Thank you for your question.
Without before and after photos it is difficult to determine the difference. Schedule a consultation to view these with your injector. Also, wait 2 weeks for the product to settle before you determine your results.
Voluma is a highly cross linked hyaluronic acid based gel filler that is approved for deeper midface injections. Volumetric fillers fill and don't lift, despite the Voluma "lift" slogan. Voluma is great for mild to moderate volume loss in the midface or cheek region, but will have no effect on the lower face. Voluma injections do not take the place of a cheek lift or High SMAS facelift which will lift the cheek and reshape and rejuvenate that area of the face. Unfortunately, moderate to severe mid-facial volume loss and aging requires surgical correction and volume replacement which many injectors do not have experience with. There needs to be more tools in the toll belt for midface rejuvenation than just a volumetric filler.
Fillers can only accomplish so much... While a subtle lift can be expected in the mid-face by injecting Voluma in the cheek area, you won't get much lift in the lower face. It is true that if enough Voluma is placed in the cheek area, it can partially efface the nasolabial folds by means of a subtle lift, but it certainly won't produce surgical results in a patient that is a surgical candidate. I'm not a fan of placing filler along the jaw line in women to camouflage the jowls because I find it creates a masculine appearing squared look. Having said that, many doctors place Voluma or other fillers in this area to "rejuvenate" the lower face non-surgically. It's important to seek the consultation of a "core" injector (facial
plastic surgeon, plastic surgeon, dermatologist, or occuloplastic
surgeon) who can evaluate your face and offer an honest assessment of the best way to spend your money to accomplish your desired result -- this may involve fillers, surgery, or a combination of both. I wish you well!
Although Voluma is thought to have the most "lift" per volume, you really do need a large quantity to get this type of result. If you needed more volume, it may have been better to use another filler such as Radiesse in combination with Voluma or Sculptra. Or it may be that the injection placement wasn't appropriate for facial shape/contour. I suggest going back to your physician and requesting another assessment. You may need more filler, a different filler, or better placement. I would consider a second opinion with someone who does fillers as a speciality. Best, Dr. Emer.
Although in the clinical trials many ccs of Voluma were injected, we are finding that most patients are satisfied with 1 to 3 syringes. Unless you had only very mild volume deficits, one syringe would not have been sufficient.
I have found that in the days after injection, water binds to the hyaluronic acid that has been injected. This gives a more rounded and natural appearance to the areas injected, but it sounds as though you will be more satisfied if you add to what has been done.
Depending on the scope of improvement that you need, you will generally need 1 to 3 syringes of Voluma to provide you the result that you desire. The voluma treatment is an advanced procedure, and you may not have the desired results (or even experience significant complications) if you have the treatment by an inexperienced injector.
You bring up a good subject. How much can fillers do? I love Voluma. But we need to address expectations.
We are talking about sagging and aging of the lower face.
Not all cosmetic docs have the same thoughts - as cosmetic medicine is not black and white. With lower face aging, I think everyone should consider a face lift at some point. (Understand the definition of a face lift is lower face and neck.) I suggest a face lift between the age of 55 and 65. Some younger, some older. I know how to do a face lift, but I do not do them - so when I give that advice, it is not self-serving. SO: FILLERS - they are great. Voluma is great. It works really well when placed in the upper cheek area, or along the jaw-line to give volume and lift.
Fillers do not get "better" over time. The results are visible and stable after about 3 weeks. Before that, there will be swelling, possible bruising, and redness that will subside. To get a nice result with Voluma, you have to 1. pick the right patient, 2. use enough to get a result - which is at least 2 syringes, and 3. pick the right patient. Make sure your cosmetic doctor is giving you a full plan for rejuvenation now, and into the future. Have them write it down for you. There are "core" specialists in cosmetic surgery. They should be cross-referring to get you, the patient, the best results possible. Make sure to visit your doctor and address your questions with him or her.
For cheek augmentation, unless you need very little correction, you would need at least 2 syringes of Voluma. A lot of the before and after photos you may have seen for Voluma can be deceptive because some of those patients have had 5-10 syringes of Voluma injected. It can definitely be disappointing when you don't get the results you want, but don't give up! You simply may need one more syringe injected. If you are concerned about the nasolabial folds you may also need some Juvederm Ultra injected to smooth those out as well.
I would recommend that you wait about 2 weeks for all the swelling and bruising (if you have any) to dissipate and then see what your injector can do for you.
Hi Gabriela. Sorry to hear that you are disappointed with your Voluma results. The most likely reason for this is that you did not get enough product. Unless you have a good foundation to begin with, most people require at least 1 syringe to each cheek if not more to achieve their desired results. The Voluma will continue to pull in moisture and enhance your results over the next couple of weeks, but you should be able to notice something immediately after your injection. The good thing is that you can always add more. You should follow up with your injector and consider adding more product. Best of luck.
The most likely reason that you don't see enough change is that you got only one syringe of Voluma and splitting it between two cheeks simply didn't provide enough volume to provide enough change for you. One syringe of Voluma for some people is a lot and works well, and for others, they need a few syringes for a good difference. In the trial itself, some people had up to 10 syringes done over 2 years.....
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