Why does my undereye look hollow after Voluma?

Question

I have had voluma to my midface/cheek and dont understand why the hollows to under outereye are looking worse? On most photos/reviews its says this area will be improved... is there something wrong?

Brock Ridenour, MD · Answer

If you increase the forward projection of the cheek (below the rim of the eye), it is possible to make the rim of the eye appear more hollow, especially where the cheek abuts the corner of the eye. Not everyone is prone to this problem, which depends on patient specific anatomy. If this occurs, it is easily treated by placing small amounts of filler between the upper portion of the cheek and the rim of the eye to create a smooth transition. Because the skin in this area is very thin, it may sometimes be better to use a less viscous filler than Voluma, such as Restylane or Juvederm Ultra. Hope this helps

Raffy Karamanoukian, MD, FACS · Answer

Often, the midface volume enhancement should be accompanied by tear trough enhancement with a lighter filler such as Belotero. Best, Dr. Karamanoukian Los Angeles

George Volpe, MD · Answer

As with all injectables, when Voluma is used, it must be carefully placed to contour the cheek region and the under eye region. It is a thicker hyaluronic gel and it can be a bit tricky under the eye to place relative to the cheek region. This can be discussed with your provider to determine if you require a bit more fill under the eye or if perhaps there was overfill of the cheeks. He or she will be able to evaluate you

Martin Jugenburg, MD · Answer

Thank you for your question. It is important that Voluma is skillfully injected to create a natural and more attractive appearance. Return to your injector and discuss your concerns. Best,

Michael H. Gold, MD · Answer

The injection of
Voluma, as with all fillers, needs to be done in an office of a board-certified
dermatologist or plastic surgeon as they best understand the anatomy of the
areas that we are injecting, the precise placement of the filler, and how to
best use these in your cheeks/mid-face and in all areas of the face. On
occasion, the problem you are describing does happen, even with skilled
injectors. It is why we routinely speak with our patients after the procedure
to make sure that they are doing well, and let them know if they have any
concerns, such as what you have, that we get them into the office and address the
concern with them. You may need a little more filler to correct the problem –
usually Juvéderm, Restylane, or Belotero will work well here as a touch up. I
would go back to your injector and find out what he or she recommends and let
them take care of it, if they are skilled enough to do so.

Michele S. Green, MD · Answer

Voluma is a fabulous product when injected in the mid face.  However, the skill of the injector and placement of the product is most important.  Most of the time, the eye area looks better even if untreated when Voluma is placed in the proper location.  I would recommend you return to your physician and discuss your results.  For the best cosmetic results please consult a board certified dermatologist with a great deal of experience with facial injections.

Katrinka L. Heher, MD · Answer

This is very unusual as you are correct that your under eye should look better. There is an art to placing the voluma in the correct location and I'm suspicious that if you look "worse" that the voluma maybe misplaced. I would recommend going back to your injector for a follow up. The good news is that the voluma can be dissolved if you continue to be unhappy with the result. Best of luck.

Steven F. Weiner, MD · Answer

It's my experience that Voluma helps this problem. I'd go back to the doctor and discuss your concerns with him/her.  Perhaps it was not placed in the correct area or there was an underlying problem that wasn't properly addressed.

F. Victor Rueckl, MD (in memoriam) · Answer

You are right that in most cases the undereye area should be improved with the correct placement of Voluma into the upper cheek region. If this isn't what you are experiencing, I would suggest a follow-up with your injector to discuss the outcome. "This answer has been solicited without seeing this patient and
cannot be held as true medical advice, but only opinion. Seek in-person
treatment with a trained medical professional for appropriate care."

Why does my undereye look hollow after Voluma?

Answers (9)

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