Juvederm, Voluma in nasolabial area?

Question

it's not approved for the smile lines area, but can voluma be used safely there? i'm getting juvaderm there every few months, but want a longer-lasting solution. i'm not comfortable with the long-term safety of permanent and semi-permanent materials currently used, though my doctor assures me in 6 years of dermal filler injection practice, she's had only one patient with a notable adverse reaction (an injection-related granuloma) to their use.

Jeffrey J. Roth, MD, FACS · Answer

Thank you for your question.  Voluma is a very good filler for your cheeks and midface.  It is a bit of a larger molecule, so it is usually placed deeper in the skin, (subdermal).  The sales people will tell you it lasts about 2 years.  In our experience it last about a year and a half.  It is not FDA approved for the NLF's.  As far as Juvederm Ultra Plus, (which we like for the nasolabial folds), and Juvederm Ultra, (which we like for the lips), the sales people will tell you it lasts about a year, in reality about 9 months. Every person is different so it can last a longer or shorter time period, depending on the patient.  It has been our experience that some folks that are hypermetabolic, (in the gym twice a day, etc.), tend to break down Botox and Fillers faster.  Each individual is different though. Please see a well trained, experienced injector.  Discuss your goals, and you should be able to come up with a plan.Jeffrey J. Roth, M.D., F.A.C.S.Board Certified Plastic SurgeonLas Vegas Plastic Surgery

Melissa Chiang, MD, FAAD · Answer

Please consider sculptra as a possibility for the nasolabial fold area.  Sculptra is a biostimulator and works by inciting collagen production.  In a major clinical trial, 80% of patients were still satisfied with their treatment results 25 months after their injections.  You may want to combine voluma to lift up the cheeks (heavy, falling cheeks are what cause nasolabial folds), along with sculptra.

Sabrina Fabi, MD · Answer

Although not FDA-approved for this indication, many in Europe, Canada and South America have used it in small amounts to the nasolabial folds with nice results when injected in the right plane and when blended with lidocaine. It is important to see a certified doctor and facial filler expert when undergoing any injectables procedure.

William Numa, MD, FACS · Answer

Voluma's approved indication is for deep injection into the malar area. Appropriate injection in this area will often help to adequately efface deep nasolabial folds in a very natural way.

Hannah Vargas, MD · Answer

Voluma is approved for deep injection in the cheek area.  Injections done in the cheek area aren't necessarily to make the cheeks bigger, but to provide support back into the area where you have lost bone, muscle, and fat.  Once this area is supported we often see improvement in the nasolabial fold.  Many docotrs will use a filler "off label", but the nasolabial fold isn't a good area for the Voluma.  Using something thinner like that Juvederm is a better option.

Steven J. Pearlman, MD, FACS · Answer

Voluma is specifically FDA approved for restoring cheek volume. Yet, in the FDA study with hundreds of patients, many felt there was a significant improvement in their nasolabial folds as well. If you still have deep nasolabial creases, we can use a thinner hyaluronic acid filler there such as juvederm. Voluma is too thick to use directly into the nasolabial folds.

Dmitriy Schwarzburg, MD · Answer

Some people respond better to a particular type of filler. Overall any hyaluronic acid should give you your desired result if injected properly. Moreover, there are different factors that determine how to appropriately administer a filler.

Michael A. Greenberg, MD · Answer

The end result of aesthetic practice is to make you look natural and refreshed, not fake.Voluma is a wonderful answer to that quest because by lifting the entire face, every part of it looks better.The product is made to go deep in the area of the cheekbone, not fill in lines in the lower face.  Other fillers can do that.But, I have suggestion...try getting the Voluma first and see how your entire face looks.  You might get enough softening of the nasolabial folds that you don't feel you need any further correction.Sometimes less is more and going slowly (and less costly) is the better road.Discuss this with your doctor and choose the best course for you.

Michele S. Green, MD · Answer

Voluma is a wonderful injectable for the mid cheek to augment and immediately lift that area.  In doing so it will augment the mid face and you will find that the smile lines should be diminished.  Voluma lasts for approximately two years and might be a great solution with longer lasting results.  For the best cosmetic results please consult a board certified dermatologist with experience in Voluma and facial injections.

Camille Cash, MD · Answer

Since its FDA approval, many of my patients who have used Juvéderm® XC have inquired about switching to Voluma™ as a longer-lasting option to treat their nasolabial folds.  Injected into the apex, apple, and/or the hollows of the cheeks, Voluma™ is a wonderful option for midfacial volume restoration and contour enhancement of the cheeks.  While the volume and lift that can be achieved with Voluma™ may indirectly improve the appearance of the nasolabial folds, it should never be injected directly into this area.The “parenthesis” that appear and become more pronounced as we age is a result of lost hyaluronic acid and as such, I find HA fillers such as Juvéderm® XC and Restylane® to produce the most natural looking appearance.  The long-lasting results Voluma™ delivers is attributed to a consistency that is much thicker and injected much more deeply than Juvéderm® XC.As such, Voluma™ would create a very artificial appearance and unnatural feel to the nasolabial area.

Juvederm, Voluma in nasolabial area?

Answers (19)

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