed the free-trial program—which Allergan has justified as a genuine "study" because patients are "surveyed" by their doctors, who provide "feedback" to the company—"the $12-billion-a-year cosmetic medical industry's budding version of the cola wars."

The paper of record quotes Dr. Lawrence Reed, a plastic surgeon in Manhattan, who compared these Juvederm freebies to the Pepsi Challenge. "This is a foolish promotion that is going to start a war of injectables between Restylane and Juvederm, which, like Coke and Pepsi, are essentially made out of the same ingredients, using slightly different formulas," Reed sniffed.

And you can imagine how the marketing department over at Medicis Pharmaceutical Corp., the company that sells Restylane, is feeling right about now. They're telling the press that the giveaway is biased, unethical, risky to patients—"a commercial platform under the guise of science"—and kicking themselves for not having thought of it first.

But Dr. Reed is right. Restylane and Juvederm are the new Coke and Pepsi of wrinkle removers: two different brand names for the same product that costs only pennies to make but is sold by means of a stupendously expensive and psychologically sophisticated advertising and promotional process intended to make you think that your life would not only be enhanced by the essentially useless product but that you actually can detect a difference between the two versions of the same product, and prefer one over the other, and even embrace one while rejecting the other, and find yourself saying, "I'm a Restylane guy" or "I'll take Juvederm or nothing!"

As I was saying, both facial fillers are a transparent gel whose "secret" ingredient is hyaluronic acid, a synthetic version of what your body naturally produces to give your skin its firm and flawless structure. And what is hyaluronic acid made of? Sugar molecules—which, come to think of it, are pretty much the chemical composition of Coke and Pepsi, minus the caffeine.

Let's hear from an expert. "Hyaluronic acid is like the Jell-O molds you made as a kid that magically suspended pieces of fruit," Dr. Richard Glogau, a clinical professor of dermatology at the University of California, San Francisco, joked to the Times. "You are basically injecting more Jell-O soup into your skin."

The Jell-O soup costs between $300 and $800 per syringe, not including the price of the "surgery." The number of syringes your doctor uses depends, of course, on the procedure—and the seriousness of the "problem." Fluffing up those laugh lines around your mouth might take only a single shot each. But constructing a new set of lips like Angelina Jolie's—or for that matter Brad Pitt's—is going to set you back a couple months' rent.

Still, the procedure is fast, the filler is harmless, the needle hurts only a little, and you can come back for seconds, thirds, and more. In fact, you have to, because the cosmetic effects start disappearing after six months as the hyaluronic acid is absorbed by your body.

To be fair, it should be pointed out that Allergan claims that the hyaluronic acid in Juvederm is more refined and less viscous than the Restylane version. This supposedly makes it less likely to thicken, clump or otherwise flop over time—and make you look like you had grains of sand implanted over your wrinkles in a foolish attempt to hide them. It may mean the company simply adds more water to the sugar molecules. For this technological advance, your doctor will pay $242 per a syringe of Juvederm that is 20 percent smaller than a $240 syringe of Restylane.

So make the test yourself. Which treatment do you prefer in order correct dermatological damage associated with aging and other processes in your lower face?

Lower face, yes. These two fillers are recommended only for the lower part of your face. There are many other products with other names to complete all the other parts of your total facial rejuvenation. Go crazy!