Voluma didn't make much of a difference. Will there be any change over time?

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. Best,

Thank you for your question. You are early in your post procedure course. Usually the patient sees the start of the neuromodulators, (Botox Dysport, Xeomin), working at day 4.  The fillers usually see some result early, but some modulation continues.  In our office we have patients come back at 2 weeks for their check on their neuromodulator or filler.  At that point, most of the swelling is usually down, and we have an idea of the result.  This may be delayed if the patient has a bruise.  Often, asymmetry can be improved.  Please make sure your well trained, experienced injector knows your current status.Jeffrey J. Roth, M.D., F.A.C.S.Board Certified Plastic SurgeonLas Vegas Plastic Surgery

Whenever a patient is injected with filler and did not notice enough change it is important to find out reasons for this:- Not enough filler (patient may need additional filler).  In some patients larger amounts of filler may be necessary- High metabolic rate (some patients "absorb" filler faster)- Skill of injector (injecting filler is an art and some injectors may not be as technical and visual as others)- Patient understanding (sometimes patients may forget how they looked and not appreciate the difference)It is unlikely that the filler will expand and fill out more and create more volume.  

It is more than likely that the result you are
seeing is the end result unless you are experiencing swelling. Unlike many of
the other fillers, Voluma does not have a tendency to attract water. It is a wonderful
product and yields beautiful natural results when injected properly with the
right quantity. You may need additional product depending on the amount of
volume loss you are experiencing. It takes 5mls (syringes) to equal 1 teaspoon
and it is not uncommon for people to require multiple syringes to achieve the
desired result. I recommend returning to your provider or an expert injector
for reevaluation.

I am sorry to hear that you've not noticed any result.  I think there are at least a couple of possible explanations.1) You have a subtle result that you are not able to appreciate.  Some of us notice small details and others do not.  Many patients are very happy with these "subtle" results, since they do not want to look "done," but they do want to look refreshed. 2) There is actually no change - in this case, the filler may have been incorrectly placed, or you may need more. Faces that have more heaviness require more filler to make a difference.  Sometimes, either due to a conservative injector style, or patient's preference, we start with a baby step, knowing that we can build upon it.It is one of our challenging responsibilities to try to convey the result that the patient can expect whether we add one, two, or six syringes.  Good photography is also usually very helpful.

Three days is a little early to assess optimal results from Voluma. If you are still dissatisfied after two weeks you should return to your injector to review your results as well as your before and after photos. It is possible you may require additional syringes of filler to achieve the desired outcome. It is important to have realistic expectations as fillers are not a substitute for surgery. In the meantime it is advised to avoid extreme heat and cold as well as direct compression to the treated area.Best regards,

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. 

There are many variables in results with volumizers such as Voluma.  In my experience, there is no question that Voluma is very efficacious.  When describing facial volume to my patients, I make the analogy of the thirsty person in the desert. If you give this individual several drops of water, he/she will still be thirsty.  If you provide adequate hydration, the thirst will be quenched. Voluma is FDA approved for injection into the cheeks for purposes of adding upper facial volume.  If a small amount is used in a patient that requires several syringes, the result is not likely to be desirable.  The second critical factor is the Doctor who is administering the injection.  If you aren't seeing a Board Certified Facial Plastic surgeon, Plastic Surgeon, Dermatologist, or Occuloplastic Surgeon for Voluma, you probably aren't in the right place.  Lastly, it is better to be under injected and return for more Voluma than to be over injected. 

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.