I have slim face, tear trough fillers don't last. Should I build up cheeks with Voluma for tear trough fillers to work?

Dear eliza bethany,
Thank you for your question. It is difficult to make an accurate assessment and recommendations based on reviewing photographs alone. I recommend you seek repeat evaluation with your provider to discuss your concerns and treatment goals. We usually treat the tear trough areas with a thinner filler like Belotero and conservatively to avoid a puffy appearance, which is different from how we treat the cheeks, usually addressed with a thicker filler such as Voluma or Restylane Refyne. Depending on your anatomy, perhaps volume enhancement to the cheeks will help bring the midface definition and attention to the eyes you are seeking and this can be discussed with your provider. 

It sounds like you may not have received enough filler under your eyes to completely even out the troughs. Dermal fillers shouldn’t move after they’ve been injected. You could ask your dermatologist for more filler, and for a longer-lasting HA filler, such as Volbella. Building up your cheekbones with Sculptra and/or Voluma could also help. Be sure to consult a board-certified dermatologist who is an expert at rejuvenating the face with dermal fillers to avoid more frustration.

Hello,

Thank you for your  question. After examining your pictures, I can say that you will need a little less than 1 cc of Juvederm Ultra. The results  are visible and lasting. I am not convinced you need the Voluma. Please examine my photo portfolio to find a similar patient.

Best,

Oxana Popescu MD

Thank you for sharing your question and photographs. I would advocate trying a different filler for the underlies, perhaps Vollure, in addition to cheek filler placement.  This should afford you a more well-rounded and proportional improvement.  Hope this helps.

A combination approach will give the most improvement. Fillers, lasers, and microneedling/PRP can improve under the eyes. My patients try to get non surgical treatments to avoid surgery. We use PRP and stem cells there often. I suggest consulting with an expert to develop a treatment plan best suited for your short and long term goals. Best, Dr. Emer

Hi Eliza, I'm sorry that your tear troughs didn't last long. Perhaps you can try the new generation type of fillers that last longer and look (and feel) more natural. I've worked with both Restylane Refyne and Volbella with amazing results.I would caution against some fillers or using too much at a time because of the risk of forming "bumps" or granulomas.  I also avoid fat transfers because it may lead to lumps which are discernable.All the best,Justin Harper, M.D.