The Clinician's Definitive Guide to Juvéderm Ultra Plus XC

Doris Dickson Dermal Fillers July 2, 2025

In modern aesthetic practice, some tools become indispensable for their reliability, versatility, and consistent results. Juvéderm Ultra Plus XC stands out as one such essential product. This robust volumizing filler holds a critical place in both the Juvéderm family and the toolkit of skilled injectors worldwide.

For clinicians, deep product knowledge separates good outcomes from exceptional ones. This comprehensive guide provides medical professionals with essential information about rheology, clinical applications, patient selection, and practical considerations for integrating Juvéderm Ultra Plus XC into practice.

What is Juvéderm Ultra Plus XC? A Foundational Overview

Juvéderm Ultra Plus XC is a sterile, biodegradable gel implant composed of cross-linked hyaluronic acid (HA) from non-animal sources. Manufactured by Allergan Aesthetics using proprietary Hylacross™ technology, it offers unique benefits:

The “Plus” Advantage: Compared to Juvéderm Ultra, this formulation contains a higher concentration of cross-linked HA, creating a firmer gel ideal for deeper wrinkles and significant volume correction.
Enhanced Comfort: The “XC” designation indicates inclusion of 0.3% lidocaine, improving patient comfort during and immediately after injection.

Rheology & Product Properties: The Science Behind the Syringe

Understanding filler rheology helps predict tissue behavior. Hylacross™ technology gives Ultra Plus XC distinctive characteristics:

High Elastic Modulus (G’): This measurement of stiffness enables excellent lift capacity, making it ideal for supporting heavy tissue and projecting structure in deep folds.
Exceptional Viscosity & Cohesivity: The formula maintains its shape after injection, resisting spreading while providing predictable, stable results for areas requiring defined structure.

Primary Clinical Indications: Where Ultra Plus XC Excels

FDA-approved for mid-to-deep dermal injection to correct moderate to severe facial wrinkles and folds, Ultra Plus XC performs exceptionally well for:

Deep Nasolabial Folds: Its superior lift capacity provides excellent correction
Marionette Lines: Effectively supports oral commissures and softens deep mouth lines
Significant Lip Augmentation: Delivers more noticeable volume than Juvéderm Ultra
Mid-face Volumization: Corrects age-related volume loss in appropriate candidates

The Ideal Patient Profile

Proper patient selection ensures optimal outcomes. Ideal candidates typically present with:

Significant volume loss and well-defined facial folds
Desire for noticeable yet natural-looking volumization
Adequate skin thickness to accommodate the robust filler
Realistic expectations focused on softening rather than complete line eradication

Clinical Considerations & Injection Techniques

Proper technique ensures safety and optimal results:

Tool Selection: Both needles (27G) and blunt-tip cannulas (25G) work well. Needles offer precision, while cannulas may reduce bruising and vascular risks.
Injection Depth: Always use mid-to-deep dermis or subcutaneous plane to prevent lumpiness or Tyndall effect.
Technique: Linear threading (retrograde or antegrade) works best. Fanning or cross-hatching builds support in depressed areas.
Post-Treatment Care: Advise patients to avoid strenuous activity, excessive heat, and alcohol for 24 hours. Cold compresses help minimize swelling.

Juvéderm Ultra Plus XC vs. The Alternatives: A Quick Comparison

Feature	Juvéderm Ultra Plus XC	Juvéderm Ultra XC	Juvéderm Voluma XC
Primary Use	Deep folds, significant volume	Moderate lines, subtle lips	Deep cheek/chin contouring
G’ (Stiffness)	High	Moderate	Very High
Technology	Hylacross™	Hylacross™	Vycross®
Feel	Firm & Volumizing	Soft & Pliable	Structural & Firm

Safety & Sourcing: Protecting Your Patients and Your Practice

While Juvéderm Ultra Plus XC has an excellent safety profile, proper sourcing remains critical. The aesthetic market contains counterfeit products that can cause serious harm. Always buy Juvéderm Ultra Plus from authorized distributors to ensure product authenticity, sterility, and proper storage. This protects both patients and your professional reputation.

