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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 (21)

Soft tissue swelling possibly.

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Restoring mid face volume can restore and rejuvenate the face. This product is technique and placement dependent. While soft tissue swelling can occur it should resolve within 2 weeks. When expertly injected Voluma is fanned in with a blunt tip micro cannula. It is important to go to a plastic surgeon trained injector who their sole responsibility is injections. Here at my practice we are among the top 1% provider in the country.

Raleigh-Durham Plastic Surgeon
4.5 out of 5 stars 46 reviews

Bumps after Voluma injection

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If you have concerns of bumpiness and irregularity, as well as soreness, I would recommend that you contact your physician regarding your concerns. Occasionally, one can see some minor bumps a day after the injection if there is some post-injection swelling. However, it is more prudent to seek out the advice of your particular injector to ensure that there is nothing more concerning going on. The use of a cannula should not be cause for concern about scar formation one day after treatment.  Hope this helps!

Sarmela Sunder, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 4 reviews

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

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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.

David Shafer, MD
New York Plastic Surgeon
5.0 out of 5 stars 60 reviews

Bumpy After Voluma

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If you look "bumpy "following a Voluma injection it is possible that the Voluma was injected too superficially.It is possible to see swelling and a "lump" if a hematoma occured at the time of the injection and/or  tissue swelling.Swelling will usually resolve within a few days but bumps may indicate that the Voluma may have to be dissolved with hyaluronidase.

Joel E. Kopelman, MD, FACS
Ridgewood Oculoplastic Surgeon
5.0 out of 5 stars 8 reviews

Swelling, bruising, and tenderness can occur after treatment

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Hi Me9 – thank you for your question. I’m sorry to hear that you are experiencing some bumpiness after treatment. While I can’t diagnose your particular case without an in-person meeting, I can relay that swelling, bruising, and tenderness can occur after treatment. These after treatment side-effects are temporary and usually dissipate after 4-5 days. I also use the cannula in my practice to minimize some of these side-effects and for optimal results.

While swelling, bruising, and tenderness can occur, there are a few things you can do before your next treatment to reduce and camouflage after-treatment bruising like avoiding any blood thinners before treatment and using topical Arnica gel and oral tablets to help with recovery.

David Mabrie, MD
Bay Area Facial Plastic Surgeon
4.5 out of 5 stars 60 reviews

Bumps after Voluma

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The symptoms you are describing are unusual after Voluma injection.  The use of a cannula, in and of itself, is not a cause for concern, but typically, you should not experience much soreness, warmth, or a bumpy feel without a smooth transition of filler placement.  I would return to your injecting physician for re-evaluation.  You may need an antibiotic in case of infection, and close follow-up for further reassessment down the road.

If you are unhappy with your injecting physician's care, please make sure your find another surgeon or dermatologist in the future who has significant experience with Voluma. As Voluma is a new filler manufactured by Allergan, most injectors' experiences are limited. 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.

Voluma Injections Give the Cheeks a Lift with Smooth and Beautiful results

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Voluma is a great injection and you should look beautiful immediately after the injections. If your skin is warm or uneven you should return immediately to your treating physician for examination.  The contours should look even and natural and not as you are describing.  Please consult a board certified dermatologist with a great deal of experience with Voluma for the best cosmetic results.

Bumpiness after Voluma injections

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Voluma in general tends to give a beautiful and smooth result when injected into the proper planes. That being said, depending on the technique your physician used to inject, there can occasionally be some bumpiness afterwards that can be the result of some swelling or deep bruising. Being a bit tender around these bumps points more towards that deep bruising or swelling as the cause of them.

With my patients, I like to use the mantra that if it bothers you, it bothers me, so do not hesitate to come see me. I'm sure your physician is in the same boat, so do not hesitate to go see them.

Normal aftercare for filler injections can include massage and icing, again this depends on the technique your physician used to inject. Voluma in particular is not terribly hydrophilic, which means if there is edema surrounding it, it should go away and will not likely be volume that is retained by the filler.

To guarantee you're receiving the highest level of care, seek out a dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these "core four" cosmetic specialties.

Cameron Chesnut, MD, FAAD
Spokane Dermatologic Surgeon
5.0 out of 5 stars 5 reviews

Bumpy Voluma one day after injection

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Juvederm Voluma XC is a great product and is the most "sculptural" of the hyaluronic acid (HA) fillers. It is "sculptural" because it is more elastic and stiffer than the other HA products and when injected deep, at the level of the cheek bone, it provides greater lift and elevation. Because it is thicker, or stiffer, it is possible to have some palpable lumpiness with the product. Initially this can be massaged away (to flatten the lumps). The injection of Voluma is very technical and whether injected by cannula technique (my preferred) or sharp needle, it is necessary to be mindful of the thickness of the product and be sure that the injection tapers smoothly. That being said, if there is lumpiness and swelling only on one side then this may represent a small deep bruise that will just take some time to go away. If the lumpiness is determined to be too much Voluma then hyaluronidase can be used to erase the product. Please contact your injector and express your concerns. There is no reason you should not have a "perfect" result. Be patient and enjoy your new look.

Unevenness / Lumpi-Bumpiness after Voluma Injections

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Unevenness is not uncommon immediately after filler injections whether it is done with the traditional technique or with a microcannula.  This should improve over the next several days but definitely consult with your injecting doctor to assure that you are not having any problems / complications.  Some doctors advocate massages to help even out the area but definitely check with your doctor to see what she / he recommends.  

Kian Karimi, MD, FACS
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 36 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.