I've had Juvederm (Voluma) and the softer type put in my face. Can I mix other types or stick with one brand? (Photo)

Thank you for sharing your excellent question and photographs.  It is possible to mix different brands and types of dermal fillers depending on your goal result, but more important than the filler type is the injector performing the treatment.  Be sure to see an experienced board certified plastic surgeon.  Hope this helps.

Thank you for your question. You submitted two photos, and state several months ago you underwent filler correction with Juvederm in the cheeks, the lips, and in the smile lines. You’re happy with the cheeks and lips, but not so happy with the smile lines. Your doctor stated they don’t really like doing the smile lines. You’re concerned about doing under eye hollows, and became aware that salons near you are offering different brands of fillers. Your question is about whether to change brands, or just stick to one brand.
I can share with you my personal philosophy about fillers and placement, as well as the ongoing perception about brand identities relevant to correction of different issues of the face. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years. I have been a part of the evolution of fillers since the very early days where there was only the collagen fillers Zyderm and Zyplast. Since then, I’ve become very well-known for the use of fillers, particularly in the Juvederm and Restylane families. I can give you an overall understanding of how I approach these areas, and my suggestions for you to move forward.
It’s very important for everyone interested in having fillers done to make some specific distinctions. Fillers, like pharmaceuticals, are produced and promoted by multibillion dollar companies. It’s in their interest to create consumer demand for their products, but the product is not worth anything unless it is placed properly by a skilled practitioner. In the United States and other areas of the world, the menu of fillers varies. There are many skilled practitioners able to get consistent results with a limited variety, or a large number of brands, so how is that possible?
As far as brands are concerned, there is a spectrum of behavior and particular characteristics of the fillers of the Juvederm or Restylane family, which are both hyaluronic acid fillers. There are differentiations based on their relative thickness, elasticity, and longevity. Based on your doctor’s comfort level and familiarity, doctors choose what they prefer.
From your experience with your doctor about the smile lines, I think most doctors would confess the nasolabial fold is not so easy to treat, which has to do with the anatomic nature of that area. Rarely can you get 100% correction because you’re treating a line as opposed to structure.
Speaking of structure, in our practice we do a procedure called structural volumizing. In people who have issues with the nasolabial folds, very often when I restore volume by placing the filler at the bone level to improve the cheeks to more directly integrate it with the bone structure, then the nasolabial fold doesn’t look as prominent or as deep - that is the art of sculpting and creating this balance.
Separating that from the different fillers, if you are really interested in getting consistency, then you should identify a practitioner skilled in using different fillers, and can achieve the outcomes you are looking for or close to them. I would dissuade you from going to salons like hair salons over medispas. Often, these places, at least in the United States, don’t have physicians present, or their model is based on volume discounts.Often, patients bounce from one to another, instead of finding the right doctor who can offer them the solutions and long-term relationship that is more productive and results in better consistency. In the end, it is more cost-effective than bargain shopping ,which certainly happens in the US.
With that understood, I would differentiate the product from the practitioner, and the method of placement. That technique and the practitioner’s style are very important. When it comes to treating the the under eye hollow area you’re concerned about, getting it just right and having the best result are really an art.  I think if you find the right doctor who can help you with all those areas, you’ll want to stick to the doctor as opposed to chasing the brands. The brand does not produce the result, it’s the doctor who performs the procedure. The art of this is for the doctor to choose the right products suited for each area based on their experience. Certainly, it’s a balance. Doctors don’t promote the way the companies do, but at least the consumers become aware of what’s available.
Either go back to the doctor you already had the experience with, or look for a doctor you feel comfortable with doing all these different procedures.That way, you can at least go to someone for consistent results. I hope that was helpful, I wish you the best of luck, and thank you for your question.This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.

Hi and thank you for your question! There shouldn't be any concerns with combining various types of fillers and it's actually even a preferred method. There are many different types of fillers and each are generally preferred for certain areas, so experienced physicians chose their filler carefully and individually based on the area and desired results. For under eyes, we generally use "softer" fillers such as Restylane Silk, Belotero or Volbella while for cheeks (and lips) fillers such as Voluma or Juvederm Ultra Plus work nicely. In any case, please make sure to work with a highly experienced physician who can show you several before and after pictures of similar patients. I hope it helps and good luck!