Voluma: Does it have to be injected just above the bone, or can it be injected into the softer areas of the lower cheeks & face?

Should it be injected at varying depths? What are the different techniques for injecting? Is one better than another? Why would PS not use a cannula to administer it? Had Voluma injections (no cannula), it was EXTREMELY painful. I'm not usually a sissy, but it hurt so bad I could almost scream. PS was very forceful with the needle. Read this should've been a pretty tolerable procedure. 4 wks later, still painful, lumpy & unevenly distributed. Thoughts?

Doctor Answers 5

Voluma Injections and placement

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Voluma is best placed under the cheeks on top of the bone.  If it is uneven or lumpy it sounds like it might not have been injected properly.  I would definitely consult a board certified dermatologist to examine the area.  Best, Dr. Green

Voluma Placement

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Voluma is ideally placed on the bone for the top of the cheekbone for duration.  If you are going midface for volume loss, or the jawline for contouring, you can place it higher with a micro-cannula to avoid bruising.  Going through the midface involves bypassing many vessels, so there is a great advantage with using a micro-cannula.  This is one of my favorite procedures to do because it is so natural!

Dr. Liu

Grace Liu, MD
Newport Beach Dermatologic Surgeon
4.9 out of 5 stars 52 reviews

Voluma: Does it have to be injected just above the bone, or can it be injected into the softer areas of the lower cheeks & face?

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Hello Petunia83,

Each filler has certain indications for use.  Anything other than that is considered off label use.  Volume is indicated for a deep injections in the cheek.  However, there are many injectors that will use it in other areas at at different depths.  Volume is a thicker product than others on the market (same with Restylane Lyft).  Because they are thicker they are more prone to be felt (and lumpy).  The benefit is they are designed to last longer.  To avoid the lumpiness, the injections are deeper (next to the bone).  But your injector may decide to inject it differently which is a common practice.  

If you aren't happy with the result, then you can inject hyaluronidase to remove it.  The drawback to this is you get rid of the product you paid for.  I would discuss your concerns with your injector.  

I hope this helps and good luck.  

William Marshall Guy, MD
The Woodlands Facial Plastic Surgeon
5.0 out of 5 stars 31 reviews

Voluma Injection with Needles vs Cannula

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I am sorry to hear of your experience.  Typically Voluma injections are comfortable.  #Voluma provides the greatest "lifting" effective when injected over bone.  Some physicians inject Voluma into the lower cheeks in an area called the V4 zone.  To precisely place Voluma along the zygomatic (cheek) bone, the supplied needle should be used.   Injection technique should be with vertical, serial injections to provide the greatest effect with the smallest amount of product.  Most injection points should have 0.1 to 0.2 cc of Voluma injected to provide the maximum effect.  Cannulas will not allow precise placement in this particular area.

I suggest returning to your plastic surgeon for further evaluation of the pain and "lumps" you are experiencing.  If he or she is not willing to see you, please consult a board certified dermatologist or plastic surgeon who has significant experience with injectables. 

Best of luck,
Suneel Chilukuri, M.D.
Houston, TX

Suneel Chilukuri, MD
Houston Dermatologic Surgeon
5.0 out of 5 stars 43 reviews

Voluma painful or not.

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Hi, generally fillers are not very painful unless injected at the lips.  But topical anesthetics generally work well at the lip.  For the cheek, most of my patients tolerated very well. Lumps are felt only if injected too superficially.  For the lift affect, it works best when injected close to the bone.  But it can be used to fill in volume on the lateral and even medial parts of your cheeks.  Cannula vs needle is the preference of the injector.  

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.