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Voluma is unique in a lot of ways, but it's the ideal filler because it's safe, it's natural, it's durable and it's reversible. To me, those are all qualities of the ideal filler. Obviously, we want to have something that's safe. It's made of hyaluronic acid, which is naturally found in the dermal layer of the skin. Natural, because it's not hydrophilic, so you don't get an artificial swelling effect. A lot of fillers, when you inject them into the cheek or different parts of the face, cause this swelling and that doesn't look natural for a while, then it settles away. Durable because it's cross-linked and it's so cohesive it lasts, so it doesn't require maintenance every three or six or nine months like some fillers do. And then reversible is always a comforting feature to have in a filler, because if for whatever reason, it just doesn't settle right, or you get it done somewhere by someone who's not quite as experienced and you want to get rid of it, you can. Whereas with some fillers, like Artefill, silicone in the past, the only way to get rid of those fillers is surgical removal and you don't want to be in that situation.

So it's really an ideal product for those reasons. I think it's special, more than that, because it's not just a filler, it's something that has a lift capacity and it really lifts the cheek. A lot of fillers just fill and plump up tissue and erase a fine line by plumping it up. This really, actually can lift and it's the closest thing we can do with an injectable treatment to a non-surgical face lift.

When this nasolabial fold becomes deep, and also when the tear trough becomes noticeable, there's a dark shadow under the eye, those are things that people would come in very often and say "My eyes are looking hollow" or "My nasolabial fold is looking deep on my smile line. When I smile, I can see that shadow." What we've realized over time and really over the past few years is that those are symptoms of cheek dissent and deflation, and volume loss in the cheek, so we've been really treating symptoms of this disease, if you will, of facial aging, and the root cause of the disease and the origin is in the mid face. So we've been filling in the nasolabial crease and tear trough and having good outcomes, but really leaving the cheek alone and ignoring it. These are processes that are really symptoms on the edge.

Whenever someone now comes and mentions that they're seeing these deep lines there, I really do educate and talk about "Well, let's look at your cheek. We probably do need to put a little bit to anchor it up, because this is there because it's falling." As soon as this is there, that's really a symptom of the fact that the cheek is falling a little bit. So the ideal combination is to lift with Voluma and then just to polish off with something lighter like a Juvaderm ultra or ultra plus.

It can already be used to sculpt places on the face outside of the cheek, such as the nose, the jawline, I would say the temple area is a space where Voluma works really well. Any area that's really a subcutaneous, deep plane, that's not just a superficial fine line but is really shaping and contouring the face, that's where it works well. So it's never going to be for fine lines around the mouth or fine lines around the eyes, but it's going to be more shaping.

I do feel that there will be a day where a product similar to a Voluma or a super Voluma-type of filler will be available to augment breast tissue and that will last two or three years or longer, and that may even replace the need for breast implants in some women.

Why Juvederm Voluma is Considered the "Ideal FIller"

Dr. Daniel Levy is a big believer in Juvederm Voluma, so he talks about its unique benefits as a filler and how other fillers like it can be reversed if the patient isn't 100% happy.