Juvederm Volift with Lidocaine Thai label

The maker's leaflet describes Juvederm Volift with Lidocaine as an injectable for deep skin depressions caused by conditions such as ageing, which can also be used to shape the face and add volume. It is injected into the deep dermis or the lip mucosa by a licensed healthcare professional.

The leaflet says not to inject the periorbital area (eyelids, under-eye, crow's feet) or between the eyebrows, never into a blood vessel, and not for breast augmentation or reconstruction. The doctor chooses the area, depth and technique for each person.

The leaflet says it must not be used in people with untreated epilepsy, a tendency to hypertrophic scarring, known hypersensitivity to hyaluronic acid or to gram-positive bacterial proteins, known hypersensitivity to lidocaine or amide-type local anaesthetics, porphyria, women who are pregnant or breastfeeding, or children.

It is not injected into skin that is inflamed or infected, such as acne or herpes, and is not used together with laser treatment, deep chemical peels or dermabrasion.

The listed side effects include redness, swelling, bruising, firm lumps or bumps at the injection point, discolouration at the injection point, and a filling result smaller than wanted. Inflammation lasting more than a week, or any other reaction, should be reported to the doctor promptly.

The rare but serious event is injection into a blood vessel, which can cause vision loss or blindness, abnormal blood supply to the brain and tissue death; the US FDA lists these too. Tell the doctor at once about any change in vision, blanching of the skin or unusual pain during or after the injection.

People with autoimmune disease, on immunosuppressive therapy, with a history of severe allergy, or taking medicines that make bleeding easier, such as warfarin, aspirin or NSAIDs, should tell the doctor first. The maker leaves the decision to the doctor case by case.

The leaflet says to store at 2-25 °C, to handle with care because the pack is fragile, that the shelf life is 2 years, and to use before the expiry date printed on the box.

If the gel in a syringe separates or looks cloudy, the maker says not to use that syringe. Do not reuse or re-sterilise, discard used needles and syringes in a suitable container, and keep the product away from quaternary ammonium compounds such as benzalkonium chloride.