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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 (16)

Bumps after Voluma injection

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!

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


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 57 reviews

Bumpiness after Voluma injections

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 4 reviews

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Bumpy Voluma one day after injection

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.

Kevin L. Smith, MD, FACS
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Unevenness / Lumpi-Bumpiness after Voluma Injections

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
Los Angeles Facial Plastic Surgeon
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Bumpy after voluma

Voluma injections can cause some temporary bumpiness in the cheeks.  If you are only one day out from your treatment it can also be some swelling or bruising.  Light massage and ice will definitely help.  You should check with your physician to make sure there is nothing else going on.  Voluma has been a great product to add to our options for filling the cheek area and smooths over 1-2 weeks in most patients.

Michelle J. Place, MD
Danville Plastic Surgeon
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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.

Glenn M. Davis, MD, FACS
Raleigh-Durham Plastic Surgeon
5.0 out of 5 stars 36 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.

Mike Majmundar, MD
Atlanta Facial Plastic Surgeon
5.0 out of 5 stars 27 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.

Joseph L. Grzeskiewicz, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 17 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

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 23 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.