Can some, but not all, Voluma be dissolved from upper cheeks?

Question

Hi! Had one syringe of Voluma in cheeks to help minimize eye bags. My face looked more youthful,troughs were softened, but not fully corrected. 2 weeks later, we added a full second syringe. I should have stopped while I was ahead. I got greedy, and now 2 weeks later, troughs look much worse, dark, puffy, hollow, shadowed. The product was not placed in troughs directly. I don't want to lose all my volume-the first syringe really looked beautiful. :( Can just some Voluma be reversed? Thanks!

Martin Jugenburg, MD · Answer

Thank you for your question. Hyaluronidase injections can be used to dissolve the product. You may have to dissolve all the product and start over. Voluma should be used in the cheeks only and an alternate product for the under eye area. Ensure you are working with an experienced injector. Best,

Christopher S. Verbin, MD · Answer

Juvederm Voluma is a hyaluronic gel filler that is more structural and firm and is FDA approved for cheek volume. The other Juvederm products - Juvederm Ultra Plus, and Ultra are a bit softer. As with all hyaluronic gel fillers, they can be dissolved with an injection of hyaluronidase - a natural enzyme our body has that can lyse or breakdown the product. Injecting this dissolves the filler - by removing what you've paid to be placed to fill the area. It's unfortunate that you might require some of those to soften and take away the overfilling in this region. I prefer not to use Voluma but the softer Juvederm Ultra with a softer overlay of Belotero superficially to best contour this region, which is very susceptible to visible nuances due to the very thin transparent overlying skin in this region.

Richard Asarch, MD · Answer

Voluma is a hyaluronic acid filler so it can be reversed by injecting hyaluronidase into the area.  It would need to be done very slowly and perhaps in more than one treatment sessiion in order to limit how much of the Voluma is reduced.

Timothy Connall, MD, FACS · Answer

The use of the reversal agent to correct problems associated with volume is not a precise procedure.  Therefore, you can not expect a controlled and limited result.Best wishes.

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

Yes, and no. Removing filler is just as difficult as putting it in. There is no good ratio developed for how much hyaluronidase to use to remove X amount of filler (depending on filler type). So it's pretty much impossible to remove just the amount or some of the amount that was added in and get it 100% back to what you want. Some can be removed, yes, but to say that it will be back to exactly what it was before you added the second syringe in.... I wouldn't make that promise to you. "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."

Can some, but not all, Voluma be dissolved from upper cheeks?

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