3.5 weeks post op, do I have a Voluma infection?

Swelling and redness may be a delayed inflammatory reaction which can happen with HA type fillers like Voluma.  The chance that it is an infection is actually very low.  Biofilm formation is possible, but the area needs to be evaluated to see what treatments may be needed.  In most of the cases I'm referred to treat these, as I specialize in complications and treatments of, I reverse the fillers with hyaluronidase enzyme and prescribe oral antibiotics for 6 weeks with major improvement.  The trend used to be to inject the area with a steroid solution, but I have found this in many cases not to help and only perpetuate the reaction if it is truly a biofilm.  I suggest going to an expert for treatment of this and for the future, only go to someone who uses a close to sterile technique for filler injections.  Best, Dr. Emer.

Swelling and redness may be signs of infection. An examination may be an excellent way to tell whether you have signs of a filler-related infection. You may need to speak to your injector. Best, Dr. Karamanoukian 

Thank you for your question.  Swelling 3 1/2 weeks out is unexpected from Voluma, and can possibly be due to an infection, especially if it is associated with pain.  I definitely agree with returning to your injecting physician for re-examination.  You will likely need an antibiotic and close follow-up.Although Voluma is a great product, please make sure your surgeon or dermatologist has significant experience with it. As Voluma is a new filler manufactured by Allergan, most injectors' experiences are limited. Infections are more likely to happen with poor, non-sterile technique.  In the future, I would seek out a plastic surgeon in your area who has extensive experience with injecting cheek fillers and typically performs many facial surgeries, as he/she is thus more likely to be familiar with the anatomy in that area, which can be variable even from one side of the face to the other. I would also ask for a plastic surgeon who took the Allergan Expert Hands-on training course specific for Voluma injection.Good luck.