Why is getting rid of voluma so difficult?

Question

2 syringes, one only on one side. i did 9 rounds of hyaluronidase including one full strength: after full strength i immediately got better (skinnier face, but i could still see the voluma soft lump so i knew it would not stay) but then within an hour i got back to almost the same with mild improvement. with all this vitrase treatments only 35% improvement (each time the extended large lump gets smaller though and i do see improvement each time, just not enough! what is my next step?

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. Voluma is a cross-linked hyaluronic acid del filler that uses Vycross technology. The gel is more viscous than the Juvederm used for plumping the lips and smoothing wrinkles throughout the face. Please use the in-person consultation with your board certified facial plastic surgeon to determine the best treatment plan for removing any Voluma. Best wishes,

Jason Emer, MD · Answer

Voluma needs more hyaluronidase it is made to act like an implant and stay in the skin much longer.  There is no surprise that more is needed.  Best, Dr. Emer.

Monika Soni, MD · Answer

Thank you for your question. For most patients it can take a series of hyaluronidase treatments to have complete removal of Voluma. However, you had only a little placed into cheek and a single round of hyaluronidase may be enough to dissolve your filler.

Kouros Azar, MD · Answer

Given the frequency of your injections, it sounds as if the best course of action is to take a break and let your face recovery. It may be that you are not allowing the swelling to go down completely before being injected again and it just keeps exacerbating the problem. Take two weeks off and then reassess. So sorry that you are having such a bad experience. Make sure to see a board certified plastic surgeon or cosmetic dermatologist for your filler. The experience makes a difference.Kindly,Kouros Azar

Alex Eshaghian, MD, PhD · Answer

Hyaluronic acid fillers such as Voluma, Juvederm, Restylane, and Belotero can be dissolved with hyaluronidase (Vitrase, Hylenex). This is great for safety as well as correcting any undesired effects. Hyaluronidase will dissolve some of the product immediately and more over time. Any time you do an injection there is a risk for swelling just from the injection itself, regardless of what was injected. For this reason I recommend reassessing one to two weeks after any injectable treatment (filler, Botox, hyaluronidase, etc.). This will allow the swelling to subside so that you can see your final results.Voluma, and Volbella (which will be available in October 2016), have higher crosslinking, a technology called hylacross. This allows patients to enjoy their results longer. At the same time it may make it more difficult to dissolve the product. So in these cases more hyaluronidase may be necessary and multiple treatments may be necessary. Good luck!

Why is getting rid of voluma so difficult?

Answers (5)