Thanks for your question and photos. Voluma is probably insufficient to completely correct the irregularity you have at your lid/cheek junction. Voluma is indicated for volume addition to the "apple" of the cheek (deep) and not for superficial fill like the tear trough. This is a very technically difficult area to inject so make sure you are seeing an experienced board certified plastic surgeon, facial plastic surgeon, oculoplastic surgeon or dermatologist. Your photos show me that you have some superficial volume loss (eye hollows) but also some skin aging with laxity. In addition to VERY judicious use of superficial filler (I like to use a "blended" Juvederm Ultra product - we call it "airbrushing") in combination with procedures that improve the quality of the overlying skin such as laser, micro-needling, peels, and good skin care) to achieve the most elegant result.
Voluma should not be used to target under eye hollows. It is specifically designed for adding volume to the cheeks which can help mask the transition between eyelid and cheek. It is very technique dependent and require an injector with a great deal of experience.
Voluma is a great product that can help with facial volume lose in the mid face. It may help inadvertently to camouflage that area by pulling the cheek area and eye area out. I usually recommend doing a combination of products to help augment the under eye and cheeks. Usually, I'll use radiesse or voluma for the cheeks and beloterro or restylane for the under eyes. So, in my opinion it's good thinking to believe that you may still need to fill your cheeks in order to fully correct that area. Hope this was helpful.
Best of Luck!
Voluma is a wonderful product, when administered conservatively in the appropriate area by an experienced injector. Voluma is not designed for under eye hollows. It could likely result in a lumpy looking appearance. The ONLY material I find predictable for tear troughs or under eye hollows is your own fat. Fat grafting can also create problems, like lumpiness, or an overfilled look. But, when performed by a surgeon with expertise, experience, patience and attanetion to detail, the result can be beautiful. It can also be permanent. before having material injected into your tear trough or under eye area, I would strongly suggest viewing a minimum of a dozen patients and before and after photos from thee angles to see what their result is like. View photos after weeks, and months after the procedure. Ideally, a plastic surgeon should be able to share several dozen patient images. But just four or five photos aren't enough. Photos are just a start when looking for a plastic surgeon, but photos can provide evidence of outcomes.
We have been using Voluma since it's release in early December 2013 and have extremely pleased with its effect at volumizing the tissues. It can be used safely if done conservatively up to the bony orbital rim, including the "tear trough" deformity and the outer (lateral) eyelid area. Your pictures appear to show a lumpiness to the eyelids, and if lumps can be felt, they can be treated effectively with injections of hyaluronidase which breaks down any hyauronic acid material (Restylane) injected previously. This is also true of Voluma which is 100% reversible if needed. It also lasts for over 2 years, making it very cost effective. It has quickly become our favorite injectable similar to its approval and use in Canada
Voluma cheek injections are likely to improve the appearance
of dark circles and under eye hollows. Voluma is formulated with hyaluronic
acid, a hydrating substance naturally found in our bodies that helps gives skin
its youthful volume. By restoring lost
volume and providing a natural lift to the cheek area, the appearance of the
under eye region will improve as well. For the most ideal results, it is best
to ask your dermatologist about fillers such Juvederm, Restylane, and Belotero
which are more commonly used to correct the tear trough area.
I do not like to use Voluma under the eye hollows and keep it in the FDA approved areas of the cheek. As this may vary by practitioner, I would suggest discussing with a Board Certified Dermatologist with expertise with Voluma.
Voluma is primarily used for cheek augmentation and can be a nice compliment to restylane or fat transfer surgery to address the lower eyelids.
I would suggest consulting with an Oculoplastic surgeon or eyelid specialist for an evaluation and proper discussion of your options for the best result.
Voluma is excellent for treating undereye hollows and has extremely low risk of Tyndall (creating a blueish discoloration after injection). Seek a cosmetic dermatologist with expertise in using fillers and im sure for you a little will go a long way with Voluma. I use cannula injection in this area so I see almost no bruising and swelling, however, with Voluma I find there is very little swelling to begin with. I wish you the best of luck, Dr. Emer.
Volume is fantastic! Since January we (myself and 4 injectors) have been using Voluma with excellent results. I would not recommend placing it underneath the eyelid; however, the cheek will help in the hollows. This has been my own practice experience as well as studies with using Voluma. Voluma and Juvederm Ultra Plus is far superior to Restylane.