Why is getting rid of voluma so difficult?

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?

Doctor Answers 8


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,

Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 117 reviews

Why is Voluma hard to dissolve?

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.


Kouros Azar

Kouros Azar, MD
Thousand Oaks Plastic Surgeon
4.9 out of 5 stars 33 reviews

Dissolving Voluma

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!

Alex Eshaghian, MD, PhD
Encino Physician
5.0 out of 5 stars 3 reviews


Hi there, what you're experiencing may be swelling or bruising. I would wait another 3-4 weeks before getting any more dissolving treatments.

Justin Harper, MD
Columbus Physician
5.0 out of 5 stars 19 reviews

Voluma - why is it hard to get rid of?

Thank you for asking about your Voluma.
  • I am sorry you were unhappy with your Voluma and wanted it dissolved.
  • It sounds as though the hyaluronidase worked, and then your face swelled.
  • With these multiple injections, you may have swelling that hasn't gone down.
  • Or the hyaluronidase may be too dilute. Or it may be outdated and working slowly.
  • Or it may just be taking a long time to dissolve 2 syringes of Volumes - it is very thick.
  • I would have no more hyaluronidase for two weeks - if it starts to improve, it is swelling and it is best to give it more time.
Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

Voluma Results and Un-happiness , Can Be Reversed with Hyaluronidase

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.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 191 reviews

Persistent Midface Lumps

If multiple injections of hyaluronidase is not "melting" the Voluma then it probabaly isn't Voluma that is causing the problem.  This sounds illogical to some people but it is possible that you have an organized hematoma (collection of blood) that will not respond to hyaluronidase.My advice is to wait several weeks before you try to treat the problem again because it may resolve spontaneously on its own.

Joel E. Kopelman, MD, FACS
Ridgewood Oculoplastic Surgeon
5.0 out of 5 stars 14 reviews

Voluma in the Face

Thank you for your question. I am sorry to hear you are having some trouble dissolving the product. Out of all of the Hyaluronic Acid fillers, Voluma is one of the most cross-linked - meaning that it lasts longer than other products (say, compared to juvederm or restylane). It also has a higher G prime, or lift, which is why it is so good at volumizing the malar or cheek region. However, it should still dissolve with vitrase, or a similar hyaluronidase. My advice is to continue with the vitrase injections, and have your injector examine you for an additional issues -infection, for example. It will eventually go away; it may just take time. You can have the lump surgically removed, but this is extreme and will likely leave a scar, depending on how superficial the product placement was. Best of luck! 

Anthony J. Taglienti, MD
Smithtown Plastic Surgeon
5.0 out of 5 stars 18 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.