28/F, Juvederm Voluma vs Sculptra for sunken cheeks? Best tear trough filler? Feeling desperate. (photos)

Question

28, lost 20 pounds to original early twenties weight and face difference is shocking! I am specifically seeking treatment for under eye hollows/tear troughs (via Restalyne?) and my sunken cheek hollows. Juviderm Voluma v Sculptra? I was thinking Sculptra but honestly want results asap due to high insecurity. Isnt Voluma every 6 months to a year the same value/cost effective as what Sculptra does building up, with quicker results? What are the best options?

Nelson Lee Novick, MD · Answer

There is absolutely no substitute, including HD photos, for an in-person examination (that allows palpation and manipulation of the skin) when evaluating the face for the best nonsurgical volumizing approaches for shaping and contouring the face. From what I can determine from the photos, there appears to be significant volume loss in the posterior cheek region (near the posterior angle of the mandible), rather than in the upper cheek area. There also seems to be a significant degree of chin recession, at least in the view provided, and some hollowing under the eyes. Radiesse, a calcium-based volumizing filler, would do the job for the posterior cheek and would last at least 1.5 years, but, since there is no enzyme to dissolve it, leaves a problem if for any reason the result is not optimal or if there is any complication. The same may be said of fat injections, which tend also to be expensive and necessitate an invasive two-step procedure (one to harvest the fat from the buttocks, belly or hips, and the other to inject the bulky fat particles through large bore cannulas). Moreover, despite the promise of permanence, most of the fat injected typically lasts about the same 1.5-2 year period. Even more potentially troubling, any fat that does remain retains the characteristics of location from which it was taken--meaning that if belly fat increases with age, so may the residual fat transplanted in the face. Sculptra, a relatively expensive collagen and elastin fiber promoter is product that may last up to two years, does not yield immediate results, and typically requires at least three treatment sessions before any significant benefits can be realized. Voluma XC, on the other hand, a hyaluronic acid-based injectable, may last up to two years in the cheeks, also possesses ability to stimulate new, native collagen and elastic fiber synthesis, and may be dissolved if necessary with the enzyme hyaluronidase. For under the eyes, I do not use ordinary Restylane, as this may result in lumpiness or small bumps or plain Juvederm, as this product possesses a great affinity for attracting water molecules, which can translate into swelling under the eyes. Instead, I typically use Belotero Balance, which goes in smoothly and evenly and possesses little to no tendency to give rise to the unwanted bluish/gray Tyndall Effect when injected superficially into the delicate tissues of that region. Make sure that you consult with a board certified aesthetic physician and ask to see his/her personal before and after photos for each area that requires treatment. Best of luck.

Jason Emer, MD · Answer

Facial sculpting and contouring of the face can be created with well-placed fillers (Voluma, Radiesse, Bellafill) and Sculptra, which would give improvement in facial balance. Fat or implants are alternatives. I recommend getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

Jonathan Kulbersh, MD · Answer

Under eye hollows and cheeks can be permanently corrected with surgery or temporarily camouflaged and augmented with fillers which can also help nasolabial folds.There are great non-surgical options to fill in under eye depressions and hollowness. Using dermal fillers, a liquid eye-lift can be performed. A dermal filler such as Restylane would be placed in the cheek and tear trough to hide the depression or bag underneath your eye. 
Surgery would require a fat-repositioning lower lid blepharoplasty. In this surgical procedure, fat from the eye area is moved into the tear trough depression filling the actual depression. 
I hope this helps!

John Tang, MD · Answer

Thanks for sharing your concerns.  Based upon your submitted photos, there are few things I would recommend for best results.  I would recommend Restylane Refyne for underneath the eyes since it potentially has a longer duration than regular Restylane.  I do see some fat wasting below the cheeks which is causing more of a gaunt look and this is best treated with Sculptra.  Even though it will take 6 months to take effect, I think it looks the most natural and has the longest duration 18-24 months in this area.  Ultimately, which ever product you end up choosing, your results are determined by the injector so I highly recommend that you go to experienced cosmetic surgeon who will know how to combine different injectables/modalities.

Anteneh Roba, MD · Answer

You have a lot of options to volumize your face . I would consider Voluma for your cheeks which is supposed to last two years , and for your test trough area Boletero would work fine. For your lower face Juvaderm or Radiesse would work. Sculptra is good if you want long term changes.

28/F, Juvederm Voluma vs Sculptra for sunken cheeks? Best tear trough filler? Feeling desperate. (photos)

Answers (7)

Answer: Tear Troughs and Sunken face

Answer: Tear Troughs and Sunken face

Answer: Juvaderm, Voluma vs sculptra for facial volume?

Answer: Juvaderm, Voluma vs sculptra for facial volume?

Recommended reading

Everything you need to know about Voluma

Our mission is to create a world where every investment in modern beauty is Worth It.

28/F, Juvederm Voluma vs Sculptra for sunken cheeks? Best tear trough filler? Feeling desperate. (photos)

Answers (7)

Answer: Tear Troughs and Sunken face

Answer: Tear Troughs and Sunken face

Answer: Juvaderm, Voluma vs sculptra for facial volume?

Answer: Juvaderm, Voluma vs sculptra for facial volume?

Browse related questions

Recommended reading

Everything you need to know about Voluma

Our mission is to create a world where every investment in modern beauty is Worth It.