What can be done about my droopy lower lid after possible nerve damage following Voluma mid face injections? (photo)

I had voluma injected into my mid face area a couple of years ago. Ever since the voluma has left my system, my left eye is drooping on the outer corner. My eyes were level and fine before voluma injections (at least not drooping!! I have attached photos of my eyes from before as well), this has only been an issue ever since voluma and since it's left my system. Could this be nerve damage from the injections? Can it only be fixed with surgery or do I have other options?

Doctor Answers 7

Droopy Lower Eyelid After Voluma

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It is not uncommon to see rounding of the lateral (temporal) portion of the lower eyelid in patients of all ages. This can occur because of anatomic considerations such as a relative prominence of the globe (eyeball) or because of a downward sloping eye shape (lateral canthal dystopia).  It can also occur with loss/atrophy of the deep under-eye fat with age. In your case, either the loss of supporting fat or the decline of your Voluma could account for the small difference between the before and after photos.  Nerve damage is extremely unlikely and can be excluded from consideration with a simple examination. The simplest solution to the problem may be to inject filler to lift and support the lateral portion of the eyelid. Hope this helps. 

Saint Louis Facial Plastic Surgeon
5.0 out of 5 stars 126 reviews

See Board Certified Dermatologist to Discuss Voluma

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The reality is that after this much time has elapsed, one could not say that Voluma would be responsible for anything that you are describing. The fact is, as others have pointed out, that there are some discrepancies in the photos that is quite normal when we look at our own photos, and that we are all constantly aging, so there are changes in our appearance over time.

I would suggest having a consultation with a board-certified dermatologist or plastic surgeon – share your concerns, go over what has happened and what is happening, and see what kind of treatment options would work best for you.

Michael Gold, MD
Nashville Dermatologic Surgeon
3.9 out of 5 stars 17 reviews

Schedule a consultation with a board certified plastic surgeon to be assessed.

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Thank you for your question,

Schedule a consultation with a board certified plastic surgeon to be assessed. It is most beneficial to have an in person consultation to obtain accurate information and discuss treatment options.


Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 521 reviews

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Effects of Voluma

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Although the photos provided provide limited information, I feel that the features you are describing are unrelated to Voluma.  Both pre- and post- photos suggest scleral show, a lack of midface support, and a slight anti-mongoloid slant that would not be caused by Voluma.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.9 out of 5 stars 104 reviews

Voluma Concerns

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Sorry for your concern. It does not appear that you have any nerve damage. Aging could create what you are noting. Express your concerns to your injector. Botox may be an alternative to correct the asymmetry that you note.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 56 reviews


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A couple of things... in general with normal aging, the lateral eye will level out and sometimes drop lower giving a downward tilting appearance. A youthful eye has an almond shape with an upward tilt as demonstrated in your before pictures. Simple aging can cause this as oppose to voluma.

So...its only been two years you say... well look at the pictures more closely. In the before pictures you are taking the shot from an elevated position...your eyes are looking up. This changes the way your eyes look and makes the tilt of your eyes appear to be more than it probably was at the time. Also...you have black eye liner on in the before pictures...another thing that will cause the appearance to differ. I would encourage you to find a picture of yourself before voluma with no make up on looking strait ahead and see if the difference is as noticeable. 

It may not be...but it just might.

Voluma in midface doesn't cause eyelid drooping

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There is minimal difference between the two eyes on you after photo except for the scar I see on the left side.  This can cause asymmetry.  There is absolutely no way the Voluma in the cheeks can affect the eyelids.  A little Botox can help if you are concerned about it.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.9 out of 5 stars 75 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.