Voluma caused malar mounds when I smile and I cannot completely dissolve it. Should I dissolve it more?

Question

Tried to dissolve it several times (@ least 6 in the course of the months). There was improvement in the malar bumps which looked like malar bags at rest (although my cheekbones still have a pointier look than my natural cheeks ) . Now I can see the festoons on,y when I smile. In certain areas it feels rubbery. Am I stuck with this look? Should I dissolve more?

Hung William Song, MD · Answer

Hi, fortunately for you, I have found that Voluma does not last nearly as long as they claim. I would leave it alone because it will be gone soon enough, but if it is really bothering you, you can have a little more dissolved away with some hyaluronidase. I think the way you are doing it, having small amounts removed at a time is smart because if you remove too much at once, you could be left with deflated wrinkled skin. There is also the risk of a reaction to the hyaluronidase. Next time you might want to consider a vampire facelift using smaller amounts of filler combined with PRP. This will give you a much more natural look because the PRP stimulated the production of your own collagen around the filler. It will make the filler last longer too.

Aaron Capuano, MD, FACS · Answer

Hello and thank you for the question. Voluma is slower to dissolve with hyaluronidase than earlier fillers like Restylane and Juvederm, so it may take a few rounds to remove it completely.  There are many variables with respect to treatment however.  First is the location, depth and amount of Voluma that was placed.  Second is the amount and location of hyaluronidase used so far to remove the Voluma thus far.  Third is the amount of inflammation in your periorbital and malar region, which can occur each time you are injected.  Lastly, you may have a component of nodule formation from an immune reaction to the filler.. while hyaluronidase may remove the cause of the nodule, the inflammation may persist for much longer unless it’s is treated concurrently.  A small injection of a steroid into the area of firmness may help.  An in person evaluation by a board certified plastic surgeon is essential.  Best of luck!

Leonard Grossman, MD · Answer

Since you've already have six treatments with hyaluronidase and your face does not look bad, I would recommend simply letting the product dissolve on its own. It should not take more than 6 to 9 months as it does in most people. too much use of hyaluronidase can cause potential problems as well. Good luck from New York City

Shaun Patel, MD · Answer

It can take several sessions using hyalurondiase to dissolve Voluma because the Vycross technology, I believe, makes Voluma harder to dissolve. It also depends on how much Hylenex (i.e. units) is being using per session.

Onir Spiegel, DDS, PhD · Answer

If you've done 6 rounds of hyaluronidase to dissolve the Voluma, I would let it ride it out. I find that I can get better outcomes with Restylane or Versa because I can get those spread between the malar eminence and tear trough area. Hope that helps. Dr. Onir from Boston.

Lamia Wassef, MD · Answer

Thanks so much for your question. Did your injector injected voluma in the tear troughs?
If yes you will have to dissolve it
This area is very soft and can’t get voluma in it.
Regards,
Dr. L. Wassef

Voluma caused malar mounds when I smile and I cannot completely dissolve it. Should I dissolve it more?

Answers (6)

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