Voluma is Not for Tear Troughs
Voluma is a high molecular weight hyaluronic acid molecule that adsorbs water which causes the hyaluronic acid to swell.This is not a problem if it is injected over the cheek bones and cheeks. However Voluma has the potential to cause too much swelling if injected into the lower eyelids and tear trough and if it is inadvertently injected into a blood vessel then you may develop an embolus of Voluma that could potentially travel to the eye or other areas. So my advice is to proceed with caution in these areas.
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Juvederm Voluma for Tear Trough Treatment
Juvederm Voluma was designed to replace volume in larger areas of the face. It’s thick and smooth formula allows us to inject it deep into hollow areas like the cheeks. Voluma along with Juvederm, Restylane, Radiesse and Boletero can also be used in the tear troughs. Your doctor is best able to discuss the best filler for your specific indication.
Reduction of lower lid skin laxity or "bags"
Injecting Voluma in the high lateral cheek area often benefits the lower lids. If a deficit continues in the lower lids, I recommend Restylane to be injected in this area.
VOLUMA IN THE TEAR TROUGH
Juvederm Voluma is indicated primarily for volumizing the midface and cheek area. Due to its thicker consistency, it is not advisable to treat the thin area under the eyelids with this product. It places the patient at high risk for unsatisfactory aesthetic outcomes and potentially serious medical problems. For tear troughs, I typically treat the area with a thinner dermal filler such as Belotero or autologous fat transfer.
Filling the tear trough
Voluma is meant for deep injection and therefore isn't the best product to place in areas where the skin is thin. The product we often use for tear trough injection is Belotero because it is thinner in consistency reducing the chances of feeling/seeing the product.
Do not recommend Voluma under the eyes
While Juvederm Voluma is an ideal filler in areas such as the cheeks and midface, I would not recommend using it under the eyes (in the tear trough). Anatomically, the tear trough is a very complex area and can be unforgiving. Restylane and Belotero are much better choices in the tear trough, in my opinion. Juvederm Voluma is a firmer filler that could lead to an unnatural result if placed in the delicate tissues under the eyes. Better to avoid Voluma in this area.
Filler treatment for tear troughs
I prefer Restylane for tear trough treatments for my Orange County patients as it causes less swelling. Juvederm Voluma is less hydrophilic (water loving) and therefore less likely to cause swelling but it works better if used in the cheek below the eye. Juvederm ultra and ultra plus are more likely to cause persistant swelling under the eyes.
Using Juvederm Voluma under the eyes in tear troughs
I am not a huge fan of using Voluma in this location since it is a thicker filler used for volume restoration and lift, so best in the cheek bones. I prefer restylane or restylane fine lines in the tear troughs after having treated hundreds of patients with various fillers in this location. Restylane or even Juvederm typically lasts 1-2 years when injected in the tear trough.