Cannot get rid of Voluma after multiple treatments. Only modest improvement.

almost one ml of voluma area under the cheekbone over 2 mos ago. w vitrase i get a modest improvement. Here is the amout of hyaluronidase that was put: 1st time 70 units 2nd time 70 units 3rd time 30 units (only in one small area right under cheekbone) 4th time 70 units but (only in one small arearight under the cheekbone) 5th time 60 units larger area 7th time 120 units improvement is too modest. last tx yesterday, waiting for swelling to abate but still looks unremarkable. is this normal?

Doctor Answers 2

Cannot get rid of Voluma after multiple treatments. Only modest improvement.

Thank your for your question and I am sorry that your Voluma results were not what you anticipated.  Because of Voluma's cross-linked nature it can often take serial treatments to achieve significant results, especially as it is placed deeply into the face.  Your dosing of Vitrase is appropriate to dissolve the Voluma but with little improvement you may want to discuss a different hyaluronidase, such as Hylenex to see if greater improvement can be obtained.  Hope this helps.


Atlanta Plastic Surgeon
5.0 out of 5 stars 43 reviews

Vitrase does not seem to be working for my Voluma

I understand you have had over 400 units of Vitrase to dissolve one cc of Voluma.  Generally any hyaluronidase would dissolve this Voluma, although Voluma is more resistant than other forms of hyaluronic acid fillers.  
If your original issue was to improve a cosmetic issue, the Voluma will naturally decrease with time.  
The number of injections in the 2 months following Voluma may be causing additional trauma and swelling, that may be difficult to distinguish from the original Voluma.
I would be patient and consider following up in one month.  At that time your doctor may consider another form of hyaluronidase, such as Hylenex.  Of course if you experience pain or worsening symptoms I would follow up immediately with your doctor.

Ernest Robinson, MD
Aliso Viejo Facial Plastic Surgeon
5.0 out of 5 stars 10 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.