I got Voluma injections in my cheek area a couple of weeks ago. I am terribly unhappy with the results, and here is why: (photo)

Question

My face looks boney-not full. Dr injected right on top of my cheekbone, which was already defined.I needed fullness in the area below. As a result , my eyes look hollow. The area/bone circling my lower eye-lids looks like a giant dark circle. It makes me look not only older but exhausted. Is that the doctor's fault, or is Voluma not a right choice for me? Do I go back to the same doctor for reversal? I had radiesse in the same area about 6 years ago (different doctor) and loved it.

Martin Jugenburg, MD · Answer

Thank you for your question, It is important to feel comfortable and share the same goals as your injector. Schedule a follow up appointment and discuss your concerns. At the time of the follow up you can also talk about hyaluronidase injections to have the product removed. Best,

Jeffrey B. Wise, MD, FACS · Answer

Facial fillers, particularly ones that enhance the midface, require a keen aesthetic eye and an abundance of experience on the part of the doctor.  The good news is that Voluma is 100 percent reversible.  After the product is reversed, I would start fresh with a new doctor.  Make sure the doctor is experienced and shares your vision.Best of luck!

Mark Glasgold, MD, FACS · Answer

The issue is not the material injected but where it was injected.  Adding volume to your cheeks made the shadowing under your eyes and below your cheekbone worse.  Facial rejuvenation with injectables is about contouring the facial features and improving shadows.  You should probably try to find someone who has a better vision of what they are trying to achieve with injectables.  Our experience with voluma has been excellent so far.  The hyaluronic acid products have a tremendous safety profile and treatments can be reversed or infections treated relatively easily.

Stephen Prendiville, MD · Answer

First of all, I am sorry that you haven't had a great experience.  Unfortunately, the photo doesn't provide the information I would like to make a comment about your result; I would recommend that you discuss it with your Doctor. However, this post should come as a general warning and a promotion for the product.  The wonderful thing about Voluma is that it produces instant volumizing results that can last for up to 2 years.  The downside of the product and any longer lasting injectable is that it is incredibly injector dependent.  There are lots of non-core Doctors, PA's, NP's, and RN's injecting things around the country because they perceive it as a more comfortable way to make a living.  The fact is that mastering facial injectables takes a long time and a lot of experience.  As far as scope of practice, the laws aren't on the patient's side, so due diligence is required.  Is it reasonable for an ER Doctor, Radiologist,  or ObGyn to inject facial fillers based on training and experience? I don't think so.  It is up to the patient/consumer to do their own homework and to avoid shopping purely by price.

Steven F. Weiner, MD · Answer

Too many people are concerned regarding the type of filler used. In most instances, that choice should be left up to the physician. It is obvious that this was a bad placement of the Voluma. I would probably go to another physician for correction and "refilling".

Anita Sethna, MD · Answer

I am sorry you are not pleased with your result! It doesn't happen often, but it's disheartening when a patient is unsatisfied with their injections. I'm sure your surgeon would like an opportunity to improve on your areas of concern, so I would give him or her the chance to do so.Firstly, Voluma is indicated for the cheek area and is intended to go right on top of the cheekbone as your surgeon seems to have performed it. If you were in fact more interested in filling the area under your cheekbone, perhaps it wasn't as clear to him or her that this was the region you were concerned with.Secondly, you mention it has been a few weeks since your injection--by this time, the majority of swelling should have settled. It is possible that as you have continued to age, filler in the same region you had it years ago may not work the same way; your face, specifically, the soft tissue and bone around the eye area changes dramatically even in a few short years.My suggestion would be to call the office and make an appointment to not only discuss your results but possibly discuss addressing your concerns with either dissolving this filler or putting other fillers in different areas (such as under the eye, where Voluma would not go). This way you assure yourself that an appropriate amount of time will be blocked off and you don't feel rushed. Hopefully, you and your surgeon will be able to come to an agreement on what needs to be improved upon, what may just need time, and what should be addressed differently!Best of luck to you!

Kevin L. Smith, MD, FACS (retired) · Answer

Thank you so much for your question. I'm sorry that you are not happy with the result...yet. Your photo does not give me enough information to fully address your specific issues but I can answer in generalities. Please return to your injector and clearly express your concerns. The beauty of Voluma is that there is a very broad safety margin. If the result is not what you desired then the Voluma can be "erased" with the injection of an enzyme - hyualuronidase. If your disappointment is due to too much Voluma or injection in the wrong site then it can be safely removed. If the result is due to insufficient volumization more filler can be added to smooth the lid/cheek transition. I think that Voluma is a wonderful filler and is perhaps the most "sculptural" filler we have - when used properly.The injection of fillers is an art and it is very important that you choose an experienced board certified plastic surgeon (or an experienced nurse injector under his or her direct supervision) to perform your injections. The injections under the eye are VERY technical and it is important that your injector be very experienced. I do not think that the problem is the Voluma per se but more of where it was placed. Often, a combination of the hyaluronic acid fillers are used to achieve lift and sculpting (Voluma) with smoothing and tapering (Juvederm Ultra, etc.). Under the right circumstances you can expect to have a very natural result with fillers. You want people to notice - not to know!

I got Voluma injections in my cheek area a couple of weeks ago. I am terribly unhappy with the results, and here is why: (photo)

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