Visible big bumps after voluma in nasolabial folds. Will the filler eventually settle? (Photo)

Hi @Amsterdam26! I recommend waiting a full two weeks to see how the product settles in. If at that point the irregularity is still present, I recommend dissolving the product with Hylenex. Best of luck, Dr. Nima!

All injectable treatments come with the risk of side effects; however VOLUMA has been approved by the FDA to provide volume and a natural lift to the face. Typical side effects may include minor itching, redness, swelling, and bruising around the treatment area. These side effects should not last longer than a few days, however if they last for more than one week you should contact your physician.

Although Voluma is FDA approved for the malar (cheek) areas, experienced injectors will use it for other areas off-label.  Since Voluma is thick in consistency, many people will find in their smile lines that it will have a lumpy feel.  Thankfully, in my experience, this improves and resolves with time, massage, and patience, but Vitrase enzyme can be used to dissolve it more fully and more quickly if a patient does not wish to wait.

Try massaging the area for a week or two.  If the bumps are still there after that, have your practitioner inject the enzyme to dissolve the product.

I suggest reversing the filler with hyaluronidase.  It may take a few treatments and would be best combined with venus legacy treatments.  Best, Dr. Emer.

This might or might not settle. This is a very early timepoint so you will see a reduction of any swelling that is present over the next 3-4 days. If it does not settle you would benefit from hyaluronidase treatment to reduce the overfill and smooth out the upper lip tissue. I do agree with my colleagues that Voluma is not ideal for this area as it is very thick and can be visible when injected superficially. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Voluma use in the nasolabial fold is an off label use. Voluma should only be administered by a board certified dermatologist. Good results can be seen when performed by the right physician. I would suggest discussing your issue with board certified dermatologist at the time of a visit.

I am in agreement with the other responses with regard to your question.It's difficult to place judgement on any off label treatments.  All doctors go off label.  But having said that, Voluma is not frequently injected into this area.I would go back and talk to your practitioner or injector and ask if this has ever happened to another of their patients and what they suggest.Or get another opinion.My gut tells me that these lumps will settle or can be massaged into place.

There might be to much filler or some migration of the filler so it is best to see your provider. You might be able to massage it out but if there is to much filler placed, it might not look normal. You might have to get some of the filler dissolved but see your provider for an opinion. This is an advanced technique so be sure to get an experienced dermatologist or plastic surgeon consultation for recommendations and treatment options.

Voluma is my favorite injection for the mid face to give an immediate lift to the cheeks.  However, it is not meant for the nasolabial area.  It appears from the photo that you have too much product lateral to where it should have been placed.  Please return to your treating physician for Vitrase to dissolve the product.  For the best cosmetic results please consult a board certified cosmetic dermatologist with experience with cosmetic injections such as Juvederm Voluma.