Voluma Uneven and Bumpy: Will it Improve?

Y'day I had Voluma injected with a Canula into my cheeks to enhance the cheek bones and create a lift. Apart from the fact that the area is extremely sore, and warm to the touch/feel, the result is quite uneven and "bumpy" you can clearly see where the filler ends without smooth transition. I want to know whether this is normal for the filler to be bumpy at first (perhaps it's self levelling, or there might be some scar tissue created because of the cannulae used?) How long b4 it improves? Tnx

Doctor Answers 33

Voluma Injections Help Lift the Cheeks giving a Smooth and Natural Result

In the vast majority of patients, you should not feel unevenness or bumps a day after your injections of Voluma. You may have mild swelling and some light massage in encouraged. However, if you have market asymmetry, pain or bumps, you need to contact your injector to discuss your issue as this is atypical. In general, Voluma injections are virtually painless (aside from a small prick of the needle entering the skin - and even this is generally numbed with anesthetic cream or ice prior to injection). Additionally, the Juvederm XC is now mixed pre-packaged with lidocaine with help with ease of injection. While some fillers do swell after they are injected, Voluma has low hydrophilic potential, meaning that it does not absorb fluid and does not swell as much as other fillers. So, usually what you see immediately after you are injection is what your result will look like. If you are still having issues, I would suggest following up with your injector and if you are not satisfied, I would seek out a well qualified injector or board certified plastic surgeon.

Good Luck.


New York Plastic Surgeon
4.9 out of 5 stars 72 reviews

Voluma Injections Give the Cheeks a Lift with Smooth and Beautiful results

Voluma is a great injection and you should look beautiful immediately after the injections. If your skin is warm or uneven you should return immediately to your treating physician for examination.  The contours should look even and natural and not as you are describing.  Please consult a board certified dermatologist with a great deal of experience with Voluma for the best cosmetic results.

Voluma Uneven and Bumpy: Will it Improve?

Thank you for your question.  Fillers are a great tool to augment facial volume loss or help soften facial lines.  Post injection, though, some swelling and mild bruising may occur and is still within the expected normal recovery period.  If it has been two weeks or so and you still see some unevenness or bumpiness, it is best to follow up with your surgeon as he or she may be able to fix any imbalances by either adding more or using a medication to dissolve any unwanted areas.  I hope this helps and best wishes to you.

Natalie Attenello, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 4 reviews

Can massage bumpy and uneven Voluma

Given only one day post-injection, lumpy bumpiness can still be massaged to help smooth the area.  Usually the injector should massage out the uneven areas for you without you having to do anything except to leave it alone and let the swelling dissipate. It is difficult to determine without examine you to see if "bumpy" areas are actually the intended filling product or tissue swelling from the product.  Usually the filler is injected retrograde as the cannula is withdrawn from the puncture site and sometimes a little product can be left behind too superficially.  If this is the case, I would see your injector about having it massaged out sooner rather than later.

Johnny Mao, MD, FACS
Orange Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

Voluma Injections Lift with Smooth and Elegant Results

It is common to experience mild bruising, swelling and tenderness three to seven days post treatment. However, it is not typical to feel bumps or lumps at any point after the treatment. The transition from where the product begins and ends should be smooth and have a natural appearance. I would recommend scheduling a follow up appointment with your injector to address your concerns.

Scott Chapin, MD, FACS
Philadelphia Plastic Surgeon
4.8 out of 5 stars 18 reviews

Voluma uneveness

Thank you for your question. I would recommend the following after filler injections:

1) Use an ice pack on/off throughout the first day or two to help minimize swelling and bruising
2) Don't massage the areas that were injected as this may increase the amount of swelling
3) Avoid activities that make you hot, sweaty or flushed: Examples include strenuous activities, alcohol, saunas, hot baths, etc… This will increase your chance of bruising. If not bruising by the next day, you should be good to go. If there is, then wait another day or two to make sure it is not getting worse
4) Take Arnica to help minimize the bruising/swelling potential
5) Return to the clinic for: any abnormal visible lumps/bumps for within the first week or two as I may mold the product to make sure that result appears smooth and even.
6) Return to the clinic if you experience bruising that cannot be covered with make-up - we may consider IPL or lymphatic stimulation to help with the healing.


Voluma: uneven and bumpy early after the injection

  Swelling and mild lumpiness after dermal filler are normal (although they can be a little bit scary). The first two weeks after the injection, swelling can the result of bruising from the needle or cannula and not necessarily the filler itself.

Unevenness and lumpiness is hard to judge in the first two weeks after the injection. Sometimes the injections created a bruise and you can feel the bruise and not the filler.  Swelling and bruising might be different between both sides of the face. Wait 2 weeks after the injection to determine if you need a touch up

You can apply ice to help speed the recovery (best for the first 2 days after the injection) and take Tylenol to help with the discomfort. Ask your injector if you can massage. I recommend waiting until two days after the injection. After that, I tell my patients it is okay to do gentle massage. The massage will help bruises settle and should not move the filler. 

If you are concerned about an injection, I encourage you to return to your injector for an evaluation in person. Signs that are worrisome are excessive pain, red and hot skin, or a fever. They would suggest an infection. Infections for cheek fillers are very rare.

Voluma should settle into the cheeks and feel just like a part of you.
In a few weeks you should not feel the product there.

Hope this helps!

Myriam Loyo, MD
Portland Facial Plastic Surgeon
5.0 out of 5 stars 5 reviews

Voluma for cheeks.

If you just had Voluma injected yesterday, it is too soon to expect anything to look perfectly smooth, and what you described sounds like there may be swelling related to the procedure. I would recommend waiting for all the swelling to subside which can take up to 2 weeks, and if it still seems like there are lumps or there is asymmetry you should follow up with your injector. Occasionally the injector may need to massage any lumps, and in the worst case anything that did not settle down and was a lump from product deposition it can be dissolved with hyaluronidase.

Kaleroy Papantoniou, MD, FAAD
Long Island Dermatologic Surgeon
5.0 out of 5 stars 22 reviews

Softening Voluma transitions

Voluma is a product that can create a marked lift.  In patients with thinner skin, it can create a bump, where you can see the product.  I accommodate for this by putting in smaller aliquots of product, more closely spaced together, and pressing down any product that protrudes. 

If you are sore and this "bumpiness" occurred after you went home, then it is partially due to swelling.  This swelling may take even a couple weeks to resolve.

If you are worried, please return to your injector to ask for an evaluation and double check that everything is going as it should.

Don't be worried - this is quite normal

With the cannula technique, there tends to be a more even placement of the product.  The filler needs time to settle which can take up to two weeks.  If you have persistent pain, I would contact your physician for a follow-up.  It is normal to have tenderness when touching the area with your fingers.  The unevenness may be due to bruising that occurs during the placement of the product, therefore, you cannot adequately assess your result right now.  It is common to feel a bumpiness after the procedure, however, the unevenness should go away.  You may always feel a lump where the product was placed but it should NOT be visible to others.  

Cheryl Perlis, MD, FACOG
Lake Bluff OB/GYN
5.0 out of 5 stars 5 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.