3.5 weeks post op, do I have a Voluma infection?

Question

Hi, I got Voluma in my cheeks 3 1/2 weeks ago. This morning that side is swollen and I think it's probably an infection. Everything was fine until I noticed a weird little pain early this week but nothing major. I'm going back in and they will probably give me antibiotics. Two years ago something similar happened to my lip with Restylane but it really swelled up. Anyway, what do you think? Will antibiotics fix this and how soon? I don't look okay and am slightly freaking out. thanks.

Jason Emer, MD · Answer

Swelling and redness may be a delayed inflammatory reaction which can happen with HA type fillers like Voluma.  The chance that it is an infection is actually very low.  Biofilm formation is possible, but the area needs to be evaluated to see what treatments may be needed.  In most of the cases I'm referred to treat these, as I specialize in complications and treatments of, I reverse the fillers with hyaluronidase enzyme and prescribe oral antibiotics for 6 weeks with major improvement.  The trend used to be to inject the area with a steroid solution, but I have found this in many cases not to help and only perpetuate the reaction if it is truly a biofilm.  I suggest going to an expert for treatment of this and for the future, only go to someone who uses a close to sterile technique for filler injections.  Best, Dr. Emer.

Raffy Karamanoukian, MD, FACS · Answer

Swelling and redness may be signs of infection. An examination may be an excellent way to tell whether you have signs of a filler-related infection. You may need to speak to your injector. Best, Dr. Karamanoukian

Mark K. Markarian, MD, MSPH, FACS · Answer

Thank you for your question.  Swelling 3 1/2 weeks out is unexpected from Voluma, and can possibly be due to an infection, especially if it is associated with pain.  I definitely agree with returning to your injecting physician for re-examination.  You will likely need an antibiotic and close follow-up.Although Voluma is a great product, please make sure your surgeon or dermatologist has significant experience with it. As Voluma is a new filler manufactured by Allergan, most injectors' experiences are limited. Infections are more likely to happen with poor, non-sterile technique.  In the future, I would seek out a plastic surgeon in your area who has extensive experience with injecting cheek fillers and typically performs many facial surgeries, as he/she is thus more likely to be familiar with the anatomy in that area, which can be variable even from one side of the face to the other. I would also ask for a plastic surgeon who took the Allergan Expert Hands-on training course specific for Voluma injection.Good luck.

Martin Jugenburg, MD · Answer

Thank you for your question. An in person evaluation is required to determine treatment. If you do have an infection an antibiotic should be able to clear it. All the best,

Brian S. Biesman, MD · Answer

There can be a number of reasons for swelling after Voluma injections.  I think that you are doing the right thing by visiting the person who injected you.  Without photographs were more information it is difficult to make further recommendations.  Make sure that an experienced injector Who is comfortable with taking care of the adverse events that can be associated with fillers is managing this issue for you.

Michael A. Zadeh, MD, FACS · Answer

Hi Melece. Without seeing you or at least seeing a picture there is no way to tell whether you have an infection in the area of your Voluma treatment. Infections usually present with swelling, redness and warmth of the area. I agree that you are doing the right thing by going in for a follow up with your injector. Please keep us posted as to what happens. Best of luck.

Michael I. Echavez, MD · Answer

It is impossible to know if you might have an infection on the side of your face from Voluma without examining you.  You are doing the right thing by going back to your doctor's office.  They will be able to evaluate you and determine possible treatment for your problem.

F. Victor Rueckl, MD (in memoriam) · Answer

It is possible that it is an infection. You are smart to head right to the doctor and have it evaluated. It is possible to get an infection after fillers, but as long as it is caught early and the proper antibiotic is prescribed, it should all be just fine. "This answer has been solicited without seeing this patient and
cannot be held as true medical advice, but only opinion. Seek in-person
treatment with a trained medical professional for appropriate care."

3.5 weeks post op, do I have a Voluma infection?

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