Why does asymmetry after Voluma look slightly less in the evening?

Two weeks after Voluma there is noticeable asymmetry that looks slightly less in the evening even though it is still obviously there, just slightly less noticeable. In the afternoon the asymmetry is very noticeable just like in the morning. I iced, slept with head elevated, etc. I had moh surgery on my nose on the side that changes throughout the day, though I only had filler in my cheeks so the nose can't be causing this can it? How can I even hope to fix asymmetry when this is happening?

Doctor Answers 8

Voluma asymmetry is less noticeable in evening

This is a frequent phenomenon and is cause by water accumulation in the filler during the night. When you are mostly upright throughout the day, the swelling will subside. This happens with all HA fillers. Correction of the problem is usually adding more one side or dissolving it. I can't give further advice without pictures. 

Panama City Facial Plastic Surgeon
4.7 out of 5 stars 41 reviews


Thank you for your question. Each patient reacts differently to surgical and non-surgical procedure, and our bodies react to the healing process differently throughout the day. I suggest that you move forward and consult with your board certified facial plastic surgeon. Please follow diligently your surgeon's recovery instructions.

Best wishes,

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 121 reviews

Voluma results

Thank you for your question randa911. I am sorry to hear about your situation. Voluma is a hyaluronic acid filler designed to restore lost volume in the face. In our office I start patients with a conservative amount of filler and have them return two weeks later to assess the final results once the swelling has subsided. At that point further enhancement may be performed if desired or if there is any asymmetry that needs correction. Please consult with a doctor for specific recommendations. Good luck!

Alex Eshaghian, MD, PhD
Encino Physician
5.0 out of 5 stars 4 reviews


Swelling from Voluma can take a few weeks to resolve.  I would wait and see how it seems after that time.  You can always have it dissolved if it doesn't look quite right. Please consult a specialist in cosmetic injections for the best results.  Best, Dr. Green

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 80 reviews

Takes time

The healing and swelling from Voluma generally improves over the first few weeks. Healing from a Mohs surgery can alter and delay the healing. 

Best to take photos that document the changes and discuss with your doctor.

Keith Denkler, MD
Marin Plastic Surgeon
5.0 out of 5 stars 19 reviews

Asymmetrical swelling

I wish that I had an answer for you, but as you are finding out, your post op swelling will change and shift daily. And it's different for each patient. You should be seeing improvement in the overall swelling at 2 weeks, and this should continue to improve over the next couple of weeks. For now, be patient and kind to yourself as your body recovers.


Kouros Azar

Kouros Azar, MD
Thousand Oaks Plastic Surgeon
4.8 out of 5 stars 35 reviews

Asymmetrical Swelling with Voluma

This is tough to answer without pictures, but it most likely has to do with tissue swelling at night that decreases during daytime. Your asymmetry can be improved with a touch-up of filler or by having it dissolved with hyaluronidase and using a different technique next time. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 196 reviews

Why does asymmetry after Voluma look slightly less in the evening?

Thank you for sharing your question.  Unfortunately without a full series of photographs it is difficult to offer definite recommendations, but as there is some natural fluctuation in tissue turgor/swelling during the course of the day I would advise seeing your injector for treatment advice.  If the side with Voluma is the side that looks larger, I would add filler to the opposite side for balance.  If the Voluma remains the smaller side, add filler to this side to create better balance.  I do not think that your previous Mohs surgery is causing the asymmetry.  Hope this helps

Nelson Castillo, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 69 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.