3 syringes of Voluma to cheeks to address nasolabial folds and marionette lines was unsuccessful. What do I do now?

1st post was 24 days ago. I had 2 syringes of Voluma injected into my cheeks to address nasolabial folds, marionette lines. under eye hollowness. 2 syringes did very little to correct the nasolabial folds and marionette lines, but improved the under eye hollowness. I returned to the doctor 2 weeks later and received a unplanned 3rd syringe of Voluma and it is not much improved. I am not going back for more Voluma because I don't think that is the answer. Where do I go from here?

Doctor Answers 9


More Voluma may just be the answer or another filler.  It is hard to say without seeing your before and after photos.  It is not uncommon to need multiple syringes to address multiple areas. 
ONE syringe of Voluma is only 1/5 of a teaspoon of product.  If you think of it this way... that is not a lot of product to correct numerous areas. 
Hope this helps. 

Los Angeles Plastic Surgeon
4.7 out of 5 stars 145 reviews

What next after unhappy results?

Without seeing you in person or even a photo, it is truly impossible to say. It sounds as if you tried to use the 2 syringes to address a number of different areas that might have perhaps been better served with a different filler. My best advice would be for you to schedule a consultation with another board certified plastic surgeon in your area to be assessed in person and discuss options for improving your results. I don't think that more Voluma is the answer. 


Kouros Azar

Kouros Azar, MD
Thousand Oaks Plastic Surgeon
4.9 out of 5 stars 33 reviews


Thank you for your question in regards to Voluma. Without a photo it is difficult to give a suggestion. Although, Voluma is used specifically to restore volume loss and fullness. If your concerns are marionette lines, additional fillers such as Juvederm Ultra Plus may be used to help achieve your desired results. To be sure what is best for you, see two or more board-certified providers in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have treatment. I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 182 reviews

Voluma and Results

Voluma is my favorite injection for the mid-face.  If you could post a photo that would be most helpful.  If you are unhappy with the results please consult a specialist.  Best, Dr. Green

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 76 reviews

Voluma to address nasolabial folds and marionette lines

Voluma is a filler specifically used to add volume to upper/mid face areas. If your main concern if nasolabial folds and marionette lines, you would need a different filler altogether. You are right in saying that Voluma is not the answer. Try Juvaderm or Radiesse for lower face filling.

Lawrence Bundrick, MD
Huntsville Plastic Surgeon
5.0 out of 5 stars 7 reviews

Facial Sculpting Using Fillers Like Voluma, Radiesse, Lyft, Juvederm and Sculptra and Fat

Please post before and after photos so appropriate treatment can be assessed. I find that with patients that do not see much improvement with Voluma, fat grafting and/or sculptra and radiesse are best.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 190 reviews

Voluma Versus Juvederm

Thank you for your question.  I am sorry to hear that you are having some concerns about your postprocedure appearance.  It is difficult to comment without seeing any photographs.  In general, Voluma is a great product for restoring age-related midfacial volume loss.  Volume restoration to your midface will accomplish several things.  It will indirectly improve the tear trough area, as you described.  It will also create an upward lift that will improve the nasolabial folds and marionette creases.  In general, optimal correction with Voluma in the midface will minimize, but usually not eliminate, the need for Juvederm in the lower third of face.  I find that even with optimal Voluma treatment, there is, at best, roughly a 50% reduction in the amount of Juvederm required to correct areas in the lower third of the face such as the nasolabial folds and marionette creases.  Very nice natural results can be achieved with a combination of Voluma and Juvederm.  Please be sure see an experienced plastic surgeon for an in-person reevaluation in order to best address your concerns, discuss your goals and expectations, and determine the best course of action.  Best wishes!

Christian N. Ford, MD
Cohasset Physician
5.0 out of 5 stars 30 reviews

Unhappy after 3 vouma syringes

Please post your before and after pictures so we can assess exactly what your result has been so far and make suggestions as to how best to resolve your concerns. 

Dilip D. Madnani, MD, FACS
New York Facial Plastic Surgeon
4.9 out of 5 stars 89 reviews

3 syringes of Voluma to cheeks to address NLF and marionette lines. What do I do now?

Thank you for your question and I am sorry to hear that your results have not been what you anticipated.  Without knowing your degree of desired improvement, or being able to see before and after photographs, it is difficult to offer definite advice.  In some patients much more Voluma may be needed to restore volume and lift tissues, but with how little improvement you have seen you may be a better surgical candidate with a combination of fat grafting and a facelift procedure.  This would offer a more dramatic impact and improvement on your facial contours than fillers will ever be able to accomplish.  Be sure to see a board certified plastic surgeon in consultation to discuss your best treatment options.  Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 65 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.