Voluma in chin: I am noticing more pain that what I usually feel with fillers. (Photos)

Question

I got one syringe of voluma in my chin about 7 hours ago and am noticing more pain that what I usually feel with fillers. Also when I was being injected it felt like maybe a nerve was hit that bothered one of my lower teeth. Wondering if my discomfort could be caused from the larger amount of filler in one area and/or hitting a nerve bothering my lower teeth (they still feel a little tingly) wondering if that is normal as well. I went to an experienced injector. Thank you

Brock Ridenour, MD · Answer

Unexpected pain after a filler injection should always be evaluated. In your case, I don't see any signs for concern based on the photographs provided. Most pain following filler is explained by minor needle trauma resulting in bruising, bleeding or inflammation. Most pain is felt as a soreness that increases with pressure or movement. Sometimes deeper injections above the cheek bone or chin can irritate the periosteum of the bone or a small adjacent nerve branch. Injections close to the bone can sometimes be more uncomfortable immediately afterwards. I think this might be what you have experienced. 
Severe pain that occurs during or after an injection, or pain that is accompanied by changes in skin color are of greater concern. This phenomena can result from the inadvertent compression or embolization of a small vessel by the filling agent. The result can be impaired blood flow that can damage the skin and/or adjacent structures such as the eye. Symptoms include unusual pain, blanching of the skin, violaceous or mottled skin color, persistent redness, or changes in vision. If any of those symptoms occur you should seek immediate medical attention. Hope this helps. My best.

Jason Emer, MD · Answer

Some pain and tenderness can be typical after injections. If it persists, I would follow up with your injector. You may also have swelling, which can be asymmetrical, and last 1-2 weeks after filler injections. If you're unhappy with your final results, you can have it reversed with hyaluronidase and try a different technique next time. See an expert. Best, Dr. Emer

Anthony J. Taglienti, MD · Answer

Thank you for your question. Depending, this can be completely normal - the chin is a very enclosed space typically, and 1 cc of Voluma (a relatively thick filler) is a good amount to place in this small space. While some discomfort and soreness is to be expected (and likely more than you have experienced in other areas), the safest thing to do is to contact your injector. From your photos everything looks fine, but it's better to have reassurance or advice from the person who actually performed your procedure. Best of luck!

Tariq Ali Khan, MD · Answer

Thank you for your question.  Fillers can cause discomfort in areas depending on the amount of injections and if it was placed in the correct locations and also any trauma to vessels.  The main thing is that if you are experiencing pain or sensations that is very different from prior experiences, especially if a larger volume was used, its best to call your injector immediately and be evaluated for any possible complications.  Good Luck! - T.Khan MD.

Sutton Graham II, MD · Answer

You are right to raise concern if you are feeling more pain than usual with an injection treatment, or tingling or numbness.  Depending on what was done there are nerves and blood vessels nearby that can be effected.  Call your treating physician now and discuss this with them.  In our practice we encourage any patient with questions following treatment or consultation, to call us anytime.

Voluma in chin: I am noticing more pain that what I usually feel with fillers. (Photos)

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