Conclusion

Juvéderm Ultra Plus XC serves as a foundational filler for addressing deep wrinkles and significant volume loss. By understanding its properties, respecting anatomy, and committing to authentic sourcing, clinicians can consistently deliver transformative, natural-looking results.

Explore Juvéderm Ultra Plus XC

1. What is the key clinical difference between Juvéderm Ultra Plus XC and Juvéderm Ultra XC?

Juvéderm Ultra Plus XC is a thicker, firmer gel with a higher G’ (stiffness) than Ultra XC. This makes Ultra Plus XC ideal for correcting deep facial folds and providing significant volume, while Ultra XC is better suited for moderate lines and more subtle lip enhancement.

2. What is the ideal injection depth for Ultra Plus XC to avoid lumpiness?

To prevent the product from being visible or palpable, it should be injected into the mid-to-deep dermis or the subcutaneous plane. Superficial injection should be avoided due to the robust nature of the gel.

3. Is Ultra Plus XC considered a hydrophilic filler and how should I manage patient expectations about swelling?

Yes, like all hyaluronic acid fillers, it is hydrophilic, meaning it attracts water. Given its robust nature, patients may experience moderate swelling for 2-3 days post-injection. It’s crucial to counsel patients that their initial result will be exaggerated by swelling and the final result will be apparent after it subsides.

4. Can Ultra Plus XC be used for chin and jawline contouring?

While Juvéderm Voluma XC and Volux™ XC are specifically indicated for these areas, some experienced practitioners use Ultra Plus XC off-label for mild to moderate chin or jawline enhancement due to its good lift capacity. However, for significant structural contouring, a higher G’ filler is often preferred.

5. Why is the G-prime (G’) of Ultra Plus XC important for treating nasolabial folds?

A high G-prime signifies that the filler is stiff and can resist deformation. This is critical for nasolabial folds because it allows the filler to provide a structural “lift” to the overlying tissue, rather than just filling the wrinkle, which leads to a more effective and natural-looking correction of deep folds.

6. Does the “XC” mean I do not need to use a topical anesthetic?

The “XC” indicates the presence of 0.3% lidocaine within the syringe, which greatly enhances comfort during injection. However, most practitioners still use a topical numbing cream prior to the procedure to minimize the initial discomfort of the needle poke for optimal patient experience.

7. When treating deep folds, is it better to use a needle or a cannula with Ultra Plus XC?

This is up to practitioner preference and experience. A needle allows for very precise, small aliquot placement. A cannula may be safer in terms of reducing bruising and the risk of intravascular injection, and it’s excellent for laying down smooth, linear threads of product along the fold.

8. How long should a patient wait before a follow-up or “touch-up” appointment?

It is best to wait at least two weeks before considering a touch-up. This allows all swelling and bruising to resolve completely, providing a clear picture of the final result and preventing overcorrection.

9. Is Ultra Plus XC easily reversible with hyaluronidase?

Yes. As it is a hyaluronic acid filler, it can be dissolved with hyaluronidase. Because it is a more highly cross-linked product, it may require a higher concentration or multiple sessions of hyaluronidase to fully dissolve compared to a thinner filler like Juvéderm Ultra XC.

10. Why is it critical for my clinic to buy Juvéderm Ultra Plus from a verified source?

Sourcing from a verified supplier is the only way to guarantee you receive an authentic, sterile, and properly stored product. Counterfeit fillers can have unknown ingredients, cause severe infections or granulomas, and lack efficacy. Using genuine product protects your patients, your license, and your practice’s reputation.

Doris Dickson

About the Author: Doris Dickson is a specialist writer for Health Supplies Plus, focusing on the aesthetic medicine industry. She diligently researches cosmetic treatments and products to provide clear, concise information relevant to licensed medical professionals. Her work supports Health Supplies Plus’s commitment to being a reliable informational resource and trusted supplier for the aesthetic community.

Disclaimer: The content provided in this article is intended for informational purposes only and is directed towards licensed medical professionals. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment, nor does it constitute an endorsement of any specific product or technique. Practitioners must rely on their own professional judgment, clinical experience, and knowledge of patient needs, and should always consult the full product prescribing information and relevant clinical guidelines before use. Health Supplies Plus does not provide medical advice.