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Voluma Uneven and Bumpy: Will it Improve?

Y'day I had Voluma injected with a Canula into my cheeks to enhance the cheek bones and create a lift. Apart from the fact that the area is extremely sore, and warm to the touch/feel, the result is quite uneven and "bumpy" you can clearly see where the filler ends without smooth transition. I want to know whether this is normal for the filler to be bumpy at first (perhaps it's self levelling, or there might be some scar tissue created because of the cannulae used?) How long b4 it improves? Tnx

Doctor Answers (11)

Voluma Injections Help Lift the Cheeks giving a Smooth and Natural Result


In the vast majority of patients, you should not feel unevenness or bumps a day after your injections of Voluma. You may have mild swelling and some light massage in encouraged. However, if you have market asymmetry, pain or bumps, you need to contact your injector to discuss your issue as this is atypical. In general, Voluma injections are virtually painless (aside from a small prick of the needle entering the skin - and even this is generally numbed with anesthetic cream or ice prior to injection). Additionally, the Juvederm XC is now mixed pre-packaged with lidocaine with help with ease of injection. While some fillers do swell after they are injected, Voluma has low hydrophilic potential, meaning that it does not absorb fluid and does not swell as much as other fillers. So, usually what you see immediately after you are injection is what your result will look like. If you are still having issues, I would suggest following up with your injector and if you are not satisfied, I would seek out a well qualified injector or board certified plastic surgeon.

Good Luck.

Web reference:

New York Plastic Surgeon
5.0 out of 5 stars 52 reviews

Lumps aren’t unusual the first day.

Since your injection was only yesterday, it is possible to see some initial lumpiness for the first day or two, and the tenderness you mentioned is also very normal. If either of these symptoms seems to get worse or continues longer than a few days, definitely call your surgeon for a follow-up. Normally, one of the prime benefits of using JUVÉDERM VOLUMA™ is that it’s a very smooth filler that delivers impressive results. If that’s not your experience, then there may be another concern that should be considered. If the unevenness isn’t resolving on its own, the HA formulation means that the effects can be quickly reversed with a hyaluronidase injection.
Raleigh-Durham Plastic Surgeon
5.0 out of 5 stars 32 reviews

First day after Voluma

The unevenness or bumpiness should resolve over the next several days.  Most likely, the tissues under the skin probably have a bruise which is making the swelling uneven and making the area sore.  It is difficult to tell without a photo but Voluma is expected to be smooth and even when injected.  Because of its soft nature when injected, it is difficult to have a bumpy injection, though results can differ between injections.  A Blunt cannula is similar to a needle and serves to inject the product under the skin.  The use of the cannula should not result in scar tissue.

Web reference:

Atlanta Facial Plastic Surgeon
4.5 out of 5 stars 19 reviews

Uneven results 1 day post-op after Voluma injection can improve

The thing that makes Voluma unique is that it is very firm and produces very strong increase in volume with just a little bit of filler.  This is why the technique of injecting it is very important.  There could be a number of reasons why your result is uneven right now.  First and foremost, there may simply be some swelling of the tissues around where the filler was injected.  This is very often the case, and it should resolve within several days to a week.  If it is not resolved by one week, then it is safe to conclude that the filler has been distributed unsatisfactorily, and it should be addressed with either hyaluronidase or the addition of more filler to even out the results.  I would also suggest some firm, but gentle massage over the uneven areas and ice for the next couple of days as this will help with swelling and hopefully redistribute any unevenly placed filler.  The use of the cannula is a great technique, and one that I employ myself for most injections, including these, but even that does not guarantee that the filler will be placed accurately.  My best advice is to be patient and do as I suggest for the next few days, and if there is no improvement, return to your injector for follow up evaluation.
San Diego Plastic Surgeon
5.0 out of 5 stars 6 reviews

Juvederm Voluma Unevenness and Bumpiness Will Likely Resolve Within A Few Days

Hi M,

The best thing for you to do is contact your injecting physician.  At the time that Voluma is injected, and before a patient leaves our office, we massage the areas of injection to insure that there are no lumps or bumps, and that there is smooth transition between areas of injection and those not injected.  There can be some swelling and possible bruising that can contribute to unevenness for the first few days, but usually patients look great immediately after the injections.  Scar tissue should not be an issue from your cannulae injection.  Hopefully by now your concerns have resolved.  Good luck and be well.

Dr. P
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 23 reviews

Uneven and Bumpy: Will my Juvederm Voluma Improve?

Mild lumpiness is not uncommon for couple of days following injection of any product. There may be some slight bleeding around the product or it may have been injected superficially. I would give it two weeks to see what happens and if not satisfied, see your plastic surgeon for a solution. I have found Voluma to very satisfactory as have my patients.
Savannah Plastic Surgeon
5.0 out of 5 stars 27 reviews

Voluma injection with a cannula


Injecting Voluma should be performed in a deep plane. The use of a cannula further ensures minimal risks to patients of intravascular injection. If you can see the filler edge than perhaps it was not placed deep enough. You should consult your injector as they will / should know how and where they placed the product. Some lumpiness may be expected for up to 2 weeks but anything unusual should be reported to your injector for immediate evaluation.

Boulder Dermatologist
5.0 out of 5 stars 1 review

Will Juvederm Voluma Improve?


Since it has only been 1 day,  I'm fairly certain you will see significant improvement in the next week or so. Uneven swelling, and bruising can be normal but should improve in time.  Avoid massaging while still bruised and swollen, but you should plan to return to your provider for recheck and adjustments when the swelling has resolved. Normally you should not form scar tissue from the cannula technique if done correctly. Deep placement in the tissue typically results in smoother results. Lastly, remember that because Voluma is an HA it is temporary and can always be dissolved if necessary. 

Seattle Facial Plastic Surgeon
5.0 out of 5 stars 126 reviews

Canulas and fillers


It is normal to swell after any filler and you should expect it to last anywhere from 7-10 days. Technically speaking using canulas, especially for much deeper fillers, shouldn't produce as much surface bruising or swelling, but it can produce swelling and bruising under the skin, which is why you feel the lumps and bumps. I'd wait at least the 7-10 days to see how the filler looks after any subsequent swelling has diminished. Especially since it's your first treatment with a canula! Then make an appointment with your injector for a follow-up if you have any concerns.

Las Vegas Dermatologist
4.5 out of 5 stars 6 reviews

Juvaderm lumps and bumps


no one can answer your question without knowing how long ago you were injected, how much was injected, and how it was injected.  Lumps and bumps is fairly normal for the first few days becuase of swelling, but it can also mean that it was injected poorly and the lumps and bumps will be there for the entire duration of the material. You should contact your injector and see them.

New York Plastic Surgeon
5.0 out of 5 stars 126 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.

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